Wzorce początku napadów padaczki w sieci gałki ocznej i kory mózgowej u pacjentów z opornością na leki
Thalamocortical seizure onset patterns in drug-resistant focal epilepsy
W skrócie
Badanie wykazało, że gałka oczna (struktura głęboka w mózgu) odgrywa ważną rolę w powstaniu i rozprzestrzenianiu się napadów padaczki opornej na leki. U większości pacjentów aktywność elektryczna w gałce ocznej towarzyszyła napadom, przy czym stwierdzono różne charakterystyczne wzorce aktywności mózgu. Odkrycia te mogą pomóc w opracowaniu lepszych metod leczenia, w tym bardziej precyzyjnej stymulacji głębokich struktur mózgu i lepszych urządzeń do wykrywania napadów.
Oryginalny abstract (angielski)
Drug-resistant epilepsy affects tens of millions of people worldwide and is associated with considerable morbidity and mortality. Thalamic deep brain stimulation and cortical responsive neurostimulation are proven treatments for focal epilepsy. Both have been used to target a range of thalamic nuclei; yet, the roles of these thalamic nuclei in focal seizure generation remain incompletely understood. Thirteen patients with drug-resistant focal epilepsy undergoing intracranial EEG were consented to undergo investigation of thalamocortical networks. Sampled regions included cortical, mesial temporal, and thalamic brain regions. Visual and spectral analyses were performed to identify seizure onset patterns and correlate thalamic and cortical seizure activity. Thalamic ictal discharges were observed in 89% of seizures. Of these, 56% demonstrated synchronous thalamocortical activity with distinct patterns. These onset patterns included hypersynchronous spiking, low-voltage fast activity, ictal baseline shifts, and broadband suppression. Multiple thalamic nuclei were involved in ictal organization and propagation, with the specific nuclei depending on the cortical seizure network. The thalamus plays a crucial role in focal onset seizure generation and propagation, with distinct seizure onset patterns and nuclei involved. These findings support exploring a broader range of thalamic nuclei in epilepsy neurostimulation and have implications for seizure detection settings in intracranial sensing devices.