| Autor: |
Shraddha Srinivasan, Steven Tobochnik, Guy M. McKhann, Hyunmi Choi, Anil Mendiratta, Cigdem I. Akman, Deepti Anbarasan, Paul F. Kent, Neil A. Feldstein, Lisa M. Bateman, Sameer A. Sheth, Carl W. Bazil, Michelle Bell, Alison M. Pack, Tristan T. Sands, Catherine A. Schevon, Danielle McBrian |
| Rok vydání: |
2021 |
| Předmět: |
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| Zdroj: |
J Clin Neurophysiol |
| ISSN: |
0736-0258 |
| DOI: |
10.1097/wnp.0000000000000833 |
| Popis: |
INTRODUCTION: Spatial patterns of long-range seizure propagation in epileptic networks have not been well characterized. Here, we use ictal high gamma activity as a proxy of intense neuronal population firing to map the spatial evolution of seizure recruitment. METHODS: Ictal high gamma activity (80–150 Hz) was analyzed in 13 patients with 72 seizures recorded by stereotactic depth electrodes, using previously validated methods. Distinct spatial clusters of channels with the ictal high gamma signature were identified, and seizure hubs defined as stereotypically recruited non-overlapping clusters. Clusters were correlated with asynchronous seizure terminations to provide supportive evidence for independent seizure activity at these sites. The spatial overlap between seizure hubs and interictal ripples was compared. RESULTS: Ictal high gamma activity was detected in 71% of seizures and 10% of implanted contacts, enabling tracking of contiguous and noncontiguous seizure recruitment. Multiple seizure hubs were identified in 54% of cases, including 43% of patients thought preoperatively to have unifocal epilepsy. Noncontiguous recruitment was associated with asynchronous seizure termination (Odds ratio=19.7, p=0.029). Interictal ripples demonstrated greater spatial overlap with ictal high gamma activity in cases with single seizure hubs compared to those with multiple hubs (100% vs 66% per patient, p=0.03). CONCLUSIONS: Ictal high gamma activity may serve as a useful adjunctive biomarker to distinguish contiguous seizure spread from propagation to remote seizure sites. High gamma sites were found to cluster in stereotyped seizure hubs rather than being broadly distributed. Multiple hubs were common even in cases that were considered unifocal. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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