Sevoflurane-based enhancement of phase-amplitude coupling and localization of the epileptogenic zone.
Sevoflurane-based enhancement of phase-amplitude coupling and localization of the epileptogenic zone.
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DOI：
10.1016/j.clinph.2021.11.004
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发表时间：
2022-03
期刊：
影响因子：
--
通讯作者：
Miyazaki T
中科院分区：
文献类型：
--
作者：
Wada K;Sonoda M;Firestone E;Sakakura K;Kuroda N;Takayama Y;Iijima K;Iwasaki M;Mihara T;Goto T;Asano E;Miyazaki T
高频(≥150 Hz)和增量(3-4 Hz)振荡之间的相位-幅度耦合-调制指数(MI)-是一种有前途的、客观的致痫生物标志物。我们确定七氟醚麻醉是否优先增强致痫区域内的这一指标。这是一项对8名耐药局灶性癫痫患者长期植入621个电极的术中皮层脑电数据的观察性研究。所有患者在切除手术中都用七氟醚麻醉，随后癫痫发作得到控制。我们将“移除的”和“保留的”大脑部位分别归类为致痫和非致痫。混合模型分析确定了哪种麻醉阶段最适合基于MI的致痫部位分类。MI随着麻醉阶段的不同而增加，范围从基线(即单纯吸氧)到七氟醚的最低肺泡浓度(MAC)，优先出现在初始MI值较高的部位。就在七氟醚达到2MAC之前，这一现象被加剧，当时，每增加1MI，一个部位被归类为癫痫的几率就增加86.6倍。在这一小群患者中，术中MI最好在七氟醚达到2MAC之前立即定位致痫区域。有必要进行前瞻性的大规模队列研究，以确定七氟醚麻醉是否可以减少术外侵入性评估的需要。
Phase-amplitude coupling between high-frequency (≥150 Hz) and delta (3-4 Hz) oscillations - modulation index (MI) - is a promising, objective biomarker of epileptogenicity. We determined whether sevoflurane anesthesia preferentially enhances this metric within the epileptogenic zone. This is an observational study of intraoperative electrocorticography data from 621 electrodes chronically implanted into eight patients with drug-resistant, focal epilepsy. All patients were anesthetized with sevoflurane during resective surgery, which subsequently resulted in seizure control. We classified ‘removed’ and ‘retained’ brain sites as epileptogenic and non-epileptogenic, respectively. Mixed model analysis determined which anesthetic stage optimized MI-based classification of epileptogenic sites. MI increased as a function of anesthetic stage, ranging from baseline (i.e., oxygen alone) to 2 minimum alveolar concentration (MAC) of sevoflurane, preferentially at sites showing higher initial MI values. This phenomenon was accentuated just prior to sevoflurane reaching 2 MAC, at which time, the odds of a site being classified as epileptogenic were enhanced by 86.6 times for every increase of 1 MI. Intraoperative MI best localized the epileptogenic zone immediately before sevoflurane reaching 2 MAC in this small cohort of patients. Prospective, large cohort studies are warranted to determine whether sevoflurane anesthesia can reduce the need for extraoperative, invasive evaluation.
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影响因子：
2.2
作者：
Brosnan RJ;Thiesen R
通讯作者：
Thiesen R
影响因子：
5.6
作者：
Motoi H;Miyakoshi M;Abel TJ;Jeong JW;Nakai Y;Sugiura A;Luat AF;Agarwal R;Sood S;Asano E
通讯作者：
Asano E
DOI：
10.1016/s0013-4694(96)96028-9
发表时间：
1997-01-01
期刊：
ELECTROENCEPHALOGRAPHY AND CLINICAL NEUROPHYSIOLOGY
影响因子：
--
作者：
Malow, BA;Kushwaha, A;Aldrich, MS
通讯作者：
Aldrich, MS
DOI：
10.1109/embc.2013.6610242
发表时间：
2013
期刊：
Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference
影响因子：
--
作者：
Miyakoshi M;Delorme A;Mullen T;Kojima K;Makeig S;Asano E
通讯作者：
Asano E
影响因子：
3.7
作者：
Doi A;Miyazaki T;Mihara T;Ikeda M;Niikura R;Andoh T;Goto T
通讯作者：
Goto T