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Measurable transitions during seizures in intracranial EEG: A stereoelectroencephalography and SPECT study.
Krishnan, Balu; Tousseyn, Simon; Taylor, Kenneth; Wu, Guiyun; Serletis, Demitre; Najm, Imad; Bulacio, Juan; Alexopoulos, Andreas V.
Afiliación
  • Krishnan B; Neurological Institute, Epilepsy Center, Cleveland Clinic, Cleveland, OH, USA. Electronic address: krishnb@ccf.org.
  • Tousseyn S; Academic Center for Epileptology, Kempenhaeghe and Maastricht UMC+, Heeze, The Netherlands; School for Mental Health and Neuroscience (MHeNs), University Maastricht (UM), Maastricht, The Netherlands.
  • Taylor K; Neurological Institute, Epilepsy Center, Cleveland Clinic, Cleveland, OH, USA.
  • Wu G; Neurological Institute, Epilepsy Center, Cleveland Clinic, Cleveland, OH, USA.
  • Serletis D; Neurological Institute, Epilepsy Center, Cleveland Clinic, Cleveland, OH, USA.
  • Najm I; Neurological Institute, Epilepsy Center, Cleveland Clinic, Cleveland, OH, USA.
  • Bulacio J; Neurological Institute, Epilepsy Center, Cleveland Clinic, Cleveland, OH, USA.
  • Alexopoulos AV; Neurological Institute, Epilepsy Center, Cleveland Clinic, Cleveland, OH, USA.
Clin Neurophysiol ; 161: 80-92, 2024 May.
Article en En | MEDLINE | ID: mdl-38452427
ABSTRACT

OBJECTIVE:

Ictal Single Photon Emission Computed Tomography (SPECT) and stereo-electroencephalography (SEEG) are diagnostic techniques used for the management of patients with drug-resistant focal epilepsies. While hyperperfusion patterns in ictal SPECT studies reveal seizure onset and propagation pathways, the role of ictal hypoperfusion remains poorly understood. The goal of this study was to systematically characterize the spatio-temporal information flow dynamics between differently perfused brain regions using stereo-EEG recordings.

METHODS:

We identified seizure-free patients after resective epilepsy surgery who had prior ictal SPECT and SEEG investigations. We estimated directional connectivity between the epileptogenic-zone (EZ), non-resected areas of hyperperfusion, hypoperfusion, and baseline perfusion during the interictal, preictal, ictal, and postictal periods.

RESULTS:

Compared to the background, we noted significant information flow (1) during the preictal period from the EZ to the baseline and hyperperfused regions, (2) during the ictal onset from the EZ to all three regions, and (3) during the period of seizure evolution from the area of hypoperfusion to all three regions.

CONCLUSIONS:

Hypoperfused brain regions were found to indirectly interact with the EZ during the ictal period.

SIGNIFICANCE:

Our unique study, combining intracranial electrophysiology and perfusion imaging, presents compelling evidence of dynamic changes in directional connectivity between brain regions during the transition from interictal to ictal states.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Convulsiones / Tomografía Computarizada de Emisión de Fotón Único / Electroencefalografía Límite: Adolescent / Adult / Child / Female / Humans / Male / Middle aged Idioma: En Revista: Clin Neurophysiol Asunto de la revista: NEUROLOGIA / PSICOFISIOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Países Bajos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Convulsiones / Tomografía Computarizada de Emisión de Fotón Único / Electroencefalografía Límite: Adolescent / Adult / Child / Female / Humans / Male / Middle aged Idioma: En Revista: Clin Neurophysiol Asunto de la revista: NEUROLOGIA / PSICOFISIOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Países Bajos