Single pulse electrical stimulation to probe functional and pathological connectivity in epilepsy.
Single pulse electrical stimulation to probe functional and pathological connectivity in epilepsy.
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DOI：
10.1016/j.seizure.2016.11.003
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发表时间：
2017-01
期刊：
影响因子：
--
通讯作者：
Nair D
中科院分区：
文献类型：
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作者：
Matsumoto R;Kunieda T;Nair D
在过去的十年中，单脉冲电刺激（SPES）已被用作癫痫手术领域的研究工具。以 ∼1 Hz 频率施加的直接皮质刺激可以通过平均皮质电图时间锁定到刺激来探测皮质-皮质连接（2 x 20-30 次试验）。这些从邻近和远端皮质发出的诱发电位被称为皮质-皮质诱发电位（CCEP）。尽管仅限于使用颅内电极进行侵入性术前评估的患者，CCEP 提供了一种探索活体人脑体内区域间连接的新方法，以探测语言和认知运动网络等功能性大脑网络。除了对系统神经科学的影响之外，该方法与 50 Hz 皮层电刺激相结合，可以通过跟踪每个患者功能性皮层区域之间的皮质-皮质连接，在临床上有助于绘制功能性大脑系统图。这种方法可能有助于识别病理学中的正常皮质-皮质网络，并揭示神经可塑性可能产生的联系。由于其高度实用性，最近已应用于脑肿瘤患者的功能性脑网络的术中监测。对于癫痫，SPES 已用于两个主要目的，一是探测病灶的皮质兴奋性，即致癫痫性，二是探测癫痫网络。早期反应（即 CCEP）和延迟反应，以及可能对应的高频振荡，都被视为致痫性的替代标志。鉴于其对人脑连接图的影响，需要全球合作建立标准化的 CCEP 连接图，作为非侵入性连接组研究的坚实参考。
In the last decade, single pulse electrical stimulation (SPES) has been used as an investigational tool in the field of epilepsy surgery. Direct cortical stimulation applied at a frequency of ∼1 Hz can probe cortico-cortical connections by averaging electrocorticogram time-lock to the stimuli (2 x 20–30 trials). These evoked potentials that emanate from adjacent and remote cortices have been termed cortico-cortical evoked potentials (CCEPs). Although limited to patients undergoing invasive presurgical evaluations with intracranial electrodes, CCEP provides a novel way to explore inter-areal connectivity in vivo in the living human brain to probe functional brain networks such as language and cognitive motor networks. In addition to its impact on systems neuroscience, this method, in combination with 50 Hz electrical cortical stimulation, could contribute clinically to map the functional brain systems by tracking the cortico-cortical connections among the functional cortical regions in each individual patient. This approach may help identify the normal cortico-cortical network within pathology as well as reveal connections that might arise from neural plasticity. Because of its high practicality, it has been recently applied for intraoperative monitoring of the functional brain networks for patients with brain tumor. With regard to epilepsy, SPES has been used for the two major purposes, one to probe cortical excitability of the focus, namely, epileptogenicity, and the other to probe seizure networks. Both early (i.e., CCEP) and delayed responses, and probably their high frequency oscillation counterparts, are regarded as a surrogate marker of epileptogenicity. With regards to its impact on the human brain connectivity map, worldwide collaboration is warranted to establish the standardized CCEP connectivity map as a solid reference for non-invasive connectome researches.