Two types of clinical ictal direct current shifts in invasive EEG of intractable focal epilepsy identified by waveform cluster analysis
Two types of clinical ictal direct current shifts in invasive EEG of intractable focal epilepsy identified by waveform cluster analysis
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DOI：
10.1016/j.clinph.2022.02.021
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发表时间：
2022-03-16
影响因子：
4.7
通讯作者：
Ikeda, Akio
中科院分区：
文献类型：
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作者：
Kajikawa, Shunsuke;Matsuhashi, Masao;Ikeda, Akio
目的：确定临床发作的直流电（DC）的变化，可以确定的时间常数（TC）为2秒，并描绘不同类型的DC偏移之间的TC的10砂2秒的不同衰减模式。方法：21例患者接受硬膜下电极植入癫痫手术进行了研究。对于习惯性发作，我们比较了TC为10 s和2 s之间最早发作DC移位的（1）峰值幅度和（2）峰值潜伏期。根据TC 10 s时波幅和峰潜伏期的衰减率进行聚类分析和Logistic回归分析。结果：分析了120次癫痫发作的发作期DC偏移，其中89.1%的DC偏移即使在TC为2 s时也能适当地描绘。聚类分析和Logistic回归分析显示两种类型的发作性DC偏移。即发作期DC峰潜伏期缩短、振幅衰减率降低（73/120次发作）为快速发展型。缓慢发展模式定义为发作性DC变化与快速发展模式的交叉流，即，峰潜伏期延长，波幅衰减率增大（47/120次发作）。局灶性皮质发育不良（FCD）1A倾向于显示快速发展模式（22/29次癫痫发作）和FCD 2A倾向于显示缓慢的发展模式（13 /18次发作），表明两种类型的发作性DC移位与某些病理之间可能存在一定的相关性。突发性DC转变，特别是快速发展模式，与10 s TC相比，2 s TC的AC放大器可以记录和识别。两种类型的发作性DC移位被确定为具有相应病理的可能性。意义：发作性DC偏移可以通过其衰减模式来区分。(c)2022国际临床神经生理学联合会。Elsevier B. V.出版，保留所有权利。
Objective: To determine clinically ictal direct current (DC) shifts that can be identified by a time constant (TC) of 2 s and to delineate different types of DC shifts by different attenuation patterns between TC of 10 sand 2 s.Methods: Twenty-one patients who underwent subdural electrode implantation for epilepsy surgery were investigated. For habitual seizures, we compared (1) the peak amplitude and (2) peak latency of the earliest ictal DC shifts between TC of 10 s and 2 s. Cluster and logistic regression analyses were per -formed based on the attenuation rate of amplitude and peak latency with TC 10 s. Results: Ictal DC shifts in 120 seizures were analyzed; 89.1% of which were appropriately depicted even by a TC of 2 s. Cluster and logistic regression analyses revealed two types of ictal DC shift. Namely, a rapid development pattern was defined as the ictal DC shifts with a shorter peak latency and they also showed smaller attenuation rate of amplitude (73/120 seizures). Slow development pattern was defined as the ictal DC shifts with crosscurrent of a rapid development pattern, i.e., a longer peak latency and larger attenuation rate of amplitude (47/120 seizures). Focal cortical dysplasia (FCD) 1A tended to show a rapid development pattern (22/29 seizures) and FCD2A tended to show a slow development pattern (13 /18 seizures), indicating there might be some correlations between two types of ictal DC shift and certain pathologies.Conclusions: Ictal DC shifts, especially rapid development pattern, can be recorded and identified by the AC amplifiers of TC of 2 s which is widely used in many institutes compared to that of TC of 10 s. Two types of ictal DC shifts were identified with possibility of corresponding pathology. Significance: Ictal DC shifts can be distinguished by their attenuation patterns.(c) 2022 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.