脑网络理论在癫痫临床中的意义及应用

Brain network theory,the significance and practice in clinical epileptology

约1/3癫痫患者抗癫痫发作药物或外科治疗均不能控制发作,其原因尚不完全了解。目前外科治疗术前定位重点在确定癫痫源区及发作起始区。上世纪90年代网络理论引入神经病学,以全新的角度深入了解发作的发生、扩布和终止。限局性发作影响全脑网络功能,但与全面性发作脑网络的异常的型式不同。脑网络是数学概念,就癫痫而言与治疗有关的是网络的节点和中心。主要算法为图论和联系性。对癫痫网络的理论研究可以深入理解癫痫的的机制,并有助于改进外科治疗的设计,同时切除癫痫源区,发作起始以及异常的中心节点,可以提高疗效。并可预测预后。甚至未来可研制新药修正异常的网络提高疗效。目前脑网络算法很多,临床医师与生物物理专家合作建立标准化,可以广泛应用的算法,是推广应用的必要条件。

Currently,about one-third of patients with anti-epilepsy drug or resective surgery continue to have sezure,the mechanism remin unknown.Up to date,the main target for presurgical evaluation is to determene the EZ and SOZ.Since the early nineties of the last century network theory was introduct into neurology,provide new insights into understanding the onset,propagation and termination.Focal seizure can impact the function of whole brain,but the abnormal pattern is differet to generalized seizure.Brain network is a conception of mathematics.According to the epilepsy,network node and hub are related to the treatment.Graphy theory and connectivity are main algorithms.Understanding the mechanism of epilepsy deeply,since study the theory of epilepsy network,can improve the planning of surgery,resection epileptogenesis zone,seizure onset zone and abnormal node of hub simultaneously,increase the effect of resectiv surgery and predict the surgery outcome.Eventually,develop new drugs for correct the abnormal network and increase the effect.Nowadays,there are many algorithms for the brain network.Cooperative study by the clinicans and biophysicists instituted standard and extensively applied algorithms is the precondition of widely used clinically.