Kučikienė Domantė, Jungilligens Johannes, Wolking Stefan, Weber Yvonne, Wellmer Jörg, Popkirov Stoyan
Department of Epileptology and Neurology, RWTH Aachen University, Aachen, Germany.
Department of Neurology, University Hospital Knappschaft Kliniken Bochum, Bochum, Germany.
Epilepsy Behav Rep. 2025 Jul 23;31:100809. doi: 10.1016/j.ebr.2025.100809. eCollection 2025 Sep.
The pathophysiology of functional/dissociative seizures (FDS), also known as psychogenic nonepileptic seizures, remains incompletely understood. Current theories suggest that ictal changes in self-awareness and behavioural control are likely related to arousal-mediated disruptions of brain network dynamics, but direct electrophysiological evidence is scarce. In a proof-of-concept, the second of its kind pilot study, we explored ictal changes in EEG microstates - quasi-stable patterns of electrical activity of 50-70 ms duration that represent fundamental building blocks of large-scale brain network dynamics. Across a sample of 13 FDS patients, four microstates yielded a high mean global explained variance of 76.2 % and qualitatively resembled the well-established "canonical" microstate map topographies A-D. Repeated measure analysis of variance did not reveal any significant differences in contribution, occurrence or global field power of microstates between baseline and ictal recordings. Microstate duration, however, was significantly different between baseline and seizure recordings with shorter durations of microstates in FDS (p = 0.007). This was most pronounced for microstate D (Cohen's = 0.75) with the change being significant in an exploratory post hoc paired -test (p = 0.044). Since microstate D is thought to reflect frontoparietal network activity, the findings of this pilot study can be interpreted as supportive of current theories of arousal-mediated disruptions of network activity that reduce cognitive and behavioural control during FDS.
功能性/分离性癫痫发作（FDS），也称为精神性非癫痫性发作，其病理生理学仍未完全明晰。当前理论表明，自我意识和行为控制的发作期变化可能与觉醒介导的脑网络动力学破坏有关，但直接的电生理证据却很匮乏。在一项同类概念验证性初步研究中，我们探究了脑电图微状态的发作期变化——持续时间为50 - 70毫秒的电活动准稳定模式，它代表了大规模脑网络动力学的基本组成部分。在13名FDS患者的样本中，四种微状态产生了76.2%的高平均全局解释方差，并且在质量上类似于已确立的“A - D”“典型”微状态图谱地形。重复测量方差分析未发现基线和发作期记录之间微状态在贡献、出现或全局场功率方面存在任何显著差异。然而，基线和癫痫发作记录之间的微状态持续时间存在显著差异，FDS中微状态持续时间较短（p = 0.007）。这在微状态D中最为明显（科恩效应量 = 0.75），在探索性事后配对检验中变化显著（p = 0.044）。由于微状态D被认为反映额顶叶网络活动，这项初步研究的结果可以解释为支持当前关于觉醒介导的网络活动破坏的理论，这种破坏会在FDS期间降低认知和行为控制。
