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稳定却又失衡:迈向理解心因性障碍中的脑网络动力学

Stable Yet Destabilised: Towards Understanding Brain Network Dynamics in Psychogenic Disorders.

作者信息

Badr Mostafa, Bröhl Timo, Dissouky Nayrin, Helmstaedter Christoph, Lehnertz Klaus

机构信息

Department of Epileptology, University of Bonn Medical Center, Venusberg Campus 1, 53127 Bonn, Germany.

Helmholtz-Institute for Radiation and Nuclear Physics, University of Bonn, Nussallee 14-16, 53115 Bonn, Germany.

出版信息

J Clin Med. 2025 Jan 21;14(3):666. doi: 10.3390/jcm14030666.

Abstract

Psychogenic non-epileptic seizures (PNES) are seizure-like episodes that resemble behavioral aspects observed for epileptic seizures but are without the abnormal electrical activity typically seen in epilepsy. The lack of an etiologic model for PNES as well as limitations of available diagnostic methods largely hinders a clear-cut distinction from epilepsy and from a normal functioning brain. In this study, we investigate the brain dynamics of people with PNES and people with epilepsy during phases far-off seizures and seizure-like events as well as the brain dynamics of a control group. Probing for differences between these groups, we utilise the network ansatz and explore local and global characteristics of time-evolving functional brain networks. We observe subject-specific differences in local network characteristics across the groups, highlighting the physiological functioning of specific brain regions. Furthermore, we observe significant differences in global network characteristics-relating to communication, robustness, and stability aspects of the brain. Our findings may provide new insights into the mechanisms underlying PNES and offer a promising diagnostic approach to differentiate them from epilepsy.

摘要

心理性非癫痫性发作(PNES)是类似癫痫发作的发作性事件,其行为表现与癫痫发作相似,但没有癫痫中常见的异常电活动。由于缺乏PNES的病因模型以及现有诊断方法的局限性,很大程度上阻碍了将其与癫痫以及正常功能的大脑进行明确区分。在本研究中,我们调查了PNES患者、癫痫患者在远离发作期和发作样事件期间的脑动力学,以及一个对照组的脑动力学。为探究这些组之间的差异,我们采用网络假设并探索随时间演变的功能性脑网络的局部和全局特征。我们观察到各组在局部网络特征方面存在个体特异性差异,突出了特定脑区的生理功能。此外,我们观察到在与大脑的通信、鲁棒性和稳定性方面相关的全局网络特征存在显著差异。我们的研究结果可能为PNES的潜在机制提供新的见解,并为将其与癫痫区分开来提供一种有前景的诊断方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/806c/11818738/686cbe7d3e30/jcm-14-00666-g001.jpg

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