Julie Lévi-Strauss , Julia Makhalova , Samuel Medina Villalon , Romain Carron , Christian G. Bénar , Fabrice Bartolomei
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引用次数: 0
Abstract
Background
Awareness is a state of consciousness that enables a subject to interact with the environment. Transient alteration of awareness (AA) is a disabling sign of many types of epileptic seizures. The brain mechanisms of awareness and its alteration are not well known.
Objective/Hypothesis
Transient and isolated AA induced by electrical brain stimulation during a stereoelectroencephalography (SEEG) recording represents an ideal model for studying the associated modifications of functional connectivity and locating the hubs of awareness networks.
Methods
We investigated the SEEG signals-based brain functional connectivity (FC) changes vs background occurring during AA triggered by three thalamic and two insular stimulations in three patients explored by SEEG in the frame of presurgical evaluation for focal drug-resistant epilepsy. The results were compared to the stimulations of the same sites that did not induce clinical changes (negative stimulations).
Results
We observed decreased node strength in the pulvinar, insula, and parietal associative cortices during the thalamic and insular stimulations that induced AA. The link strengths characterizing functional coupling between the thalamus and the insular, prefrontal, temporal, or parietal associative cortices were also decreased. In contrast, there was an increased synchronization between the precuneus and the temporal lateral cortex. These FC changes were absent during the negative stimulations.
Conclusion
Our study highlights the role of the pulvinar, insular, and parietal hubs in maintaining the awareness networks and paves the way for invasive or non-invasive neuromodulation protocols to reduce AA manifestations during epileptic seizures.
背景：意识是一种能让人与环境互动的意识状态。短暂的意识改变（AA）是多种类型癫痫发作的致残征兆。意识及其改变的大脑机制尚不十分清楚：/假设：在立体脑电图（SEEG）记录过程中通过脑电刺激诱发的短暂和孤立的意识障碍是研究相关功能连接性改变和定位意识网络中心的理想模型：方法：我们研究了在对局灶性耐药性癫痫进行手术前评估的框架内，通过 SEEG 对三名患者进行了探索，在三次丘脑刺激和两次岛叶刺激引发的 AA 期间，基于 SEEG 信号的大脑功能连接性（FC）变化与背景的对比。结果与刺激相同部位但未引起临床变化（负刺激）的结果进行了比较：结果：我们观察到，在丘脑和岛叶刺激诱发 AA 时，脉络膜、岛叶和顶叶联想皮层的节点强度降低。丘脑与岛叶、前额叶、颞叶或顶叶联想皮层之间功能耦合的联系强度也有所下降。相反，楔前皮质和颞侧皮质之间的同步性增强。结论：我们的研究强调了脉冲皮质在大脑皮层中的作用：我们的研究强调了脉络膜、岛叶和顶叶枢纽在维持意识网络中的作用，并为有创或无创神经调节方案减少癫痫发作时的 AA 表现铺平了道路。
期刊介绍：
Brain Stimulation publishes on the entire field of brain stimulation, including noninvasive and invasive techniques and technologies that alter brain function through the use of electrical, magnetic, radiowave, or focally targeted pharmacologic stimulation.
Brain Stimulation aims to be the premier journal for publication of original research in the field of neuromodulation. The journal includes: a) Original articles; b) Short Communications; c) Invited and original reviews; d) Technology and methodological perspectives (reviews of new devices, description of new methods, etc.); and e) Letters to the Editor. Special issues of the journal will be considered based on scientific merit.
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