Epileptic seizures can be anticipated by non-linear analysis
Epileptic seizures can be anticipated by non-linear analysis
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DOI：
10.1038/2667
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发表时间：
1998-10-01
期刊：
影响因子：
82.9
通讯作者：
Varela, FJ
中科院分区：
文献类型：
--
作者：
Martinerie, J;Adam, C;Varela, FJ
癫痫发作是一种主要的脑功能障碍，具有重要的公共卫生影响，因为它们影响了0.8%的人类。其中许多患者（20%）对药物治疗有耐药性。在这种情况下，预测癫痫发作的能力将允许临床干预。目前对慢性局灶性癫痫的看法是，异常放电的神经元作为起搏器，通过抑制和同步丧失，招募和牵引其他正常神经元达到临界质量(2)。因此，在招募阶段应该可以检测到预测变化。传统的信号分析，如聚焦峰密度计数(3)、频率相干性(4)或频谱分析都不是可靠的预测因素。非线性指标可能在癫痫发作前后发生一致的变化（5-7）。我们的目标是通过将植入患者的颅内记录重建为相空间中的轨迹，然后引入非线性指标来表征它们，从而跟踪癫痫发作的转变（8,9）。这些指标考虑到癫痫恢复过程的扩展时空性质（10）和相应的生理事件在时间序列中受短期因果关系支配。我们证明，在大多数情况下（19例中的17例），癫痫发作可以提前很好地预测（提前2-6分钟），并且所有受试者似乎都有类似的癫痫发作“路线”。
Epileptic seizures are a principal brain dysfunction with important public health implications, as they affect 0.8% of humans. Many of these patients (20%) are resistant to treatment with drugs'. The ability to anticipate the onset of seizures in such cases would permit clinical interventions. The view of chronic focal epilepsy now is that abnormally discharging neurons act as pacemakers to recruit and entrain other normal neurons by loss of inhibition and synchronization into a critical mass(2). Thus, preictal changes should be detectable during the stages of recruitment. Traditional signal analyses, such as the count of focal spike density(3), the frequency coherence(4) or spectral analyses are not reliable predictors. Non-linear indicators may undergo consistent changes around seizure onset(5-7). Our objective was to follow the transition into seizure by reconstructing intracranial recordings in implanted patients as trajectories in a phase space and then introduce non-linear indicators to characterize them(8,9). These indicators take into account the extended spatio-temporal nature of the epileptic recruitment processes(10) and the corresponding physiological events governed by short-term causalities in the time series. We demonstrate that in most cases (17 of 19), seizure onset could be anticipated well in advance (between 2-6 minutes beforehand), and that all subjects seemed to share a similar 'route' towards seizure.