同步脑电-功能磁共振成像技术对儿童失神性癫痫的研究

Investigation of Childhood Absence Seizures Based on EEG Correlated fMRI Technology

儿童失神癫痫是一类常见的原发全面性癫痫,表现为无抽搐性的阵发性意识丧失,以及3 Hz左右的头皮脑电全面慢波发放。应用同步记录头皮脑电与功能磁共振(simultaneous electroencephalography-functional magnetic resonance imaging,EEG-fMRI)技术,可以同时从血氧代谢和脑电生理角度对癫痫活动的空间特征进行观察。本研究采用EEG-fMRI技术对3例儿童失神癫痫进行研究,针对特征性的3 Hz失神癫痫波进行功率谱相关设计,发现双侧丘脑呈现出显著的激活信号,而双侧顶下小叶、后扣带回、前扣带回、角回、颞中回等默认网络区域呈现出显著的负激活。结果提示丘脑可能是失神性癫痫活动的起源区,而广泛的皮层功能抑制则可能是失神性癫痫意识丧失的神经病理生理基础。

Typical childhood absence seizures consist of brief impairments of consciousness with characteristic bilaterally synchronous 3 Hz generalized spike-wave discharges（GSWD） on electroencephalography（EEG）.Simultanoeus EEG-FMRI allows us observing the epileptic activation from haemodynamic and electrophysiological aspects.In present study,three patients with typical childhood absence seizures were studied using EEG-FMRI with 3 Hz epileptic wave power spectrum analysis.Significant activation was found in the bilateral thalamus,while the significant deactivation was found to be widely distributed within the bilateral parietal lobe,posterior cingulate cortex,angular gyrus,and middle temporal lobe etc.The findings suggest that the thalamus may be the origin of epileptic activation,and the widely cortical functional inhibition may underlie the neuron-pathophysiological manchnism of impairments of consciousness in typical childhood absence seizures.