Network signatures define consciousness state during focal seizures.

Autor:	Doss DJ; Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA.; Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Vanderbilt Institute for Surgery and Engineering, Nashville, Tennessee, USA., Johnson GW; Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA.; Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Vanderbilt Institute for Surgery and Engineering, Nashville, Tennessee, USA., Makhoul GS; Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA.; Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Vanderbilt Institute for Surgery and Engineering, Nashville, Tennessee, USA., Rashingkar RV; Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA., Shless JS; Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA., Bibro CE; Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA., Paulo DL; Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA., Gummadavelli A; Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA., Ball TJ; Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA., Reddy SB; Department of Pediatrics, Vanderbilt Children's Hospital, Nashville, Tennessee, USA., Naftel RP; Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA., Haas KF; Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA., Dawant BM; Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA.; Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Vanderbilt Institute for Surgery and Engineering, Nashville, Tennessee, USA.; Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Department of Electrical and Computer Engineering, Vanderbilt University, Nashville, Tennessee, USA., Constantinidis C; Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA.; Vanderbilt Brain Institute, Vanderbilt University, Nashville, Tennessee, USA.; Department of Ophthalmology and Visual Sciences, Vanderbilt University, Nashville, Tennessee, USA., Williams Roberson S; Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA.; Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA., Bick SK; Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA.; Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA., Morgan VL; Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA.; Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Vanderbilt Institute for Surgery and Engineering, Nashville, Tennessee, USA.; Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA., Englot DJ; Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA.; Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Vanderbilt Institute for Surgery and Engineering, Nashville, Tennessee, USA.; Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Department of Electrical and Computer Engineering, Vanderbilt University, Nashville, Tennessee, USA.; Vanderbilt Brain Institute, Vanderbilt University, Nashville, Tennessee, USA.
Jazyk:	angličtina
Zdroj:	Epilepsia [Epilepsia] 2024 Sep; Vol. 65 (9), pp. 2686-2699. Date of Electronic Publication: 2024 Jul 26.
DOI:	10.1111/epi.18074
Abstrakt:	Objective: Epilepsy is a common neurological disorder affecting 1% of the global population. Loss of consciousness in focal impaired awareness seizures (FIASs) and focal-to-bilateral tonic-clonic seizures (FBTCSs) can be devastating, but the mechanisms are not well understood. Although ictal activity and interictal connectivity changes have been noted, the network states of focal aware seizures (FASs), FIASs, and FBTCSs have not been thoroughly evaluated with network measures ictally. Methods: We obtained electrographic data from 74 patients with stereoelectroencephalography (SEEG). Sliding window band power, functional connectivity, and segregation were computed on preictal, ictal, and postictal data. Five-minute epochs of wake, rapid eye movement sleep, and deep sleep were also extracted. Connectivity of subcortical arousal structures was analyzed in a cohort of patients with both SEEG and functional magnetic resonance imaging (fMRI). Given that custom neuromodulation of seizures is predicated on detection of seizure type, a convolutional neural network was used to classify seizure types. Results: We found that in the frontoparietal association cortex, an area associated with consciousness, both consciousness-impairing seizures (FIASs and FBTCSs) and deep sleep had increases in slow wave delta (1-4 Hz) band power. However, when network measures were employed, we found that only FIASs and deep sleep exhibited an increase in delta segregation and a decrease in gamma segregation. Furthermore, we found that only patients with FIASs had reduced subcortical-to-neocortical functional connectivity with fMRI versus controls. Finally, our deep learning network demonstrated an area under the curve of .75 for detecting consciousness-impairing seizures. Significance: This study provides novel insights into ictal network measures in FASs, FIASs, and FBTCSs. Importantly, although both FIASs and FBTCSs result in loss of consciousness, our results suggest that ictal network changes in FIASs uniquely resemble those that occur during deep sleep. Our results may inform novel neuromodulation strategies for preservation of consciousness in epilepsy. (© 2024 The Author(s). Epilepsia published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.)
Databáze:	MEDLINE
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