绘制中核区健康状态和癫痫状态。

IF 3.2 3区 医学 Q2 CLINICAL NEUROLOGY
David Satzer, Lesley C Kaye, Megan V Ryan, Steven G Ojemann, John A Thompson, Daniel R Kramer
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引用次数: 0

摘要

背景:中央核(CM)的神经调节对癫痫发作频率有有益的影响。在CM区域内,刺激的效果因位置而异,在闭环刺激过程中,不同的触点被用于记录和刺激。解剖结构、刺激效果和记录效用之间的空间关系尚不清楚。材料和方法:记录接受响应性神经刺激的参与者的局部场电位,以CM为目标治疗癫痫。光谱特征,包括周期功率和非周期偏移,来源于基线记录。从设备检测到的癫痫样活动中计算线长和带通检测器指标,并与基线进行比较。利用蒙特利尔神经学研究所空间坐标和局部场电位源空间重建,根据通道位置映射光谱和检测特征。结果:10名成人受试者,包括8名遗传性全身性癫痫患者,1名lenox - gastaut综合征患者,1名多灶性癫痫患者。周期光谱显示白天的β峰和夜间的α /低β峰。所有光谱特征和检测特征均存在空间差异。日间非周期指数、日间周期性β功率和夜间周期性α功率在内侧CM最高(p < 0.001),在运动丘脑中有额外的β空间最大值。线长检测在CM后部显示出最大值,在先前描述的刺激“甜蜜点”附近较低(p < 0.001)。最大带通检测出现在距离刺激最佳点3mm的侧CM处(p < 0.001)。结论:在CM外侧观察到最大带通检测,靠近先前描述的刺激甜蜜点。其他光谱和检测特征在内侧/后部CM中升高,这被描述为一个功能不同的亚区。侧CM似乎是检测癫痫样活动的有利区域。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Mapping Healthy and Epileptic States in the Centromedian Nucleus Region.

Background: Neuromodulation of the centromedian nucleus (CM) has shown beneficial effects on seizure frequency. The effects of stimulation vary by location within the CM region, and during closed-loop stimulation, different contacts have been used for recording and stimulation. The spatial relationships between anatomy, stimulation efficacy, and recording utility remain unclear.

Materials and methods: Local field potentials were recorded from participants undergoing responsive neurostimulation targeting the CM for the treatment of epilepsy. Spectral features, including periodic power and aperiodic offset, were derived from baseline recordings. Line length and bandpass detector metrics were calculated from device-detected epileptiform activity and compared with baseline. Spectral and detection features were mapped according to channel locations using coordinates in Montreal Neurological Institute space and spatial reconstruction of local field potential sources.

Results: Ten adult participants were studied, including eight with genetic generalized epilepsy, one with Lennox-Gastaut syndrome, and one with multifocal epilepsy. Periodic spectra demonstrated a daytime beta peak and a nighttime alpha/low beta peak. Spatial variation was noted for all spectral and detection features. Daytime aperiodic exponent, daytime periodic beta power, and nighttime periodic alpha power were highest in the medial CM (p < 0.001), with an additional beta spatial maximum in the motor thalamus. Line length detection exhibited a maximum in the posterior CM and was lower near a previously described "sweet spot" for stimulation (p < 0.001). Maximal bandpass detection was observed in the lateral CM (p < 0.001), 3 mm away from the stimulation sweet spot.

Conclusions: Maximal bandpass detection was observed in the lateral CM, near a previously described stimulation sweet spot. Other spectral and detection features were elevated in the medial/posterior CM, which has been described as a functionally distinct subregion. The lateral CM appears to be a favorable region for detection of epileptiform activity.

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来源期刊
Neuromodulation
Neuromodulation 医学-临床神经学
CiteScore
6.40
自引率
3.60%
发文量
978
审稿时长
54 days
期刊介绍: Neuromodulation: Technology at the Neural Interface is the preeminent journal in the area of neuromodulation, providing our readership with the state of the art clinical, translational, and basic science research in the field. For clinicians, engineers, scientists and members of the biotechnology industry alike, Neuromodulation provides timely and rigorously peer-reviewed articles on the technology, science, and clinical application of devices that interface with the nervous system to treat disease and improve function.
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