Neuroimaging, energetics, and neuronal activity in spike-wave seizures

描述（由申请人提供）： 失神癫痫是儿童中常见的癫痫发作障碍，与5 - 10秒的无反应性发作相关，可对儿童的学习成绩和心理社会互动产生不利影响。在EEG上，失神发作的特征是有节律的“尖峰波”放电（SWD），可能由皮质丘脑神经元网络产生。虽然失神发作被经典地认为是全身性癫痫事件，但最近的研究表明，局灶性脑区参与，而其他区域则幸免。我们的中心假设是，特定的皮质和皮质下网络参与SWD，与基线相比，一些区域显示增加的神经元活动和其他显示减少的活动。 功能性神经影像学有潜力映射区域活动的变化，在SWD非侵入性整个大脑。以前的神经影像学研究已经建立了功能磁共振成像信号和神经元活动之间的密切关系。然而，神经成像具有有限的时空分辨率，并且仅与神经元活动间接相关。这些局限性可以通过将fMRI信号与局部能量学联系起来，然后直接将能量学与神经元活动联系起来来克服。因此，为了准确地表征参与棘波癫痫发作的大脑区域，我们提出了一个多模式的研究SWD在大鼠模型中，使用跨越广泛的时空域的技术。我们的具体目标是：1）使用fMRI绘制SWD中涉及的皮层和皮层下网络，2）测量SWD期间的血管反应并计算神经能量学，将成像信号与神经元活动相关联，以及3）直接测量SWD期间涉及的脑区域内的电生理变化。神经影像学和电生理学技术的这种组合将允许明确描述SWD期间整个大脑神经元活动的变化，从而全面表征这些癫痫发作中涉及的网络。我们期望发现区域异质性，在SWD期间，某些区域显示神经元活动增加，一些显示减少，其他区域保留。皮质和皮质下网络参与SWD的知识将指导未来的研究到失神癫痫的局部病理生理学，并可能导致靶向治疗的发展。 公共卫生相关性：失神发作影响了17%的癫痫儿童，并与凝视法术有关，对儿童的学校表现和社会交往产生负面影响。更好地了解失神发作的机制和涉及哪些大脑区域的知识可能会导致更好地治疗失神癫痫和其他相关的癫痫发作障碍。

DESCRIPTION (provided by applicant): Absence epilepsy is a common seizure disorder in children, associated with 5-10 second episodes of unresponsiveness that can adversely affect a child's academic performance and psychosocial interactions. On EEG, absence seizures are characterized by rhythmic "spike-wave" discharges (SWD), likely generated by corticothalamic neuronal networks. Although absence seizures are classically considered generalized epileptic events, recent studies suggest that focal brain regions are involved while other areas are spared. Our central hypothesis is that specific cortical and subcortical networks are involved in SWD, with some regions displaying increased neuronal activity and others showing decreased activity compared to baseline. Functional neuroimaging has the potential to map regional activity changes during SWD noninvasively throughout the brain. Previous neuroimaging studies have established a strong relationship between fMRI signals and neuronal activity. However, neuroimaging has limited spatiotemporal resolution and is only indirectly related to neuronal activity. These limitations can be overcome by associating fMRI signals with localized energetics and then directly connecting energetics to neuronal activity. Therefore, to accurately characterize the brain regions involved in spike-wave seizures, we propose a multimodal study of SWD in a rat model, using techniques spanning a wide range of spatiotemporal domains. Our specific aims are: 1) To map the cortical and subcortical networks involved in SWD using fMRI, 2) To measure vascular responses and calculate neuroenergetics during SWD, relating imaging signals to neuronal activity, and 3) To directly measure electrophysiological changes during SWD within involved brain regions. This combination of neuroimaging and electrophysiological techniques will allow unambiguous description of changes in neuronal activity throughout the brain during SWD, allowing a comprehensive characterization of the networks involved in these seizures. We expect to find regional heterogeneity, with certain regions showing increases in neuronal activity during SWD, some showing decreases, and sparing of other areas. Knowledge of which cortical and subcortical networks are involved in SWD will guide future studies into the local pathophysiology of absence epilepsy and may lead to the development of targeted treatments. Public Health Relevance: Absence seizures affect 17% of children with epilepsy, and are associated with staring spells that negatively impact a child's school performance and social interactions. A better understanding of the mechanisms of absence seizures and knowledge of which brain regions are involved may lead to better treatments for absence epilepsy and other related seizure disorders.