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Chacon LM, Garcia LG, Bosch-Bayard J, García-Ramo KB, Martin MMB, Alfonso MA, Batista SB, de la Paz Bermudez T, González JG, Coroneux AS. Relation of Brain Perfusion Patterns to Sudden Unexpected Death Risk Stratification: A Study in Drug Resistant Focal Epilepsy. Behav Sci (Basel) 2022; 12:207. [PMID: 35877277 PMCID: PMC9311833 DOI: 10.3390/bs12070207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 05/21/2022] [Accepted: 05/31/2022] [Indexed: 11/24/2022] Open
Abstract
To explore the role of the interictal and ictal SPECT to identity functional neuroimaging biomarkers for SUDEP risk stratification in patients with drug-resistant focal epilepsy (DRFE). Twenty-nine interictal-ictal Single photon emission computed tomography (SPECT) scans were obtained from nine DRFE patients. A methodology for the relative quantification of cerebral blood flow of 74 cortical and sub-cortical structures was employed. The optimal number of clusters (K) was estimated using a modified v-fold cross-validation for the use of K means algorithm. The two regions of interest (ROIs) that represent the hypoperfused and hyperperfused areas were identified. To select the structures related to the SUDEP-7 inventory score, a data mining method that computes an automatic feature selection was used. During the interictal and ictal state, the hyperperfused ROIs in the largest part of patients were the bilateral rectus gyrus, putamen as well as globus pallidus ipsilateral to the seizure onset zone. The hypoperfused ROIs included the red nucleus, substantia nigra, medulla, and entorhinal area. The findings indicated that the nearly invariability in the perfusion pattern during the interictal to ictal transition observed in the ipsi-lateral putamen F = 12.60, p = 0.03, entorhinal area F = 25.80, p = 0.01, and temporal middle gyrus F = 12.60, p = 0.03 is a potential biomarker of SUDEP risk. The results presented in this paper allowed identifying hypo- and hyperperfused brain regions during the ictal and interictal state potentially related to SUDEP risk stratification.
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Affiliation(s)
- Lilia Morales Chacon
- International Center for Neurological Restoration, 25th Ave, No 15805, Playa, Havana PC 11300, Cuba; (K.B.G.-R.); (M.M.B.M.); (M.A.A.); (S.B.B.); (T.d.l.P.B.); (J.G.G.); (A.S.C.)
| | - Lidice Galan Garcia
- Cuban Neurosciences Center, 25th Ave, No 15202, Playa, Havana PC 11300, Cuba;
| | - Jorge Bosch-Bayard
- McGill Centre for Integrative Neuroscience, Ludmer Centre for Neuroinformatics and Mental Health, Montreal Neurological Institute, Montreal, QC H3A 0G4, Canada;
| | - Karla Batista García-Ramo
- International Center for Neurological Restoration, 25th Ave, No 15805, Playa, Havana PC 11300, Cuba; (K.B.G.-R.); (M.M.B.M.); (M.A.A.); (S.B.B.); (T.d.l.P.B.); (J.G.G.); (A.S.C.)
| | - Margarita Minou Báez Martin
- International Center for Neurological Restoration, 25th Ave, No 15805, Playa, Havana PC 11300, Cuba; (K.B.G.-R.); (M.M.B.M.); (M.A.A.); (S.B.B.); (T.d.l.P.B.); (J.G.G.); (A.S.C.)
| | - Maydelin Alfonso Alfonso
- International Center for Neurological Restoration, 25th Ave, No 15805, Playa, Havana PC 11300, Cuba; (K.B.G.-R.); (M.M.B.M.); (M.A.A.); (S.B.B.); (T.d.l.P.B.); (J.G.G.); (A.S.C.)
| | - Sheyla Berrillo Batista
- International Center for Neurological Restoration, 25th Ave, No 15805, Playa, Havana PC 11300, Cuba; (K.B.G.-R.); (M.M.B.M.); (M.A.A.); (S.B.B.); (T.d.l.P.B.); (J.G.G.); (A.S.C.)
| | - Tania de la Paz Bermudez
- International Center for Neurological Restoration, 25th Ave, No 15805, Playa, Havana PC 11300, Cuba; (K.B.G.-R.); (M.M.B.M.); (M.A.A.); (S.B.B.); (T.d.l.P.B.); (J.G.G.); (A.S.C.)
| | - Judith González González
- International Center for Neurological Restoration, 25th Ave, No 15805, Playa, Havana PC 11300, Cuba; (K.B.G.-R.); (M.M.B.M.); (M.A.A.); (S.B.B.); (T.d.l.P.B.); (J.G.G.); (A.S.C.)
| | - Abel Sánchez Coroneux
- International Center for Neurological Restoration, 25th Ave, No 15805, Playa, Havana PC 11300, Cuba; (K.B.G.-R.); (M.M.B.M.); (M.A.A.); (S.B.B.); (T.d.l.P.B.); (J.G.G.); (A.S.C.)
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Devergnas A, Wichmann T. Cortical potentials evoked by deep brain stimulation in the subthalamic area. Front Syst Neurosci 2011; 5:30. [PMID: 21625611 PMCID: PMC3097379 DOI: 10.3389/fnsys.2011.00030] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Accepted: 04/29/2011] [Indexed: 11/13/2022] Open
Abstract
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) has been used since the mid-1990s as a treatment for patients with Parkinson's disease, and more recently also in other conditions, such as dystonia or obsessive compulsive disorder. Non-invasive studies of cortical evoked potentials (EPs) that follow individual STN-DBS stimuli has provided us with insights about the conduction of the DBS pulses to the cortex. Such EPs have multiple components of different latencies, making it possible to distinguish short-latency and long-latency responses (3-8 ms and 18-25 ms latency, respectively). The available evidence indicates that these short- and long-latency EPs correspond to conduction from the STN stimulation site to the cortical recording location via anti- and orthodromic pathways, respectively. In this review we survey the literature from recording studies in human patients treated with STN-DBS for Parkinson's disease and other conditions, as well as recent animal studies (including our own) that have begun to elucidate details of the pathways, frequency dependencies, and other features of EPs. In addition, we comment on the possible clinical utility of this knowledge.
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Affiliation(s)
- Annaelle Devergnas
- Wichmann Lab, Division of Neuropharmacology and Neurologic Diseases, Yerkes National Primate Research Center, Emory University Atlanta, GA, USA
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Badawy RAB, Harvey AS, Macdonell RAL. Cortical hyperexcitability and epileptogenesis: Understanding the mechanisms of epilepsy - part 2. J Clin Neurosci 2009; 16:485-500. [PMID: 19230676 DOI: 10.1016/j.jocn.2008.10.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2008] [Accepted: 10/03/2008] [Indexed: 12/19/2022]
Abstract
Epilepsy encompasses a diverse group of seizure disorders caused by a variety of structural, cellular and molecular alterations of the brain primarily affecting the cerebral cortex, leading to recurrent unprovoked epileptic seizures. In this two-part review we examine the mechanisms underlying normal neuronal function and those predisposing to recurrent epileptic seizures starting at the most basic cellular derangements (Part 1, Volume 16, Issue 3) and working up to the highly complex epileptic networks and factors that modulate the predisposition to seizures (Part 2). We attempt to show that multiple factors can modify the epileptic process and that different mechanisms underlie different types of epilepsy, and in most situations there is an interplay between multiple genetic and environmental factors.
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Affiliation(s)
- Radwa A B Badawy
- Department of Neurology, Austin Health, Heidelberg, Victoria, Australia
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