Kokkinos Vasileios, Urban Alexandra, Frauscher Birgit, Simon Mirela, Hussein Helweh, Bush Alan, Williams Ziv, Bagić Anto I, Mark Richardson R
Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA; University of Pittsburgh Comprehensive Epilepsy Center, Pittsburgh, PA, USA.
Clin Neurophysiol. 2022 Apr;136:150-157. doi: 10.1016/j.clinph.2022.01.132. Epub 2022 Feb 4.
To investigate whether barques can be localized across the hippocampal longitudinal axis with sufficient specificity.
We identified 51 focal epilepsy patients implanted with a minimum of two electrodes - unilateral anterior and posterior - in either hippocampus. We used visual inspection of the intracranial electroencephalogram (iEEG) and 3D brain volume spectrum-based statistical parametric mapping (SPM) to localize barques.
In 18/51 patients (35.29%), barques were identified in 22/70 (31.42%) hippocampi. In all hippocampi (100%), barques were present in the posterior hippocampus, while 9 (40.90%) showed concurrent non-independent barque activity anteriorly (P < 0.0001). Statistical parametric mapping confirmed the posterior barque localization, with significant differences in t-values (t = 8.08, P < 0.0001) and z-scores (t = 6.85, P < 0.0001) between anterior and posterior hippocampal barque activity. Posterior lateral extrahippocampal contacts demonstrated phase reversals of positive polarity during barque activity (P = 0.0092, compared to anterior extrahippocampal contacts).
This study highlights the posterior hippocampal predominance of barques. Our findings are concordant with the posterior distribution of the scalp manifestation of barques as "14&6/sec positive spikes". The posterio-lateral hippocampal barque phase reversal can explain the positive polarity of scalp 14&6/sec spikes.
Understanding the properties of barques is critical for the iEEG interpretation in epilepsy surgery evaluations that include the hippocampus.
研究是否能够以足够的特异性在海马体纵轴上定位棘波。
我们确定了51例局灶性癫痫患者，他们在任一海马体中至少植入了两个电极——单侧前部和后部电极。我们通过对颅内脑电图（iEEG）进行视觉检查以及基于三维脑体积谱的统计参数映射（SPM）来定位棘波。
在51例患者中的18例（35.29%），在70个海马体中的22个（31.42%）发现了棘波。在所有海马体（100%）中，棘波均出现在海马体后部，而9个（40.90%）海马体在前部同时显示出非独立的棘波活动（P < 0.0001）。统计参数映射证实了棘波的后部定位，海马体前部和后部棘波活动之间的t值（t = 8.08，P < 0.0001）和z分数（t = 6.85，P < 0.0001）存在显著差异。海马体后部外侧海马外接触在棘波活动期间显示出正极性的相位反转（与海马体外前部接触相比，P = 0.0092）。
本研究突出了棘波在海马体后部的优势。我们的发现与棘波头皮表现为“14&6/秒正棘波”的后部分布一致。海马体后外侧棘波相位反转可以解释头皮14&6/秒棘波的正极性。
了解棘波的特性对于包括海马体在内的癫痫手术评估中的iEEG解释至关重要。
