Catania Cecilia, Mancuso Marco, Mazzeo Adolfo, Salamone Enrico Michele, Orlando Biagio, Morano Alessandra, Leodori Giorgio, Casciato Sara, Di Gennaro Giancarlo, Giallonardo Anna Teresa, Di Bonaventura Carlo, Cerulli Irelli Emanuele
Department of Human Neurosciences, Sapienza University, Rome, Italy; EEG and Epilepsy Unit, Department of Neuroscience, University Hospital and Faculty of Medicine of Geneva, University of Geneva, Geneva, Switzerland.
Department of Human Neurosciences, Sapienza University, Rome, Italy.
Clin Neurophysiol. 2025 May;173:124-131. doi: 10.1016/j.clinph.2025.03.002. Epub 2025 Mar 8.
Previous neuroimaging studies indicate complex network alterations in psychogenic non-epileptic seizures (PNES) patients, but brain activity modifications occurring during PNES remain unexplored. This study aimed to analyze EEG microstate metrics in PNES patients both during events and resting state to investigate the neurophysiological changes underlying these dissociative events.
We recruited 22 PNES patients and 24 age- and sex-matched healthy controls. Inclusion criteria included a history of PNES and at least one recorded akinetic PNES during video-EEG.
A two-way repeated-measures ANOVA revealed significant class*condition interactions for microstate duration (p = 0.017), coverage (p = 0.012), and global field power (GFP) (p = 0.008). Post-hoc FDR-adjusted paired t-tests showed a significant decrease in microstate C duration (p = 0.036), coverage (p = 0.04), and GFP (p = 0.036) during PNES events compared to resting state. Mann-Whitney U tests showed significantly higher microstate C duration in PNES patients during resting state compared to controls (p = 0.009).
Microstate C, previously associated with the default mode network, showed increased duration during resting state and decreased representation during PNES, suggesting a prominent shift in neural activity dynamics within this network during dissociative events.
These findings provide insights into neurophysiological changes occurring during PNES, suggestingan interplay between pathological and adaptive mechanisms in their pathophysiology.
先前的神经影像学研究表明，心理性非癫痫发作（PNES）患者存在复杂的网络改变，但PNES发作期间发生的脑活动变化仍未得到探索。本研究旨在分析PNES患者在发作期间和静息状态下的脑电图微状态指标，以研究这些分离性发作背后的神经生理变化。
我们招募了22名PNES患者和24名年龄及性别匹配的健康对照者。纳入标准包括有PNES病史且在视频脑电图监测期间至少记录到一次无动性PNES发作。
双向重复测量方差分析显示，微状态持续时间（p = 0.017）、覆盖率（p = 0.012）和全局场功率（GFP）（p = 0.008）存在显著的类别*条件交互作用。事后经FDR校正的配对t检验显示，与静息状态相比，PNES发作期间微状态C的持续时间（p = 0.036）、覆盖率（p = 0.04）和GFP（p = 0.036）显著降低。曼-惠特尼U检验显示，与对照组相比，PNES患者在静息状态下微状态C的持续时间显著更长（p = 0.009）。
先前与默认模式网络相关的微状态C，在静息状态下持续时间增加，在PNES发作期间代表性降低，这表明在分离性发作期间该网络内神经活动动力学发生了显著变化。
这些发现为PNES发作期间发生的神经生理变化提供了见解，提示其病理生理学中病理机制与适应性机制之间存在相互作用。
