Guo Yi, Lin Zhonghua, Fan Zhen, Tian Xin
Department of Neurology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China.
Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China.
Neural Regen Res. 2024 Dec 1;19(12):2637-2648. doi: 10.4103/1673-5374.391307. Epub 2023 Dec 21.
Epilepsy can be defined as a dysfunction of the brain network, and each type of epilepsy involves different brain-network changes that are implicated differently in the control and propagation of interictal or ictal discharges. Gaining more detailed information on brain network alterations can help us to further understand the mechanisms of epilepsy and pave the way for brain network-based precise therapeutic approaches in clinical practice. An increasing number of advanced neuroimaging techniques and electrophysiological techniques such as diffusion tensor imaging-based fiber tractography, diffusion kurtosis imaging-based fiber tractography, fiber ball imaging-based tractography, electroencephalography, functional magnetic resonance imaging, magnetoencephalography, positron emission tomography, molecular imaging, and functional ultrasound imaging have been extensively used to delineate epileptic networks. In this review, we summarize the relevant neuroimaging and neuroelectrophysiological techniques for assessing structural and functional brain networks in patients with epilepsy, and extensively analyze the imaging mechanisms, advantages, limitations, and clinical application ranges of each technique. A greater focus on emerging advanced technologies, new data analysis software, a combination of multiple techniques, and the construction of personalized virtual epilepsy models can provide a theoretical basis to better understand the brain network mechanisms of epilepsy and make surgical decisions.
癫痫可被定义为脑网络功能障碍，每种类型的癫痫都涉及不同的脑网络变化，这些变化在发作间期或发作期放电的控制与传播中所起的作用各不相同。获取有关脑网络改变的更详细信息有助于我们进一步理解癫痫的发病机制，并为临床实践中基于脑网络的精准治疗方法铺平道路。越来越多的先进神经影像学技术和电生理技术，如基于扩散张量成像的纤维束示踪、基于扩散峰度成像的纤维束示踪、基于纤维球成像的纤维束示踪、脑电图、功能磁共振成像、脑磁图、正电子发射断层扫描、分子成像和功能超声成像，已被广泛用于描绘癫痫网络。在本综述中，我们总结了用于评估癫痫患者脑结构和功能网络的相关神经影像学和神经电生理技术，并广泛分析了每种技术的成像机制、优势、局限性及临床应用范围。更多地关注新兴的先进技术、新的数据分析软件、多种技术的联合应用以及个性化虚拟癫痫模型的构建，可为更好地理解癫痫的脑网络机制及做出手术决策提供理论依据。
