Engagement of cortico-cortical and cortico-subcortical networks in a patient with epileptic spasms: An integrated neurophysiological study期刊界 All Journals 搜尽天下杂志传播学术成果专业期刊搜索期刊信息化学术搜索

Engagement of cortico-cortical and cortico-subcortical networks in a patient with epileptic spasms: An integrated neurophysiological study

Affiliation:	1. Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan;2. Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan;3. Department of Clinical Laboratory, Kyoto University Hospital, Kyoto, Japan;4. Department of Respiratory Care and Sleep Control Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan;5. Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine, Kyoto, Japan;6. Human Brain Research Center, Kyoto University Graduate School of Medicine, Japan

Abstract:	ObjectiveWe aimed to delineate the engagement of cortico-cortical and cortico-subcortical networks in the generation of epileptic spasms (ES) using integrated neurophysiological techniques.MethodsSeventeen-year-old male patient with intractable ES underwent chronic subdural electrode implantation for presurgical evaluation. Networks were evaluated in ictal periods using high-frequency oscillation (HFO) analysis and in interictal periods using magnetoencephalography (MEG) and simultaneous electroencephalography, and functional magnetic resonance imaging (EEG-fMRI). Cortico-cortical evoked potentials (CCEPs) were recorded to trace connections among the networks.ResultsIctal HFO revealed a network comprising multilobar cortical regions (frontal, parietal, and temporal), but sparing the positive motor area. Interictally, MEG and EEG-fMRI revealed spike-and-wave-related activation in these cortical regions. Analysis of CCEPs provided evidence of connectivity within the cortico-cortical network. Additionally, EEG-fMRI results indicate the involvement of subcortical structures, such as bilateral thalamus (predominantly right) and midbrain.ConclusionsIn this case study, integrated neurophysiological techniques provided converging evidence for the involvement of a cortico-cortical network (sparing the positive motor area) and a cortico-subcortical network in the generation of ES in the patient.SignificanceCortico-cortical and cortico-subcortical pathways, with the exception of the direct descending corticospinal pathway from the positive motor area, may play important roles in the generation of ES.

Keywords:	Epileptic spasm High frequency oscillation Cortico-cortical evoked potential EEG with functional MRI (EEG-fMRI) ES"} {"#name":"keyword" "$":{"id":"k0030"} "$$":[{"#name":"text" "_":"epileptic spasms HFO"} {"#name":"keyword" "$":{"id":"k0040"} "$$":[{"#name":"text" "_":"high-frequency oscillation EMG"} {"#name":"keyword" "$":{"id":"k0050"} "$$":[{"#name":"text" "_":"electromyogram CCEP"} {"#name":"keyword" "$":{"id":"k0060"} "$$":[{"#name":"text" "_":"cortico-cortical evoked potential ECoG"} {"#name":"keyword" "$":{"id":"k0070"} "$$":[{"#name":"text" "_":"electrocorticogram EEG-fMRI"} {"#name":"keyword" "$":{"id":"k0080"} "$$":[{"#name":"text" "_":"EEG with functional MRI BOLD"} {"#name":"keyword" "$":{"id":"k0090"} "$$":[{"#name":"text" "_":"blood-oxygen-level-dependent PMA"} {"#name":"keyword" "$":{"id":"k0100"} "$$":[{"#name":"text" "_":"positive motor area STFT"} {"#name":"keyword" "$":{"id":"k0110"} "$$":[{"#name":"text" "_":"short-time Fourier transform IPL"} {"#name":"keyword" "$":{"id":"k0120"} "$$":[{"#name":"text" "_":"inferior parietal lobule CST"} {"#name":"keyword" "$":{"id":"k0130"} "$$":[{"#name":"text" "_":"corticospinal tract CRT"} {"#name":"keyword" "$":{"id":"k0140"} "$$":[{"#name":"text" "_":"corticoreticular tract RST"} {"#name":"keyword" "$":{"id":"k0150"} "$$":[{"#name":"text" "_":"reticulospinal tract
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