Urasaki E, Uematsu S, Lesser R P
Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Electroencephalogr Clin Neurophysiol. 1993 Mar-Apr;88(2):92-104. doi: 10.1016/0168-5597(93)90060-3.
We analyzed the intracranial spatiotemporal distributions of the N18 component of short latency median nerve somatosensory evoked potentials (SSEPs) in 3 patients with epilepsy. In these patients, depth electrodes were implanted bilaterally into the frontal and temporal lobes, with targets including the amygdala and hippocampus; the latter two targets are close to the upper pons and midbrain. In this study N18 was divided into the initial negative peak (N18a) and the following prolonged negativity (N18b). Mapping around the upper pons and midbrain showed that: (1) the amplitude of the first negativity, which coincided with scalp N18a, was larger contralateral to the side of stimulation, but showed no polarity change around the upper brain-stem; and (2) the second negativity, which was similar to scalp N18b, did show an amplitude difference or a polarity change. This wave appeared to reflect a positive-negative dipole directed in a dorso-ventral as well as dorso-lateral direction from the midbrain, where positivity arises from the dorsum of the midbrain, contralateral to the side of the stimulation. Recordings from depth electrode derivations oriented in a caudo-rostral direction suggest that N18a and N18b may in part reflect neural activity originating from the upper pons to midbrain region which projects to the rostral subcortical white matter of the frontal lobe as stationary peaks.
我们分析了3例癫痫患者短潜伏期正中神经体感诱发电位(SSEPs)中N18成分的颅内时空分布。在这些患者中,双侧额叶和颞叶植入了深度电极,靶点包括杏仁核和海马体;后两个靶点靠近脑桥上段和中脑。在本研究中,N18被分为初始负峰(N18a)和随后的延长负波(N18b)。脑桥上段和中脑周围的图谱显示:(1)与头皮N18a一致的第一个负波的幅度在刺激侧对侧较大,但在脑桥上部周围未显示极性变化;(2)与头皮N18b相似的第二个负波确实显示出幅度差异或极性变化。该波似乎反映了一个正负偶极,从中脑向背腹以及背外侧方向定向,其中正性来自刺激侧对侧的中脑背侧。沿尾-头方向的深度电极记录表明,N18a和N18b可能部分反映了源自脑桥上段至中脑区域的神经活动,该活动作为固定峰投射至额叶的头侧皮质下白质。