Vezyroglou Aikaterini, Hebden Peter, De Roever Isabel, Thornton Rachel, Mitra Subhabrata, Worley Alan, Alves Mariana, Dean Emma, Cross Judith Helen, Tachtsidis Ilias
Developmental Neurosciences, UCL Great Ormond Street Institute of Child Health, London WC1N 1EH, UK.
Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, UK.
Metabolites. 2022 Mar 17;12(3):260. doi: 10.3390/metabo12030260.
Epileptic seizures are transiently occurring symptoms due to abnormal excessive or synchronous neuronal activity in the brain. Previous functional near-infrared spectroscopy (fNIRS) studies during seizures have focused in only monitoring the brain oxygenation and haemodynamic changes. However, few tools are available to measure actual cellular metabolism during seizures, especially at the bedside. Here we use an in-house developed multichannel broadband NIRS (or bNIRS) system, that, alongside the changes in oxy-, deoxy- haemoglobin concentration (HbO, HHb), also quantifies the changes in oxidised cytochrome-c-oxidase Δ(oxCCO), a marker of cellular oxygen metabolism, simultaneously over 16 different brain locations. We used bNIRS to measure metabolic activity alongside brain tissue haemodynamics/oxygenation during 17 epileptic seizures at the bedside of a 3-year-old girl with seizures due to an extensive malformation of cortical development in the left posterior quadrant. Simultaneously Video-EEG data was recorded from 12 channels. Whilst we did observe the expected increase in brain tissue oxygenation (HbD) during seizures, it was almost diminished in the area of the focal cortical dysplasia. Furthermore, in the area of seizure origination (epileptic focus) ΔoxCCO decreased significantly at the time of seizure generalization when compared to the mean change in all other channels. We hypothesize that this indicates an incapacity to sustain and increase brain tissue metabolism during seizures in the region of the epileptic focus.
癫痫发作是由于大脑中异常过度或同步的神经元活动而短暂出现的症状。以往在癫痫发作期间进行的功能近红外光谱（fNIRS）研究仅专注于监测大脑氧合和血流动力学变化。然而，很少有工具可用于测量癫痫发作期间的实际细胞代谢，尤其是在床边。在此，我们使用自行研发的多通道宽带近红外光谱（bNIRS）系统，该系统除了能测量氧合血红蛋白和脱氧血红蛋白浓度（HbO、HHb）的变化外，还能在16个不同脑区同时量化氧化细胞色素c氧化酶Δ(oxCCO)的变化，Δ(oxCCO)是细胞氧代谢的一个指标。我们使用bNIRS在一名3岁因左侧后象限广泛皮质发育畸形而癫痫发作的女孩床边，在17次癫痫发作期间测量代谢活动以及脑组织血流动力学/氧合情况。同时记录12通道的视频脑电图数据。虽然我们确实观察到癫痫发作期间脑组织氧合（HbD）如预期那样增加，但在局灶性皮质发育异常区域这种增加几乎消失。此外，与所有其他通道的平均变化相比，在癫痫发作泛化时，癫痫发作起始区域（癫痫灶）的ΔoxCCO显著下降。我们推测，这表明癫痫灶区域在癫痫发作期间无法维持和增加脑组织代谢。
