Impaired consciousness during temporal lobe seizures is related to increased long-distance corticalsubcortical synchronization
Impaired consciousness during temporal lobe seizures is related to increased long-distance corticalsubcortical synchronization
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DOI：
10.1093/brain/awp086
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发表时间：
2009-08-01
期刊：
影响因子：
14.5
通讯作者：
Bartolomei, Fabrice
中科院分区：
文献类型：
--
作者：
Arthuis, Marie;Valton, Luc;Bartolomei, Fabrice
意识丧失（Loss of Consciousness，简称LSE）是颞叶癫痫发作的一种重要临床表现。其潜在机制可能涉及改变支持意识信息处理的大脑区域之间的协调神经元活动。意识访问假设假设存在一个全球工作空间，其中信息通过神经元模块内的同步活动变得可用，通常广泛分布在整个大脑中。再进入回路，特别是丘脑-皮层通信，对于将不同的模块功能性地结合在一起至关重要。在本研究中，我们使用颅内记录的皮质和皮质下结构的12例患者，难治性颞叶癫痫（TLE），作为他们的术前评估的一部分，以调查意识状态和脑内神经元活动之间的关系。通过非线性回归分析，估计了脑电信号在远距离区域之间的同步性作为时间的函数。我们报告说，颞叶癫痫发作过程中发生的癫痫的特点是增加长距离的同步结构，是至关重要的处理意识，包括丘脑（Th）和顶叶皮质。研究发现，大脑皮层活动的程度与丘脑-皮层系统的同步化程度有关。我们认为，过度的同步使参与意识处理的结构过载，阻止它们处理传入的信息，从而导致意识障碍。
Loss of consciousness (LOC) is a dramatic clinical manifestation of temporal lobe seizures. Its underlying mechanism could involve altered coordinated neuronal activity between the brain regions that support conscious information processing. The consciousness access hypothesis assumes the existence of a global workspace in which information becomes available via synchronized activity within neuronal modules, often widely distributed throughout the brain. Re-entry loops and, in particular, thalamo-cortical communication would be crucial to functionally bind different modules together. In the present investigation, we used intracranial recordings of cortical and subcortical structures in 12 patients, with intractable temporal lobe epilepsy (TLE), as part of their presurgical evaluation to investigate the relationship between states of consciousness and neuronal activity within the brain. The synchronization of electroencephalography signals between distant regions was estimated as a function of time by using non-linear regression analysis. We report that LOC occurring during temporal lobe seizures is characterized by increased long-distance synchronization between structures that are critical in processing awareness, including thalamus (Th) and parietal cortices. The degree of LOC was found to correlate with the amount of synchronization in thalamo-cortical systems. We suggest that excessive synchronization overloads the structures involved in consciousness processing, preventing them from treating incoming information, thus resulting in LOC.