Bilateral Representation of Sensorimotor Responses in Benign Adult Familial Myoclonus Epilepsy: An MEG Study.
Bilateral Representation of Sensorimotor Responses in Benign Adult Familial Myoclonus Epilepsy: An MEG Study.
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DOI：
10.3389/fneur.2021.759866
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发表时间：
2021
影响因子：
3.4
通讯作者：
Stufflebeam S
中科院分区：
文献类型：
--
作者：
Matsubara T;Ahlfors SP;Mima T;Hagiwara K;Shigeto H;Tobimatsu S;Goto Y;Stufflebeam S
皮质反射性肌阵挛患者由于初级感觉运动皮质(S1/M1)的过度兴奋而表现出典型的神经生理学特征，即对侧巨大的体感诱发电位/场和刺激臂的C反射(CR)。一些患者对单侧刺激的反应表现为双臂CR，与刺激臂相比，非刺激臂延迟约10ms。这种双侧C反射(BCR)可能反映了双侧S1/M1的强烈参与。然而，50ms内BCR的意义和确切的病理生理机制尚未确定，因为在对侧大脑半球存在巨大成分的情况下，很难识别真正的同侧反应。我们假设，在BCR患者中，双侧S1/M1活动将使用MEG源定位来检测，并且S1/M1皮质之间的大脑半球间连接将比健康对照组(HCS)更强。我们招募了5名患有BCR的皮质反射性肌阵挛患者和15名HC患者。所有患者均为良性成人家族性肌阵挛癫痫。单侧正中神经电刺激。在由对侧刺激的N20m反应决定的感兴趣区，研究同侧的活动。在30~50ms和30~100 Hz的时频窗内，用加权相位滞后指数(WPLI)检测功能连接性。在10只BCR患者的7只手臂中，受刺激手臂与非刺激手臂之间的平均起病延迟为8.4ms。患者的同侧S1/M1活动显著。双侧大脑皮质活动的平均时间差为9.4ms。在特定的皮质-皮质连接中，患者的平均wPLI显著高于HCS。这些联系包括大脑半球间的中央前-中央前、中央后-中央后、顶下-中央前和IP-中央后皮质(对侧区-同侧区)，以及半球内的中央前-IP和中央后-IP区(对侧区-对侧区)。BCR患者的同侧反应可能是一种病理上增强的运动反应，与巨大成分同源，在HCS中太弱而无法可靠地检测到。感觉-运动反应的双侧表达与同源运动皮质内的跨痂抑制通路的去抑制有关，这是由IP介导的。IP可能在抑制皮质肌阵挛中的不适当运动方面发挥作用。
Patients with cortical reflex myoclonus manifest typical neurophysiologic characteristics due to primary sensorimotor cortex (S1/M1) hyperexcitability, namely, contralateral giant somatosensory-evoked potentials/fields and a C-reflex (CR) in the stimulated arm. Some patients show a CR in both arms in response to unilateral stimulation, with about 10-ms delay in the non-stimulated compared with the stimulated arm. This bilateral C-reflex (BCR) may reflect strong involvement of bilateral S1/M1. However, the significance and exact pathophysiology of BCR within 50 ms are yet to be established because it is difficult to identify a true ipsilateral response in the presence of the giant component in the contralateral hemisphere. We hypothesized that in patients with BCR, bilateral S1/M1 activity will be detected using MEG source localization and interhemispheric connectivity will be stronger than in healthy controls (HCs) between S1/M1 cortices. We recruited five patients with cortical reflex myoclonus with BCR and 15 HCs. All patients had benign adult familial myoclonus epilepsy. The median nerve was electrically stimulated unilaterally. Ipsilateral activity was investigated in functional regions of interest that were determined by the N20m response to contralateral stimulation. Functional connectivity was investigated using weighted phase-lag index (wPLI) in the time-frequency window of 30–50 ms and 30–100 Hz. Among seven of the 10 arms of the patients who showed BCR, the average onset-to-onset delay between the stimulated and the non-stimulated arm was 8.4 ms. Ipsilateral S1/M1 activity was prominent in patients. The average time difference between bilateral cortical activities was 9.4 ms. The average wPLI was significantly higher in the patients compared with HCs in specific cortico-cortical connections. These connections included precentral-precentral, postcentral-precentral, inferior parietal (IP)-precentral, and IP-postcentral cortices interhemispherically (contralateral region-ipsilateral region), and precentral-IP and postcentral-IP intrahemispherically (contralateral region-contralateral region). The ipsilateral response in patients with BCR may be a pathologically enhanced motor response homologous to the giant component, which was too weak to be reliably detected in HCs. Bilateral representation of sensorimotor responses is associated with disinhibition of the transcallosal inhibitory pathway within homologous motor cortices, which is mediated by the IP. IP may play a role in suppressing the inappropriate movements seen in cortical myoclonus.
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影响因子：
5.7
作者：
Fischl, B;Sereno, MI;Dale, AM
通讯作者：
Dale, AM
影响因子：
4.3
作者：
Gramfort A;Luessi M;Larson E;Engemann DA;Strohmeier D;Brodbeck C;Goj R;Jas M;Brooks T;Parkkonen L;Hämäläinen M
通讯作者：
Hämäläinen M
影响因子：
4.7
作者：
Hanajima, R.;Okabe, S.;Ugawa, Y.
通讯作者：
Ugawa, Y.
DOI：
10.1016/0013-4694(91)90153-u
发表时间：
1991-07-01
期刊：
ELECTROENCEPHALOGRAPHY AND CLINICAL NEUROPHYSIOLOGY
影响因子：
--
作者：
BAUMGARTNER, C;SUTHERLING, WW;BARTH, DS
通讯作者：
BARTH, DS
DOI：
10.1016/0168-5597(89)90030-0
发表时间：
1989-11-01
期刊：
ELECTROENCEPHALOGRAPHY AND CLINICAL NEUROPHYSIOLOGY
影响因子：
--
作者：
CRACCO, RQ;AMASSIAN, VE;CRACCO, JB
通讯作者：
CRACCO, JB