Involvement of medial pulvinar thalamic nucleus in human temporal lobe seizures
Involvement of medial pulvinar thalamic nucleus in human temporal lobe seizures
复制标题
DOI：
10.1111/j.1528-1167.2006.00375.x
复制
发表时间：
2006-01-01
期刊：
影响因子：
5.6
通讯作者：
Magnin, M
中科院分区：
文献类型：
--
作者：
Rosenberg, DS;Mauguière, F;Magnin, M
目的：一些动物研究表明丘脑可能参与癫痫发作的维持和传播。然而，电生理学的证据，这在人类部分性癫痫发作的影响仍然缺乏。考虑到内侧枕（PuM）与颞叶的丰富和相互连接，我们评估了这一丘脑核在颞叶癫痫（TLE）中的潜在参与。方法：在14例难治性TLE术前评估的自发性颞叶癫痫患者的立体脑电图探查过程中记录PuM的电生理活动。我们记录了我们分析的74次癫痫发作中80%的PuM发作活动。这种活动的特点是有节奏的慢波或有节奏的尖峰（RSW-RS）或两者兼而有之，或低电压快速活动（LVFA），分别在64%和36%的癫痫发作。RSW-RS主要发生在近中颞叶结构引起的癫痫发作中，而LVFA更常见于新皮质起源的癫痫发作中。在15次无PuM发作活动的癫痫发作中，从未发生癫痫发作蔓延到发作区之外，而在78%有PuM发作活动的癫痫发作中，癫痫发作蔓延到发作区之外。放电传播是系统的PUM参与时，对应于LVFA，无论癫痫发作区是，而它只代表66%的癫痫发作时，PUM表现出RSW-RS.Conclusions：本研究表明，在颞叶癫痫发作期间经常观察到PUM活动的发作变化，并表明丘脑核可能参与其传播。
Purpose: Several animal studies suggest that the thalamus might be involved in the maintenance and propagation of epileptic seizures. However, electrophysiologic evidence for this implication in human partial epileptic seizures is still lacking. Considering the rich and reciprocal connectivity of the medial pulvinar (PuM) with the temporal lobe, we evaluated a potential participation of this thalamic nucleus in temporal lobe epilepsy (TLE).Methods: The electrophysiologic activity of PuM was recorded during stereoelectroencephalographic exploration of spontaneous temporal lobe seizures in 14 patients referred for presurgical assessment of refractory TLE.Results: We recorded PuM ictal activity in 80% of the 74 seizures that we analyzed. This activity was characterized by rhythmic slow-waves or rhythmic spikes (RSW-RS) or both or by low-voltage fast activity (LVFA) in 64% and 36% of seizures, respectively. RSW-RS occurred mostly in seizures arising from mesiotemporal structures, whereas LVFA was more frequently observed in seizures of neocortical origin. In the 15 seizures without PuM ictal activity, spreading of the seizure outside the onset zone never occurred, whereas it did in 78% of seizures with PuM ictal involvement. Discharge propagation was systematic when PuM involvement corresponded to LVFA, whatever the seizure onset zone was, whereas it represented only 66% of the seizures when PuM exhibited RSW-RS.Conclusions: This study shows that ictal changes in PuM activity are frequently observed during temporal lobe seizures and suggests that this thalamic nucleus might participate in their propagation.