Positive and negative network correlations in temporal lobe epilepsy
Positive and negative network correlations in temporal lobe epilepsy
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DOI：
10.1093/cercor/bhh048
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发表时间：
2004-08-01
期刊：
影响因子：
3.7
通讯作者：
Spencer, SS
中科院分区：
文献类型：
--
作者：
Blumenfeld, H;McNally, KA;Spencer, SS
颞叶癫痫伴有复杂的行为现象，包括意识丧失、张力障碍运动和神经内分泌改变。这些现象可能是由颞叶以外的扩展神经网络引起的。为了研究这一点，我们在进行连续视频/脑电图监测的同时，利用单光子发射计算机断层扫描（SPECT）成像人类颞叶癫痫发作期间的脑血流量（CBF）变化。我们发现，与意识丧失相关的颞叶癫痫发作使颞叶CBF增加，随后双侧中线皮层下结构增加。这些变化伴随着额叶和顶叶联合皮层的双侧CBF明显减少。相比之下，没有意识的颞叶癫痫发作并没有伴随这些广泛的CBF变化。额叶和顶叶联合皮层的脑血流减少与中线结构（如丘脑中背侧）的增加密切相关。这些结果表明，颞叶癫痫发作中的意识受损可能是由颞叶和皮层下网络的局灶性异常活动引起的，这些网络与关联皮层的广泛功能受损有关。
Temporal lobe seizures are accompanied by complex behavioral phenomena including loss of consciousness, dystonic movements and neuroendocrine changes. These phenomena may arise from extended neural networks beyond the temporal lobe. To investigate this, we imaged cerebral blood flow (CBF) changes during human temporal lobe seizures with single photon emission computed tomography (SPECT) while performing continuous video/EEG monitoring. We found that temporal lobe seizures associated with loss of consciousness produced CBF increases in the temporal lobe, followed by increases in bilateral midline subcortical structures. These changes were accompanied by marked bilateral CBF decreases in the frontal and parietal association cortex. In contrast, temporal lobe seizures in which consciousness was spared were not accompanied by these widespread CBF changes. The CBF decreases in frontal and parietal association cortex were strongly correlated with increases in midline structures such as the mediodorsal thalamus. These results suggest that impaired consciousness in temporal lobe seizures may result from focal abnormal activity in temporal and subcortical networks linked to widespread impaired function of the association cortex.