Structural and effective connectivity in focal epilepsy.
Structural and effective connectivity in focal epilepsy.
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DOI：
10.1016/j.nicl.2017.12.020
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Ourselin S
中科院分区：
文献类型：
--
作者：
Parker CS;Clayden JD;Cardoso MJ;Rodionov R;Duncan JS;Scott C;Diehl B;Ourselin S
难治性局灶性癫痫患者可能需要进行神经外科手术，有些患者可能需要放置颅内脑电图电极来定位癫痫发作。评估大脑对单脉冲电刺激（spe）的反应可能提供有用的诊断数据。SPES产生皮质-皮质诱发电位（CCEPs），可以推断大脑的有效连接。弥散加权图像和神经束造影可用于估计脑结构连通性。这种结合提供了观察癫痫发作及其在整个大脑中的传播的机会，沿着电极探测的皮层连续或非连续地传播。我们分析了7例局灶性癫痫患者的ccep和弥散束造影，重建了有效的和结构性的脑网络。我们的目的是评估跨皮质的网络在大范围内的多模态相似性，癫痫发作区的有效和结构连通性，并研究非连续发作扩散的潜在机制。我们发现结构网络和有效网络之间存在明显的重叠。有效网络CCEP振幅、基线变化和向外连通性在初始区较高，而初始区内的结构连接强度趋于较高。这些发现支持了过度兴奋皮层与癫痫发作有关的概念。从初始发作区到非连续扩散部位的结构和有效连接的高发生率表明，宏观结构和有效连接可能是非连续发作扩散的途径。多式联运网络一致性高于偶然性，相关性较低。高的CCEP振幅，基线变化和在初始起病区的异常程度。流线密度在初始起爆区内趋于较高。高发病区与早期和晚期发作扩散部位的连通性。
Patients with medically-refractory focal epilepsy may be candidates for neurosurgery and some may require placement of intracranial EEG electrodes to localise seizure onset. Assessing cerebral responses to single pulse electrical stimulation (SPES) may give diagnostically useful data. SPES produces cortico-cortical evoked potentials (CCEPs), which infer effective brain connectivity. Diffusion-weighted images and tractography may be used to estimate structural brain connectivity. This combination provides the opportunity to observe seizure onset and its propagation throughout the brain, spreading contiguously along the cortex explored with electrodes, or non-contiguously. We analysed CCEPs and diffusion tractography in seven focal epilepsy patients and reconstructed the effective and structural brain networks. We aimed to assess the inter-modal similarity of the networks at a large scale across the cortex, the effective and structural connectivity of the ictal-onset zone, and investigate potential mechanisms of non-contiguous seizure spread. We found a significant overlap between structural and effective networks. Effective network CCEP amplitude, baseline variation, and outward connectivity was higher at ictal-onset zones, while structural connection strength within the ictal-onset zone tended to be higher. These findings support the concept of hyperexcitable cortex being associated with seizure generation. The high prevalence of structural and effective connections from the ictal-onset zone to sites of non-contiguous spread suggests that macroscopic structural and effective connections are plausible routes for non-contiguous seizure spread. Inter-modal network agreement was higher than by chance and correlation was low. High CCEP amplitude, baseline variation and outdegree at the ictal-onset zone. Streamline density tended to be higher within the ictal-onset zone. High ictal-onset zone connectivity to early and late seizure spread sites.
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影响因子：
1
作者：
Brandes, U
通讯作者：
Brandes, U
DOI：
10.1016/0013-4694(94)00286-t
发表时间：
1995-05-01
期刊：
ELECTROENCEPHALOGRAPHY AND CLINICAL NEUROPHYSIOLOGY
影响因子：
--
作者：
ALARCON, G;BINNIE, CD;POLKEY, CE
通讯作者：
POLKEY, CE
影响因子：
5.6
作者：
Flanagan, Danny;Valentin, Antonio;Boyd, Stewart G.
通讯作者：
Boyd, Stewart G.
影响因子：
5.7
作者：
Guye, M;Parker, GJM;Duncan, JS
通讯作者：
Duncan, JS
影响因子：
2.9
作者：
Besseling RM;Jansen JF;Overvliet GM;van der Kruijs SJ;Ebus SC;de Louw AJ;Hofman PA;Aldenkamp AP;Backes WH
通讯作者：
Backes WH