Pharmaco-resistant seizures: self-triggering capacity, scale-free properties and predictability?
Pharmaco-resistant seizures: self-triggering capacity, scale-free properties and predictability?
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DOI：
10.1111/j.1460-9568.2009.06923.x
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发表时间：
2009-10-01
影响因子：
3.4
通讯作者：
Milton, John
中科院分区：
文献类型：
--
作者：
Osorio, Ivan;Frei, Mark G.;Milton, John
诸如癫痫发作的可预测性及其引发更多癫痫发作的能力等相关和及时的问题仍然是癫痫学中争论的主题。本研究试图通过采用非还原论方法和使用数学工具来深入了解这些动态问题。癫痫发作能量和发作间隔的概率分布函数，以及癫痫发作发生的概率取决于上一次癫痫发作的时间，通过对药物抵抗性癫痫发作、接受手术评估、减少剂量或不使用药物的受试者的长时间记录进行估计。在普遍的研究条件下，药物抗性发作的能量和发作间隔分布受幂律（“无标度”行为）的支配。药物抵抗性癫痫发作往往成群发生，下一次癫痫发作的时间随着上一次癫痫发作后无癫痫发作间隔时间的延长而增加。然而，在少数受试者中发现了特征尺寸能量概率密度函数。这些发现表明：(1)耐药癫痫发作具有内在的自触发能力；（ii）根据幂律分布的存在和它们的自触发能力，它们的发生时间和强度是可以预测的；（iii）它们缺乏典型的规模和持续时间（无标度），这些特征是它们被分类为临界或间歇的主要依据，可能是不充分/不充分的分类器。
Relevant and timely questions such as regarding the predictability of seizures and their capacity to trigger more seizures remain the subject of debate in epileptology. The present study endeavors to gain insight into these dynamic issues by adopting a non-reductionist approach and via the use of mathematical tools. Probability distribution functions of seizure energies and inter-seizure intervals and the probability of seizure occurrence conditional upon the time elapsed from the previous seizure were estimated from prolonged recordings from subjects with pharmaco-resistant seizures, undergoing surgical evaluation, on reduced doses of or on no medications. The energy and inter-seizure interval distributions for pharmaco-resistant seizures, under the prevailing study conditions, are governed by power laws ('scale-free' behavior). Pharmaco-resistant seizures tend to occur in clusters and the time to the next seizure increases with the duration of the seizure-free interval since the last one. However, characteristic size energy probability density functions were found in a few subjects. These findings suggests that: (i) pharmaco-resistant seizures have an inherent self-triggering capacity; (ii) their time of occurrence and intensity may be predictable in light of the existence of power law distributions and of their self-triggering capacity; and (iii) their lack of typical size and duration (scale-free), features upon which their classification into ictal or interictal is largely based, may be inadequate/insufficient classifiers.