Soriano Jaymar, Kubo Takatomi, Ikeda Kazushi
Annu Int Conf IEEE Eng Med Biol Soc. 2020 Jul;2020:2532-2535. doi: 10.1109/EMBC44109.2020.9175157.
Experiments with animal models of epilepsy have consistently shown that focal cooling of epilepsy-induced brain region reversibly suppresses or terminates epileptic discharge activity. Recently, we formulated a physiologically plausible temperature dependence in a neural mass model that can reproduce the effect of focal cooling on epileptic discharge activity. This can be used to implement a temperature control in an implantable cooling device for thermal neuromodulation of the epileptogenic zone in patients with partial epilepsy when seizure activity is detected. However, there have been no experiments that looked into the effect of focal cooling in animal models of epilepsy with secondary generalization in which the seizure activity spreads from the pathologic region to other regions of the brain. Using the temperature-dependent neural mass model and a physiological coupling model, we show that focal cooling stops the propagation of low-frequency discharge activity; on the other hand, it increases the amount of coupling required to propagate high-frequency discharge activity. Moreover, discharge activities that are propagated with cooling are lower in both magnitude and frequency compared to those propagated without cooling. These results suggest the feasibility of focal cooling as an effective alternative therapeutic treatment for medically intractable partial epilepsy even with secondary generalization.Clinical Relevance- The computational study establishes focal cooling of the brain region with partial epilepsy not only suppresses epileptic discharges but can also prevent its generalization to other brain regions.
癫痫动物模型实验一直表明，对癫痫诱发脑区进行局部冷却可可逆地抑制或终止癫痫放电活动。最近，我们在神经团模型中构建了一种符合生理的温度依赖性，该模型能够重现局部冷却对癫痫放电活动的影响。当检测到癫痫发作活动时，这可用于在植入式冷却装置中实现温度控制，以对部分癫痫患者的致痫区进行热神经调节。然而，尚无实验研究局部冷却对癫痫动物模型继发性泛化的影响，在这种模型中癫痫发作活动会从病变区域扩散到大脑的其他区域。利用温度依赖性神经团模型和生理耦合模型，我们发现局部冷却会阻止低频放电活动的传播；另一方面，它会增加高频放电活动传播所需的耦合量。此外，与未冷却时传播的放电活动相比，冷却时传播的放电活动在幅度和频率上都更低。这些结果表明，即使对于有继发性泛化的药物难治性部分癫痫，局部冷却作为一种有效的替代治疗方法也是可行的。临床意义——该计算研究表明，对部分癫痫患者的脑区进行局部冷却不仅能抑制癫痫放电，还可防止其扩散至其他脑区。
