Weiss Shennan A, Sheybani Laurent, Seenarine Nitish, Fried Itzhak, Wu Chengyuan, Sharan Ashwini, Engel Jerome, Sperling Michael R, Nir Yuval, Staba Richard J
Dept. of Neurology, State University of New York Downstate, Brooklyn, New York 11203, USA; Dept. of Physiology and Pharmacology, State University of New York Downstate, Brooklyn, New York 11203, USA; Dept. of Neurology, New York City Health + Hospitals/Kings County, Brooklyn, NY, USA.
EEG and Epilepsy Unit / Neurology, Department of Clinical Neuroscience, University Hospitals and Faculty of Medicine of University of Geneva, Geneva, Switzerland; Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, UK.
Neurobiol Dis. 2022 Dec;175:105928. doi: 10.1016/j.nbd.2022.105928. Epub 2022 Nov 17.
Epileptiform spikes are used to localize epileptogenic brain tissue. The mechanisms that spontaneously trigger epileptiform discharges are not yet elucidated. Pathological fast ripple (FR, 200-600 Hz) are biomarkers of epileptogenic brain, and we postulated that FR network interactions are involved in generating epileptiform spikes. Using macroelectrode stereo intracranial EEG (iEEG) recordings from a cohort of 46 patients we found that, in the seizure onset zone (SOZ), propagating FR were more often followed by an epileptiform spike, as compared with non-propagating FR (p < 0.05). Propagating FR had a distinct frequency and larger power (p < 1e-10) and were more strongly phase coupled to the peak of iEEG delta oscillation, which likely correspond with the DOWN states during non-REM sleep (p < 1e-8), than non-propagating FR. While FR propagation was rare, all FR occurred with the highest probability within +/- 400 msec of epileptiform spikes with superimposed high-frequency oscillations (p < 0.05). Thus, a sub-population of epileptiform spikes in the SOZ, are preceded by propagating FR that are coordinated by the DOWN state during non-REM sleep.
癫痫样棘波用于定位致痫性脑组织。自发触发癫痫样放电的机制尚未阐明。病理性快波（FR，200 - 600Hz）是致痫性脑的生物标志物，我们推测FR网络相互作用参与了癫痫样棘波的产生。通过对46例患者队列进行宏观电极立体颅内脑电图（iEEG）记录，我们发现，在癫痫发作起始区（SOZ），与非传播性FR相比，传播性FR之后更常跟随一个癫痫样棘波（p < 0.05）。传播性FR具有独特的频率和更大的功率（p < 1e - 10），并且与iEEGδ振荡的峰值相位耦合更强，这可能与非快速眼动睡眠期间的DOWN状态相对应（p < 1e - 8），而非传播性FR则不然。虽然FR传播很少见，但所有FR在伴有叠加高频振荡的癫痫样棘波的±400毫秒内出现的概率最高（p < 0.05）。因此，SOZ中一部分癫痫样棘波之前存在传播性FR，这些FR在非快速眼动睡眠期间由DOWN状态协调。
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