Thalamocortical relationship in epileptic patients with generalized spike and wave discharges--A multimodal neuroimaging study.
Thalamocortical relationship in epileptic patients with generalized spike and wave discharges--A multimodal neuroimaging study.
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DOI：
10.1016/j.nicl.2015.07.014
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
He B
中科院分区：
文献类型：
--
作者：
Zhang CH;Sha Z;Mundahl J;Liu S;Lu Y;Henry TR;He B
与局灶性或部分性癫痫不同，其影响范围有限，特发性全身性癫痫（IGE）通常影响整个或更大部分的大脑，而没有明显的已知原因。重要的是要了解产生癫痫活动和癫痫活动传播的潜在网络。本研究的目的是调查丘脑皮质的关系，使用非侵入性成像方式在一组IGE患者。我们特别研究了丘脑和内侧额叶皮层的内侧背核在产生和传播IGE活动中的作用。我们假设这两个结构之间的连接是理解受IGE影响的大脑中癫痫活动的产生和传播的关键。我们使用EEG、fMRI和EEG知情的fMRI三种成像技术，确定了广义棘波放电（GSWDs）产生和传播的重要参与者。脑电信息fMRI显示多个脑区与GSWDs相关，包括前扣带回内侧额叶区、丘脑背内侧核、尾状核等。随后的基于种子的功能磁共振成像分析显示了相互的皮质和双丘脑功能连接。通过基于EEG的格兰杰因果关系分析使用（DTF）和自适应DTF，在相互丘脑皮层电路，丘脑似乎作为一个更强的源驱动皮层活动从启动到传播的GSWD。这种连通性变化在GSWD之前开始，并持续到慢波放电结束。丘脑，特别是内侧背核，可能作为脑深部电刺激的潜在靶点，为耐药全身性癫痫患者提供更有效的治疗选择。我们使用EEG和fMRI研究了广义癫痫的机制和网络。连通性分析显示内侧背核-内侧额叶皮层网络。我们使用格兰杰因果关系研究了丘脑皮层网络。丘脑被认为是突出的球员在丘脑皮质的相互作用。
Unlike focal or partial epilepsy, which has a confined range of influence, idiopathic generalized epilepsy (IGE) often affects the whole or a larger portion of the brain without obvious, known cause. It is important to understand the underlying network which generates epileptic activity and through which epileptic activity propagates. The aim of the present study was to investigate the thalamocortical relationship using non-invasive imaging modalities in a group of IGE patients. We specifically investigated the roles of the mediodorsal nuclei in the thalami and the medial frontal cortex in generating and spreading IGE activities. We hypothesized that the connectivity between these two structures is key in understanding the generation and propagation of epileptic activity in brains affected by IGE. Using three imaging techniques of EEG, fMRI and EEG-informed fMRI, we identified important players in generation and propagation of generalized spike-and-wave discharges (GSWDs). EEG-informed fMRI suggested multiple regions including the medial frontal area near to the anterior cingulate cortex, mediodorsal nuclei of the thalamus, caudate nucleus among others that related to the GSWDs. The subsequent seed-based fMRI analysis revealed a reciprocal cortical and bi-thalamic functional connection. Through EEG-based Granger Causality analysis using (DTF) and adaptive DTF, within the reciprocal thalamocortical circuitry, thalamus seems to serve as a stronger source in driving cortical activity from initiation to the propagation of a GSWD. Such connectivity change starts before the GSWDs and continues till the end of the slow wave discharge. Thalamus, especially the mediodorsal nuclei, may serve as potential targets for deep brain stimulation to provide more effective treatment options for patients with drug-resistant generalized epilepsy. We studied the generalized epilepsy mechanisms and networks using EEG and fMRI. Connectivity analysis revealed mediodorsal nucleus–medial frontal cortex network. We investigated the thalamocortical network using Granger Causality. Thalamus was found to be the prominent player in the thalamocortical interaction.