Epileptology Department, Aix Marseille Univ, APHM, INSERM, INS, Inst Neurosci Syst, Timone Hospital, Marseille, France.
Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France.
Epilepsia. 2020 Aug;61(8):e101-e106. doi: 10.1111/epi.16623. Epub 2020 Jul 30.
Psychogenic nonepileptic seizures (PNES) are paroxysmal clinical events that are often misdiagnosed as epileptic seizures, but which are not associated with electrographic discharge. Brain connectivity changes occurring during PNES are not known. We studied functional connectivity (Fc) in two patients with drug-resistant epilepsy, explored by stereotactic electroencephalography (EEG), in whom we recorded both epileptic seizures (ES) and PNES. Functional connectivity using pair-wise nonlinear correlation was computed between signals from seven brain areas: amygdala, hippocampus, lateral temporal cortex, anterior insula, orbitofrontal cortex, prefrontal cortex, and lateral parietal cortex. We assessed changes in global Fc during PNES in comparison with a background period. During PNES, a global decrease of Fc occurred between the different brain regions studied, compared with the interictal period. In both patients, decreased Fc was prominent in connections involving the anterior insula and parietal cortex. In conclusion, some PNES are associated with ictal functional disconnection between brain areas, particularly involving the parietal cortices and the anterior insula.
心因性非癫痫性发作（PNES）是阵发性临床事件，常被误诊为癫痫发作，但与电放电无关。PNES 期间发生的脑连接变化尚不清楚。我们研究了两名耐药性癫痫患者的功能连接（Fc），这些患者通过立体定向脑电图（EEG）进行了研究，我们在这些患者中记录了癫痫发作（ES）和 PNES。使用两两非线性相关计算了来自七个脑区的信号之间的功能连接：杏仁核、海马体、外侧颞叶皮层、前岛叶、眶额皮层、前额叶皮层和外侧顶叶皮层。我们评估了与背景期相比，PNES 期间全局 Fc 的变化。与间歇期相比，PNES 期间，研究的不同脑区之间的 Fc 整体下降。在两名患者中，前岛叶和顶叶皮层参与的连接中 Fc 下降更为明显。总之，一些 PNES 与发作期间脑区之间的功能连接中断有关，特别是涉及顶叶皮层和前岛叶。
