Cechy elektryczne jądra śródśrodkowego wzgórza u pacjentów z ogniskową epilepsją - badanie EEG między napadami
Interictal Electroencephalographic Characteristics of the Human Centromedian Thalamic Nucleus Recorded in Focal Epilepsy
W skrócie
Badacze analizowali rejestrowania elektryczne z głębokich struktur mózgu (wzgórza) u 33 pacjentów z trudną do leczenia epilepsją ogniskową. Odkryli, że jądro śródśrodkowe wzgórza zmienia swoją aktywność elektryczną w zależności od tego, czy pacjent jest czuwający czy śpi, a u ponad jednej trzeciej pacjentów pojawiały się tam anomalne wyładowania elektryczne typowe dla epilepsji. Wyniki sugerują, że wzgórze odgrywa ważną rolę w sieciach mózgowych odpowiedzialnych za epilepcję i może być nowym celem do badań nad lepszym leczeniem tej choroby.
Oryginalny abstract (angielski)
OBJECTIVES: The centromedian (CM) thalamic nucleus is critical in sleep-wake regulation and epileptic networks; yet its electroencephalography (EEG) characteristics remain incompletely understood. CM EEG across vigilance states and interictal epileptic discharges (IEDs) in focal epilepsy were investigated. METHODS: Interictal stereo-electroencephalography (SEEG) recordings from the CM and neighboring ventroposterior (VP) and ventrolateral (VL) nuclei were analyzed with synchronous cortical SEEG and scalp EEG during wakefulness, non-rapid eye movement sleep, rapid eye movement sleep, and spontaneous non-epileptic arousal. Spectral power was quantified across frequency bands. Sleep-related thalamic activities and thalamic IEDs were visually identified. RESULTS: SEEG data from 33 patients with drug-resistant focal epilepsy and 3 non-epileptic individuals were analyzed. CM exhibited continuous fast activity during wakefulness and delta/theta-dominant activity during sleep, confirmed by increased gamma-fast ripple power in wakefulness and enhanced delta/theta power in sleep (all p < 0.014). During spontaneous non-epileptic arousal, thalamic EEG changes preceded scalp EEG arousal (median 800 ms; interquartile range: 400-1500 ms). Four sleep-related thalamic EEG activities were reproducibly observed in non-epileptic individuals, supporting a potential physiological nature. Thalamic IEDs occurred in 36.4% of patients with focal epilepsy, invariably involved the CM. Thalamic IEDs were more frequent in extratemporal than temporal lobe epilepsy and were not associated with surgical outcome. CONCLUSIONS: CM SEEG demonstrates distinct, state-dependent electrophysiological dynamics across the sleep-wake cycle and preferential involvement in interictal epileptic activity compared with VL/VP nuclei. SIGNIFICANCE: These findings lay the foundation for a thalamic EEG atlas and refine understanding of differential engagement of thalamic nuclei in epileptic networks.