Cellular and network mechanisms of spike-wave seizures
Cellular and network mechanisms of spike-wave seizures
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DOI：
10.1111/j.1528-1167.2005.00311.x
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发表时间：
2005-01-01
期刊：
影响因子：
5.6
通讯作者：
Blumenfeld, H
中科院分区：
文献类型：
--
作者：
Blumenfeld, H
棘波发作通常被认为是一种相对“纯粹”的癫痫形式，所有患者都存在统一的缺陷，并且均匀地累及整个大脑。在这里，我们提出了反对这些常见误解的证据。棘波节律不是一种统一的紊乱，而是由大脑兴奋性和抑制性回路的正常固有网络特性引起的，它们可以由几个不同大脑网络中的许多不同损伤引起。在这里，我们讨论了几种不同的细胞和分子机制，可能有助于产生棘波癫痫发作，特别是在特发性全身性癫痫。此外，我们讨论了越来越多的证据表明，电，神经影像学和分子变化的棘波癫痫发作不涉及整个大脑均匀。相反，棘波放电选择性地发生在一些丘脑皮层网络，而不影响其他网络。希望对异质性缺陷和所涉及的选择性脑区域的更好理解将最终导致对棘波癫痫发作的更有效治疗。
Spike-wave seizures are often considered a relatively "pure" form of epilepsy, with a uniform defect present in all patients and involvement of the whole brain homogenously. Here, we present evidence against these common misconceptions. Rather than a uniform disorder, spike-wave rhythms arise from the normal inherent network properties of brain excitatory and inhibitory circuits, where they can be provoked by many different insults in several different brain networks. Here we discuss several different cellular and molecular mechanisms that may contribute to the generation of spike-wave seizures, particularly in idiopathic generalized epilepsy. In addition, we discuss growing evidence that electrical, neuroimaging, and molecular changes in spike-wave seizures do not involve the entire brain homogenously. Rather, spike-wave discharges occur selectively in some thalamocortical networks, while sparing others. It is hoped that improved understanding of the heterogeneous defects and selective brain regions involved will ultimately lead to more effective treatments for spike-wave seizures.