Department of Neurology, Stanford University School of Medicine, Palo Alto, CA, USA.
Clin Neurophysiol. 2022 Dec;144:123-134. doi: 10.1016/j.clinph.2022.09.015. Epub 2022 Oct 7.
To understand the impact of interictal spikes on brain connectivity in patients with Self-Limited Epilepsy with Centrotemporal Spikes (SeLECTS).
Electroencephalograms from 56 consecutive SeLECTS patients were segmented into periods with and without spikes. Connectivity between electrodes was calculated using the weighted phase lag index. To determine if there are chronic alterations in connectivity in SeLECTS, we compared spike-free connectivity to connectivity in 65 matched controls. To understand the acute impact of spikes, we compared connectivity immediately before, during, and after spikes versus baseline, spike-free connectivity. We explored whether behavioral state, spike laterality, or antiseizure medications affected connectivity.
Children with SeLECTS had markedly higher connectivity than controls during sleep but not wakefulness, with greatest difference in the right hemisphere. During spikes, connectivity increased globally; before and after spikes, left frontal and bicentral connectivity increased. Right hemisphere connectivity increased more during right-sided than left-sided spikes; left hemisphere connectivity was equally affected by right and left spikes.
SeLECTS patient have persistent increased connectivity during sleep; connectivity is further elevated during the spike and perispike periods.
Testing whether increased connectivity impacts cognition or seizure susceptibility in SeLECTS and more severe epilepsies could help determine if spikes should be treated.
了解中央颞区棘波良性癫痫伴癫痫发作（SeLECTS）患者棘波间期对脑连接的影响。
将 56 例连续 SeLECTS 患者的脑电图分为有棘波和无棘波期。使用加权相位滞后指数计算电极之间的连通性。为了确定 SeLECTS 中是否存在慢性连通性改变，我们将无棘波连通性与 65 例匹配对照进行比较。为了了解棘波的急性影响，我们将棘波前后与基线、无棘波连通性进行了比较。我们探讨了行为状态、棘波偏侧性或抗癫痫药物是否影响连通性。
在睡眠期间，患有 SeLECTS 的儿童的连通性明显高于对照组，但在觉醒时则不然，右半球差异最大。在棘波期间，连通性整体增加；在棘波之前和之后，左额和双中央连通性增加。右侧棘波比左侧棘波引起的右半球连通性增加更多；左半球的连通性受到右侧和左侧棘波的影响相同。
SeLECTS 患者在睡眠期间持续存在连通性增加；在棘波和棘波间期进一步升高。
测试增加的连通性是否会影响 SeLECTS 和更严重癫痫的认知或易感性，可能有助于确定是否应治疗棘波。
