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丘脑前核在癫痫网络中起作用。

The anterior nucleus of the thalamus plays a role in the epileptic network.

机构信息

Department of Functional Neurosurgery, Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.

Department of Neurology, Comprehensive Epilepsy Center of Beijing, Beijing Key Laboratory of Neuromodulation, Xuanwu Hospital, Capital Medical University, Beijing, China.

出版信息

Ann Clin Transl Neurol. 2022 Dec;9(12):2010-2024. doi: 10.1002/acn3.51693. Epub 2022 Nov 5.

DOI:10.1002/acn3.51693
PMID:36334281
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9735375/
Abstract

OBJECTIVES

We investigated both the metabolic differences and interictal/ictal discharges of the anterior nucleus of the thalamus (ANT) in patients with epilepsy to clarify the relationship between the ANT and the epileptic network.

METHODS

Nineteen patients with drug-resistant epilepsy who underwent stereoelectroencephalography were studied. Metabolic differences in ANT were analyzed using [18F] fluorodeoxyglucose-positron emission tomography with three-dimensional (3D) visual and quantitative analyses. Interictal and ictal discharges in the ANT were analyzed using visual and time-frequency analyses. The relationship between interictal discharge and metabolic differences was analyzed.

RESULTS

We found that patients with temporal lobe epilepsy (TLE) showed significant metabolic differences in bilateral ANT compared with extratemporal lobe epilepsy in 3D visual and quantitative analyses. Four types of interictal activities were recorded from the ANT: spike, high-frequency oscillation (HFO), slow-wave, and α-rhythmic activity. Spike and HFO waveforms were recorded mainly in patients with TLE. Two spike patterns were recorded: synchronous and independent. In 83.3% of patients, ANT was involved during seizures. Three seizure onset types of ANT were recorded: low-voltage fast activity, rhythmic spikes, and theta band discharge. The time interval of seizure onset between the seizure onset zone and ANT showed two patterns: immediate and delayed.

INTERPRETATION

ANT can receive either interictal discharges or ictal discharges which propagate from the epileptogenic zones. Independent epileptic discharges can also be recorded from the ANT in some patients. Metabolic anomalies and epileptic discharges in the ANT indicate that the ANT plays a role in the epileptic network in most patients with epilepsy, especially TLE.

摘要

目的

我们研究了癫痫患者丘脑前核（ANT）的代谢差异和发作间期/发作期放电，以阐明 ANT 与癫痫网络之间的关系。

方法

研究了 19 例接受立体脑电图检查的耐药性癫痫患者。使用三维（3D）视觉和定量分析，通过[18F]氟脱氧葡萄糖正电子发射断层扫描分析 ANT 的代谢差异。使用视觉和时频分析分析 ANT 的发作间期和发作期放电。分析发作间期放电与代谢差异之间的关系。

结果

我们发现，与颞叶癫痫（TLE）相比，颞叶外癫痫患者双侧 ANT 在 3D 视觉和定量分析中存在明显的代谢差异。从 ANT 记录到四种类型的发作间期活动：棘波、高频振荡（HFO）、慢波和α节律活动。棘波和 HFO 波形主要记录在 TLE 患者中。记录到两种棘波模式：同步和独立。83.3%的患者在发作期间ANT 参与。记录到三种 ANT 发作起始类型：低电压快活动、节律性棘波和θ带放电。发作起始区和 ANT 之间的发作起始时间间隔有两种模式：即刻和延迟。

解释

ANT 可以接收来自致痫区的发作间期放电或发作期放电。在一些患者中，也可以从 ANT 记录到独立的癫痫放电。ANT 的代谢异常和癫痫放电表明，ANT 在大多数癫痫患者的癫痫网络中发挥作用，尤其是 TLE。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d52/9735375/3b57ddd7fa49/ACN3-9-2010-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d52/9735375/be9c92a66ef5/ACN3-9-2010-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d52/9735375/13c5e31a69af/ACN3-9-2010-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d52/9735375/cb4b98ff65fb/ACN3-9-2010-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d52/9735375/a1c846671abc/ACN3-9-2010-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d52/9735375/a367d317ce47/ACN3-9-2010-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d52/9735375/3b57ddd7fa49/ACN3-9-2010-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d52/9735375/be9c92a66ef5/ACN3-9-2010-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d52/9735375/13c5e31a69af/ACN3-9-2010-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d52/9735375/cb4b98ff65fb/ACN3-9-2010-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d52/9735375/a1c846671abc/ACN3-9-2010-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d52/9735375/a367d317ce47/ACN3-9-2010-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d52/9735375/3b57ddd7fa49/ACN3-9-2010-g001.jpg

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