Correlations between ictal propagation and response to electrical cortical stimulation: A cortico-cortical evoked potential study
Correlations between ictal propagation and response to electrical cortical stimulation: A cortico-cortical evoked potential study
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DOI：
10.1016/j.eplepsyres.2012.03.004
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发表时间：
2012-08-01
影响因子：
2.2
通讯作者：
Nair, Dileep R.
中科院分区：
文献类型：
--
作者：
Enatsu, Rei;Jin, Kazutaka;Nair, Dileep R.
目的：利用皮层诱发电位(CCEP)揭示癫痫发作的脑神经网络，更好地了解癫痫发作的传播过程。方法：对11例难治性局灶性癫痫患者的11次发作的脑电记录进行分析，确定癫痫发作的传播部位和时间。6例患者有二次泛化病史(Gen(+)组)，5例患者无继发泛化病史(Gen(-)组)。然后对发作区施加重复的1 Hz双极电刺激，通过平均皮层脑电记录CCEP。结果：邻近扩散的传播速度明显快于非邻近扩散的传播速度(p=0.033)。在4例患者中，发作期传播区的CCEP波幅明显大于传播区外。然而，CCEP反应的分布并不一定与整个发作期传播区域一致。此外，Gen(+)组的发作期传播区域明显大于Gen(-)组(p=0.017)。结论：本研究结果提示，发作期发作区周围兴奋性的增强可以解释发作期的连续传播速度快于非邻接性传播。此外，有一组纤维在癫痫发作期间是“闭合的”，二次泛化可能更多地与广泛皮质区域的皮质抑制受损有关，而不是直接联系。(C)爱思唯尔出版的2012年。
Objective: To better understand the process of ictal propagation in epilepsy by using cortico-cortical evoked potential (CCEP), which reveals the brain networks.Methods: Intracranial EEG recordings of 11 seizures from 11 patients with pharmacoresistant focal epilepsy were studied to identify the propagation sites and times. Six patients had a history of secondary generalization (Gen (+) group) and five patients did not (Gen (-) group). Thereafter repetitive 1 Hz bipolar electrical stimuli were applied to the ictal onset zones and CCEPs were recorded by averaging electrocorticograms.Results: The propagation of contiguous spread was significantly faster than non-contiguous spread (p = 0.033). In four patients, CCEP amplitudes were significantly larger in the ictal propagation area than out of the propagation area. However, the distribution of CCEP responses was not necessarily consistent with the ictal propagation area as a whole. Furthermore, the ictal propagation areas out of CCEP-positive areas were significantly broader in Gen (+) group than Gen (-) group (p = 0.017).Conclusion: The present findings suggest that contiguous spread is faster than non-contiguous spread, which can be explained by the enhancement of excitability around the ictal onset area. Furthermore, there is a group of fibers that is "closed" during the seizures and secondary generalization might be more associated with the impairment of cortical inhibition over the broad cortical area rather than direct connection. (C) 2012 Published by Elsevier B.V.