Engagement of cortico-cortical and cortico-subcortical networks in a patient with epileptic spasms: An integrated neurophysiological study
Engagement of cortico-cortical and cortico-subcortical networks in a patient with epileptic spasms: An integrated neurophysiological study
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DOI：
10.1016/j.clinph.2020.04.167
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发表时间：
2020-09-01
影响因子：
4.7
通讯作者：
Ikeda, Akio
中科院分区：
文献类型：
--
作者：
Inoue, Takeshi;Kobayashi, Katsuya;Ikeda, Akio
目的：我们的目的是描绘参与皮质-皮质和皮质-皮质下网络的产生癫痫痉挛（ES）使用集成neurophysiological techniques.Methods：17岁的男性患者顽固性ES进行慢性硬膜下电极植入术术前评估。在发作期使用高频振荡（HFO）分析和发作间期使用脑磁图（MEG）和同步脑电图，以及功能性磁共振成像（EEG-fMRI）网络进行了评估。皮质-皮质诱发电位（CCEPs）被记录到跟踪networks.Results之间的连接：发作HFO揭示了一个网络，包括多叶皮层区域（额叶，顶叶，颞叶），但保留了积极的运动区。发作间期，MEG和EEG-fMRI显示这些皮层区域的棘波相关激活。CCEP分析提供了皮质-皮质网络内连通性的证据。此外，脑电图功能磁共振成像结果表明，皮质下结构的参与，如双侧丘脑（主要是右脑）和中脑。结论：在本案例研究中，综合神经生理技术为皮质-皮质网络的参与提供了汇聚的证据（保留正运动区）和皮质-皮质下网络在患者ES的产生中的作用。皮质-皮质和皮质-皮质下通路，除了从正运动区直接下行的皮质脊髓通路外，可能在ES的产生中起重要作用。(C)2020国际临床神经生理学联合会。由Elsevier B. V.出版，版权所有。
Objective: We aimed to delineate the engagement of cortico-cortical and cortico-subcortical networks in the generation of epileptic spasms (ES) using integrated neurophysiological techniques.Methods: Seventeen-year-old male patient with intractable ES underwent chronic subdural electrode implantation for presurgical evaluation. Networks were evaluated in ictal periods using high-frequency oscillation (HFO) analysis and in interictal periods using magnetoencephalography (MEG) and simultaneous electroencephalography, and functional magnetic resonance imaging (EEG-fMRI). Cortico-cortical evoked potentials (CCEPs) were recorded to trace connections among the networks.Results: Ictal HFO revealed a network comprising multilobar cortical regions (frontal, parietal, and temporal), but sparing the positive motor area. Interictally, MEG and EEG-fMRI revealed spike-and-wave-related activation in these cortical regions. Analysis of CCEPs provided evidence of connectivity within the cortico-cortical network. Additionally, EEG-fMRI results indicate the involvement of subcortical structures, such as bilateral thalamus (predominantly right) and midbrain.Conclusions: In this case study, integrated neurophysiological techniques provided converging evidence for the involvement of a cortico-cortical network (sparing the positive motor area) and a cortico-subcortical network in the generation of ES in the patient.Significance: Cortico-cortical and cortico-subcortical pathways, with the exception of the direct descending corticospinal pathway from the positive motor area, may play important roles in the generation of ES. (C) 2020 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.