Wu Di, Liu Jinghui, Ren Liankun
Department of Neurology, Clinical Center for Epilepsy, Xuanwu Hospital, Capital Medical University, NO.45 Changchun Street, Beijing, 100053, Xicheng District, China.
National Center for Neurological Disorders, Beijing, 100053, China.
Acta Epileptol. 2023 Nov 1;5(1):26. doi: 10.1186/s42494-023-00138-z.
Stroke is the leading cause of neurological diseases globally. Remarkably, epilepsy is a common complication of stroke, which greatly impairs the quality of life of patients and poses a significant clinical challenge. Therefore, a better understanding of the risk factors for poststroke epilepsy is crucial. A recent study published in JAMA Neurology studied the brain network associated with poststroke epilepsy in a group of 76 patients compared to a cohort of 625 control patients using lesion mapping techniques. The results showed that negative functional connectivity between lesion locations and regions in the basal ganglia and cerebellum confers a higher risk of developing epilepsy after stroke. The lesion network nodes associated with epilepsy were identical across different lesion types including hematomas, traumas, tumors, and tubers. Furthermore, the poststroke epilepsy brain network has potential therapeutic relevance to deep brain stimulation (DBS). In a cohort of 30 patients, the functional connectivity between anterior thalamic DBS sites and the lesion network nodes was found to correlate with seizure control after DBS. In summary, the finding provides a novel method for predicting the risk of poststroke epilepsy in patients and may guide brain stimulation treatments for epilepsy.
中风是全球神经系统疾病的主要病因。值得注意的是，癫痫是中风的常见并发症，这极大地损害了患者的生活质量，并带来了重大的临床挑战。因此，更好地了解中风后癫痫的危险因素至关重要。最近发表在《美国医学会神经病学杂志》上的一项研究，使用病变映射技术，对76名患者与625名对照患者组成的队列进行了研究，以探究与中风后癫痫相关的脑网络。结果显示，病变部位与基底神经节和小脑区域之间的负功能连接会增加中风后发生癫痫的风险。与癫痫相关的病变网络节点在不同的病变类型（包括血肿、创伤、肿瘤和结节）中是相同的。此外，中风后癫痫脑网络与深部脑刺激（DBS）具有潜在的治疗相关性。在一个30名患者的队列中，发现丘脑前DBS部位与病变网络节点之间的功能连接与DBS后的癫痫控制相关。总之，这一发现为预测患者中风后癫痫的风险提供了一种新方法，并可能指导癫痫的脑刺激治疗。
