Chacon Lilia Morales, Garcia Lidice Galan, Bosch-Bayard Jorge, García-Ramo Karla Batista, Martin Margarita Minou Báez, Alfonso Maydelin Alfonso, Batista Sheyla Berrillo, de la Paz Bermudez Tania, González Judith González, Coroneux Abel Sánchez
International Center for Neurological Restoration, 25th Ave, No 15805, Playa, Havana PC 11300, Cuba.
Cuban Neurosciences Center, 25th Ave, No 15202, Playa, Havana PC 11300, Cuba.
Behav Sci (Basel). 2022 Jun 24;12(7):207. doi: 10.3390/bs12070207.
To explore the role of the interictal and ictal SPECT to identity functional neuroimaging biomarkers for SUDEP risk stratification in patients with drug-resistant focal epilepsy (DRFE). Twenty-nine interictal-ictal Single photon emission computed tomography (SPECT) scans were obtained from nine DRFE patients. A methodology for the relative quantification of cerebral blood flow of 74 cortical and sub-cortical structures was employed. The optimal number of clusters (K) was estimated using a modified v-fold cross-validation for the use of K means algorithm. The two regions of interest (ROIs) that represent the hypoperfused and hyperperfused areas were identified. To select the structures related to the SUDEP-7 inventory score, a data mining method that computes an automatic feature selection was used. During the interictal and ictal state, the hyperperfused ROIs in the largest part of patients were the bilateral rectus gyrus, putamen as well as globus pallidus ipsilateral to the seizure onset zone. The hypoperfused ROIs included the red nucleus, substantia nigra, medulla, and entorhinal area. The findings indicated that the nearly invariability in the perfusion pattern during the interictal to ictal transition observed in the ipsi-lateral putamen F = 12.60, = 0.03, entorhinal area F = 25.80, = 0.01, and temporal middle gyrus F = 12.60, = 0.03 is a potential biomarker of SUDEP risk. The results presented in this paper allowed identifying hypo- and hyperperfused brain regions during the ictal and interictal state potentially related to SUDEP risk stratification.
为探讨发作间期和发作期单光子发射计算机断层扫描（SPECT）在识别耐药性局灶性癫痫（DRFE）患者心源性猝死（SUDEP）风险分层的功能性神经影像学生物标志物中的作用。从9例DRFE患者中获取了29次发作间期-发作期SPECT扫描。采用一种对74个皮质和皮质下结构的脑血流量进行相对定量的方法。使用改进的v折交叉验证法估计K均值算法的最佳聚类数（K）。确定了代表灌注不足和灌注过度区域的两个感兴趣区域（ROI）。为了选择与SUDEP-7量表评分相关的结构，使用了一种计算自动特征选择的数据挖掘方法。在发作间期和发作期，大部分患者的灌注过度ROI为双侧直回、壳核以及发作起始区同侧的苍白球。灌注不足的ROI包括红核、黑质、延髓和内嗅区。研究结果表明，在同侧壳核（F = 12.60，P = 0.03）、内嗅区（F = 25.80，P = 0.01）和颞中回（F = 12.60，P = 0.03）观察到的发作间期到发作期过渡期间灌注模式的几乎不变性是SUDEP风险的潜在生物标志物。本文给出的结果有助于识别发作期和发作间期可能与SUDEP风险分层相关的灌注不足和灌注过度的脑区。
