Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan.
Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan.
Epilepsy Behav. 2021 Dec;125:108405. doi: 10.1016/j.yebeh.2021.108405. Epub 2021 Nov 18.
The present study investigated the cortical areas and networks responsible for hyperkinetic seizures by analyzing invasive recordings and diffusion tensor imaging (DTI) tractography.
Seven patients with intractable focal epilepsy in whom hyperkinetic seizures were recorded during an invasive evaluation at Sapporo Medical University between January 2012 and March 2020 were enrolled in the present study. Intracranial recordings were analyzed to localize seizure-onset zones (SOZs) and symptomatogenic zones (spread areas at clinical onset). DTI was used to identify the subcortical fibers originating from SOZs.
Ten SOZs were located in four areas: (1) the inferior parietal lobule (two SOZs in two patients), (2) temporo-occipital junction (three SOZs in two patients), (3) medial temporal area (three SOZs in three patients) and (4) medial/lateral frontal lobe (two SOZs in two patients). Symptomatogenic zones appeared to be the premotor area, basal temporal area, temporo-occipital junction, and the postcentral gyrus/supramarginal gyrus. The tractographic analysis revealed that the inferior fronto-occipital fasciculus (IFOF), inferior longitudinal fasciculus (ILF), middle longitudinal fasciculus (MLF), arcuate fasciculus (AF)/superior longitudinal fasciculus (SLF) II, III, and cingulum bundle may be associated with hyperkinetic seizures.
The present results suggest the cortical areas (the inferior parietal lobule, temporo-occipital junction, medial temporal area, and medial/lateral frontal lobe) and subcortical fibers (IFOF, ILF, MLF, AF/SLFII, III, and the cingulum bundle) responsible for generating hyperkinetic seizures.
本研究通过分析侵入性记录和弥散张量成像（DTI）示踪术，研究导致运动性发作的皮质区和网络。
本研究纳入了 2012 年 1 月至 2020 年 3 月期间在札幌医科大学进行侵入性评估时记录到运动性发作的 7 例难治性局灶性癫痫患者。对颅内记录进行分析以定位发作起始区（SOZ）和症状发生区（临床起始时的扩散区）。DTI 用于识别来自 SOZ 的皮质下纤维。
10 个 SOZ 位于 4 个区域：（1）下顶叶（2 个 SOZ，2 例患者），（2）颞枕交界区（2 个 SOZ，2 例患者），（3）内侧颞叶区（3 个 SOZ，3 例患者）和（4）内侧/外侧额叶（2 个 SOZ，2 例患者）。症状发生区似乎是运动前区、基底颞区、颞枕交界区和后中央回/缘上回。示踪分析显示，下额枕束（IFOF）、下纵束（ILF）、中纵束（MLF）、弓状束（AF）/上纵束（SLF）II、III 和扣带束可能与运动性发作有关。
本研究结果提示与产生运动性发作相关的皮质区（下顶叶、颞枕交界区、内侧颞叶区和内侧/外侧额叶）和皮质下纤维（IFOF、ILF、MLF、AF/SLF II、III 和扣带束）。
