评估儿童癫痫兴奋性/抑制性失衡的无创生物标志物。

IF 4 2区 医学 Q1 NEUROSCIENCES
Sakar Rijal,F Kathryn King,Hmayag Partamian,Saeed Jahromi,M Scott Perry,Crystal Cooper,Christos Papadelis
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引用次数: 0

摘要

癫痫发作涉及由功能失调的中间神经元驱动的皮层兴奋-抑制不平衡,导致伽马振荡的产生。虽然在癫痫中经常报道伽马振荡受损,但宽带和窄带伽马以及β振荡的动态仍未得到充分研究。这些振荡可能作为与皮层动力学改变相关的无创电生理标记,可能反映癫痫中潜在的兴奋-抑制失衡。在此,我们记录了48例癫痫患者(20例女性)和49例儿童(26例女性)的高密度脑电图和脑磁图数据,以研究视觉刺激引发的皮层振荡。我们发现,与对照组相比,癫痫的特征是视觉刺激后诱发皮层反应的振幅降低,潜伏期延长,N1峰和M100、M150和M250组分发生改变(p<0.05)。此外,源成像显示癫痫患者的振荡特征中断,包括视觉皮层诱发和诱导的β和γ振荡的抑制功率、振幅降低和潜伏期增加(p<0.05)。这些改变在不同的癫痫亚型中是一致的,包括局灶性、全身性和非病变性癫痫病例。利用这些差异,我们开发了一种新的分类模型,以高精度区分癫痫患者和对照组,为癫痫诊断提供了潜在的临床应用。我们的研究结果表明,β和γ振荡的中断可能与抑制机制受损和皮层动力学改变有关,可能表明兴奋-抑制失衡。我们的研究结果强调了无创电生理生物标志物在捕捉可能受癫痫兴奋-抑制失衡影响的皮质动力学方面的潜力,支持了它们在早期诊断和疾病监测中的应用。诊断小儿癫痫是具有挑战性的,因为癫痫发作通常表现微妙或模仿良性行为,使脑电图解释复杂化。这强调了对非侵入性神经生理标记物的需求,这些标记物可以表征皮层功能障碍。兴奋-抑制失衡被广泛认为是癫痫病理生理的关键机制,有大量证据表明其与皮层伽马振荡有关。在这里,我们发现了癫痫儿童视觉诱发和诱导的β和γ振荡的一致变化,这可能反映了抑制控制的紊乱和皮层网络动力学的广泛破坏。由这些振荡产生的特征可以很准确地将癫痫与对照区分开来。这些发现表明,视觉刺激相关的电生理特征是帮助儿童癫痫早期诊断和跟踪疾病进展的有希望的生物标志物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Noninvasive Biomarkers for Assessing the Excitatory/Inhibitory Imbalance in Children with Epilepsy.
Epileptic seizures involve a cortical excitation-inhibition imbalance driven by dysfunctional interneurons that contribute to gamma oscillations generation. While impaired gamma oscillations are commonly reported in epilepsy, the dynamics of broadband and narrowband gamma as well as beta oscillations remain underexplored. These oscillations may serve as noninvasive electrophysiological markers associated with altered cortical dynamics, potentially reflecting underlying excitation-inhibition imbalance in epilepsy. Here, we recorded high-density electroencephalography and magnetoencephalography data to investigate visual stimuli-elicited cortical oscillations in 48 neurotypical (20 females) and 49 children (26 females) with epilepsy. We found that epilepsy is characterized by reduced amplitude and prolonged latency of evoked cortical response compared to controls after visual stimulation, with alterations in N1 peaks, and M100, M150, and M250 components (p<0.05). Additionally, source imaging revealed disrupted oscillatory features in epilepsy patients, including suppressed power, reduced amplitude, and increased latency in evoked and induced beta and gamma oscillations from the visual cortex (p<0.05). These alterations were consistent across diverse epilepsy subtypes, including focal, generalized, and non-lesional epilepsy cases. Utilizing these differences, we developed a novel classification model that differentiates individuals with epilepsy from controls with high accuracy, offering potential clinical utility in epilepsy diagnosis. Our results suggest that disrupted beta and gamma oscillations may be associated with impaired inhibitory mechanisms and altered cortical dynamics, potentially indicative of an excitation-inhibition imbalance. Our findings highlight the potential of noninvasive electrophysiological biomarkers to capture cortical dynamics possibly influenced by excitation-inhibition imbalance in epilepsy, supporting their use in early diagnosis and disease monitoring.Significance Statement Diagnosing pediatric epilepsy is challenging as seizures often manifest subtly or mimic benign behaviors, complicating electroencephalogram interpretation. This underscores the need for noninvasive neurophysiological markers that can characterize cortical dysfunction. Excitation-inhibition imbalance is widely recognized as a key mechanism in the pathophysiology of epilepsy, with substantial evidence linking it to cortical gamma oscillations. Here, we identified consistent alterations in visually evoked and induced beta and gamma oscillations in children with epilepsy, which possibly reflect disturbances in inhibitory control and broader disruptions in cortical network dynamics. Features derived from these oscillations distinguished epilepsy from controls with good accuracy. These findings indicate that visual stimulus-related electrophysiological features are promising biomarkers for assisting early diagnosis and tracking disease progression in pediatric epilepsy.
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来源期刊
Journal of Neuroscience
Journal of Neuroscience 医学-神经科学
CiteScore
9.30
自引率
3.80%
发文量
1164
审稿时长
12 months
期刊介绍: JNeurosci (ISSN 0270-6474) is an official journal of the Society for Neuroscience. It is published weekly by the Society, fifty weeks a year, one volume a year. JNeurosci publishes papers on a broad range of topics of general interest to those working on the nervous system. Authors now have an Open Choice option for their published articles
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