Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China.
Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China.
Epilepsy Behav. 2020 Nov;112:107369. doi: 10.1016/j.yebeh.2020.107369. Epub 2020 Aug 25.
Focal impaired awareness seizures are common in temporal lobe epilepsy (TLE). The cognitive impairment associated with this type of seizure is unclear. Alertness is a fundamental aspect of cognition. The locus coeruleus (LC) is closely related to alertness. We aimed to assess the impairment in alertness and LC-related alertness network in patients with focal impaired awareness seizures.
Patients with unilateral TLE were grouped into the only focal impaired awareness seizure group (focal group, n = 19) and the focal impaired awareness seizure with focal to bilateral tonic-clonic seizure (FBTCS) group (FBTCS group, n = 19) and compared with matched healthy controls (HC, n = 19). Alertness was assessed with the attention network test. Functional magnetic resonance imaging (fMRI) was used to construct an alertness-related LC-based functional connectivity (FC) network.
The focal group exhibited impaired tonic and phasic alertness and exhibited a decreased trend of LC-based FC to the left superior frontal gyrus (SFG). The FBTCS group exhibited impaired tonic alertness, phasic alertness, and alertness efficiency. No significant difference or trend in LC-based FC was found in the FBTCS group.
This study reveals disrupted alertness and alertness-related LC-based FC in patients with focal impaired awareness seizures. Our results further demonstrate that the patterns of impaired alertness and of changed LC-based FC were not significantly different between focal impaired awareness seizures and FBTCS.
局灶性意识障碍发作是颞叶癫痫（TLE）的常见症状。与这种类型的发作相关的认知障碍尚不清楚。警觉是认知的一个基本方面。蓝斑（LC）与警觉密切相关。我们旨在评估局灶性意识障碍发作患者的警觉障碍和与 LC 相关的警觉网络。
将单侧 TLE 患者分为单纯局灶性意识障碍发作组（局灶组，n=19）和局灶性意识障碍发作伴局灶性到双侧强直阵挛发作（FBTCS 组，n=19），并与匹配的健康对照组（HC，n=19）进行比较。警觉性通过注意力网络测试进行评估。功能性磁共振成像（fMRI）用于构建基于 LC 的警觉相关功能连接（FC）网络。
局灶组表现出强直和相位警觉障碍，并且表现出对左侧额上回（SFG）的基于 LC 的 FC 减少的趋势。FBTCS 组表现出强直警觉、相位警觉和警觉效率障碍。在 FBTCS 组中，未发现基于 LC 的 FC 的显著差异或趋势。
本研究揭示了局灶性意识障碍发作患者警觉和与 LC 相关的警觉相关 FC 的破坏。我们的结果进一步表明，局灶性意识障碍发作和 FBTCS 之间的警觉障碍和改变的基于 LC 的 FC 模式没有显著差异。
