Attenuated heart-brain integration predicts functional non-epileptic seizures
Attenuated heart-brain integration predicts functional non-epileptic seizures
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心脑整合减弱可预测功能性非癫痫发作
DOI：
10.1136/jnnp-2022-abn2.34
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Elkommos S
中科院分区：
文献类型：
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作者：
Elkommos S
背景：功能性癫痫（FS）患者在癫痫发作前可经历精神分离（人格解体）。人格解体包括一种分离的感觉，据推测是由传入内脏映射减少引起的，即内感受处理的变化。心跳诱发电位（HEP）是对个体心跳同步神经反应的脑电图（EEG）指数，也是内感受表征的标志。据报道，HEP振幅在深度人格化-现实感丧失障碍中降低。目的评估HEP指标的内感受加工改变是否发生在FSs之前，并将其与癫痫发作（ES）进行比较。方法对25例FS患者和19例ES患者进行视频脑电图监测，计算脑电图的shep振幅，并比较其间期和痫前状态。结果FS组在F8 （rB=0.612, p=0.006）和C4 （rB=0.600, p=0.007）时，间期和期前状态HEP幅值明显降低。ES组间期和前期HEP振幅无差异。研究结果与心率、平均心电图或QRS振幅无关，在不同状态或组之间没有差异。结论本研究的数据支持异常内感受在分离性FS发生前支持分离的观点。HEP振幅的变化可能反映FS的神经生理生物标志物。
BackgroundPatients with functional seizures (FS) can experience dissociation (depersonalisation) before their seizures. Depersonalisation encompasses a feeling of disembodiment, putatively caused by reduced afferent visceral mapping, that is, changes in interoceptive processing. The heartbeat-evoked potential (HEP) is an electroencephalographic (EEG) index of synchronised neural responses to individual heart- beats, and a marker of interoceptive representation. HEP amplitude is reported to be reduced in dep- ersonalisation-derealisation disorder.PurposeTo assess whether alterations in interoceptive processing indexed by the HEP occur prior to FSs, and compare this with epileptic seizures (ES).MethodsHEP amplitudes were calculated from EEG during video-EEG monitoring in 25 patients with FS and 19 patients with ES, and compared between interictal and preictal states.ResultsThe FS group demonstrated a significant reduction in HEP amplitude between interictal and preictal states at F8 (rB=0.612, p=0.006) and C4 (rB=0.600, p=0.007). No differences in HEP amplitude were found between interictal and preictal states in the ES group. Findings were not related to heart rate, mean ECG or QRS amplitudes, which did not differ between states or groups.ConclusionOur data support the notion that aberrant interoception underpins disembodiment prior to dissociative FS. Changes in HEP amplitude may reflect a neurophysiological biomarker of FS.