电皮质刺激调节人类癫痫病灶中的尖峰和尖峰后慢相关高频活动。

Electrical cortical stimulations modulate spike and post-spike slow-related high-frequency activities in human epileptic foci.

机构信息

Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan; Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan; Division of Neurology, Kobe University Graduate School of Medicine, Kobe, Japan.

出版信息

Clin Neurophysiol. 2020 Aug;131(8):1741-1754. doi: 10.1016/j.clinph.2020.03.042. Epub 2020 May 11.

DOI:10.1016/j.clinph.2020.03.042

PMID:32504935

Abstract

OBJECTIVE

Using interictal epileptiform discharges (IEDs), consisting of spikes and post-spike slow waves (PSSs), and IED-related high-frequency activities (HFAs), we elucidated inhibitory effects of electrical cortical stimulation (ECS) on human epileptic foci.

METHODS

We recruited 8 patients with intractable focal epilepsy, and 50-Hz ECS was applied to the seizure-onset zone (SOZ) and non-SOZ. Before (5-min) and after (20-min) ECS, we evaluated the number of IED, the amplitudes of spikes and PSSs, spike-related HFA power, and PSS-related low gamma (30-50 Hz) activities.

RESULTS

SOZ stimulation significantly decreased the number of IEDs and amplitude of spikes. Spike-related HFA power values in fast ripple (200-300 Hz) and ripple (80-150 Hz) bands were significantly suppressed only by SOZ stimulation in 4 and 3 patients, respectively. Among 4 patients with discrete PSSs, the amplitude ratio of spike/PSS decreased and the PSS-related low gamma activity power increased significantly in 2 patients and marginally in 1 patient.

CONCLUSIONS

ECS potentially modulates cortical excitability by reducing excitation and increasing inhibition, and monitoring IED-related HFAs may help achieve the optimal effects of ECS.

SIGNIFICANCE

IED and IED-related HFAs are dynamic, potential surrogate markers for epileptic excitability during the interictal period.

摘要

目的

通过棘波和棘波后慢波（PSS）组成的发作间期癫痫样放电（IED）以及 IED 相关高频活动（HFA），我们阐明了电皮质刺激（ECS）对人类癫痫灶的抑制作用。

方法

我们招募了 8 名患有难治性局灶性癫痫的患者，并对致痫区（SOZ）和非 SOZ 进行了 50-Hz ECS 刺激。在 ECS 前后（5 分钟和 20 分钟），我们评估了 IED 的数量、棘波和 PSS 的幅度、棘波相关 HFA 功率以及 PSS 相关低伽马（30-50 Hz）活动。

结果

SOZ 刺激显著减少了 IED 的数量和棘波的幅度。在 4 名患者中，仅 SOZ 刺激显著抑制了快纹（200-300 Hz）和纹（80-150 Hz）带中棘波相关 HFA 功率值，在 3 名患者中分别有显著抑制和边缘抑制。在 4 名具有离散 PSS 的患者中，2 名患者的棘波/PSS 幅度比降低，PSS 相关低伽马活动功率显著增加，1 名患者略有增加。