Multimodal effective connectivity analysis reveals seizure focus and propagation in musicogenic epilepsy
Multimodal effective connectivity analysis reveals seizure focus and propagation in musicogenic epilepsy
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DOI：
10.1016/j.neuroimage.2015.03.027
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发表时间：
2015-06-01
期刊：
影响因子：
5.7
通讯作者：
Focke, Niels K.
中科院分区：
文献类型：
--
作者：
Klamer, Silke;Rona, Sabine;Focke, Niels K.
动态因果模型(DCM)是一种非侵入性评估脑区间有效连通性的方法。音乐性癫痫是一种罕见的反射性癫痫综合征，可由音乐刺激引发癫痫发作，因此为研究复杂的人类大脑网络和测试连通性分析工具提供了独特的可能性。我们使用功能磁共振成像、高密度(HD-)脑电和脑磁图的DCM研究了一例音乐性癫痫的有效连接性，并用颅内脑电记录验证了结果。对一名音乐性癫痫患者进行了HD-EEG/fMRI检查，并同时使用源分析技术和DCM来表征致痫灶和传播效应。我们用HD-EEG/fMRI记录了1个癫痫发作，用HD-EEG/MEG记录了4个光环。在癫痫发作期间，可观察到右侧内侧颞区以及双侧内侧额区的活动增加。FMRI和HD-EEG/MEG的有效连接性分析表明，在所有三种模式下，右侧内侧颞叶神经元的活动都一致地驱动额区的变化，这一点得到了有创脑电记录的证实。因此，癫痫发作似乎起源于右侧内侧颞叶，并传播到额叶内侧区域。使用DCM进行功能磁共振、HD-EEG和脑磁图检查，我们能够正确定位癫痫活动的病灶和传播，从而表征音乐性癫痫患者的潜在癫痫网络。经侵入性监测证实的所有三种功能模式之间的一致性是值得注意的，无论是对于癫痫活动的扩散还是对于有效的连接性分析来说都是如此。(C)2015 Elsevier Inc.保留所有权利。
Dynamic causal modeling (DCM) is a method to non-invasively assess effective connectivity between brain regions. 'Musicogenic epilepsy' is a rare reflex epilepsy syndrome in which seizures can be elicited by musical stimuli and thus represents a unique possibility to investigate complex human brain networks and test connectivity analysis tools. We investigated effective connectivity in a case of musicogenic epilepsy using DCM for fMRI, high-density (hd-) EEG and MEG and validated results with intracranial EEG recordings.A patient with musicogenic seizures was examined using hd-EEG/fMRI and simultaneous '256-channel hd-EEG'/'whole head MEG' to characterize the epileptogenic focus and propagation effects using source analysis techniques and DCM. Results were validated with invasive EEG recordings.We recorded one seizure with hd-EEG/fMRI and four auras with hd-EEG/MEG. During the seizures, increases of activity could be observed in the right mesial temporal region as well as bilateral mesial frontal regions. Effective connectivity analysis of fMRI and hd-EEG/MEG indicated that right mesial temporal neuronal activity drives changes in the frontal areas consistently in all three modalities, which was confirmed by the results of invasive EEG recordings. Seizures thus seem to originate in the right mesial temporal lobe and propagate to mesial frontal regions.Using DCM for fMRI, hd-EEG and MEG we were able to correctly localize focus and propagation of epileptic activity and thereby characterize the underlying epileptic network in a patient with musicogenic epilepsy. The concordance between all three functional modalities validated by invasive monitoring is noteworthy, both for epileptic activity spread as well as for effective connectivity analysis in general. (C) 2015 Elsevier Inc. All rights reserved.