Bou Assi Elie, Zerouali Younes, Robert Manon, Lesage Frederic, Pouliot Philippe, Nguyen Dang K
University of Montreal Hospital Research Center (CRCHUM), University of Montreal, Montreal, QC, Canada.
Department of Neuroscience, University of Montreal, Montreal, QC, Canada.
Front Neurol. 2020 Dec 23;11:529460. doi: 10.3389/fneur.2020.529460. eCollection 2020.
It is increasingly recognized that deep understanding of epileptic seizures requires both localizing and characterizing the functional network of the region where they are initiated, i. e., the epileptic focus. Previous investigations of the epileptogenic focus' functional connectivity have yielded contrasting results, reporting both pathological increases and decreases during resting periods and seizures. In this study, we shifted paradigm to investigate the time course of connectivity in relation to interictal epileptiform discharges. We recruited 35 epileptic patients undergoing intracranial EEG (iEEG) investigation as part of their presurgical evaluation. For each patient, 50 interictal epileptic discharges (IEDs) were marked and iEEG signals were epoched around those markers. Signals were narrow-band filtered and time resolved phase-locking values were computed to track the dynamics of functional connectivity during IEDs. Results show that IEDs are associated with a transient decrease in global functional connectivity, time-locked to the peak of the discharge and specific to the high range of the gamma frequency band. Disruption of the long-range connectivity between the epileptic focus and other brain areas might be an important process for the generation of epileptic activity. Transient desynchronization could be a potential biomarker of the epileptogenic focus since 1) the functional connectivity involving the focus decreases significantly more than the connectivity outside the focus and 2) patients with good surgical outcome appear to have a significantly more disconnected focus than patients with bad outcomes.
人们越来越认识到,要深入理解癫痫发作,需要对癫痫发作起始区域(即癫痫病灶)的功能网络进行定位和特征描述。先前对癫痫病灶功能连接性的研究得出了相互矛盾的结果,报告了静息期和发作期病理上的增加和减少。在本研究中,我们转换范式来研究与发作间期癫痫样放电相关的连接性时间进程。我们招募了35名接受颅内脑电图(iEEG)检查作为术前评估一部分的癫痫患者。对于每位患者,标记50次发作间期癫痫放电(IED),并围绕这些标记对iEEG信号进行分段。对信号进行窄带滤波,并计算时间分辨锁相值以追踪IED期间功能连接性的动态变化。结果表明,IED与全局功能连接性的短暂降低有关,时间锁定在放电峰值,且特定于γ频段的高频范围。癫痫病灶与其他脑区之间远程连接的中断可能是癫痫活动产生的一个重要过程。短暂去同步化可能是癫痫病灶的一个潜在生物标志物,因为1)涉及病灶的功能连接性下降明显大于病灶外的连接性,2)手术效果良好的患者似乎比效果不佳的患者病灶连接性明显更低。