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Liu YT, Chen YC, Kwan SY, Chou CC, Yu HY, Yen DJ, Liao KK, Chen WT, Lin YY, Chen RS, Jih KY, Lu SF, Wu YT, Wang PS, Hsiao FJ. Aberrant Sensory Gating of the Primary Somatosensory Cortex Contributes to the Motor Circuit Dysfunction in Paroxysmal Kinesigenic Dyskinesia. Front Neurol 2018; 9:831. [PMID: 30386286 PMCID: PMC6198142 DOI: 10.3389/fneur.2018.00831] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 09/18/2018] [Indexed: 12/19/2022] Open
Abstract
Paroxysmal kinesigenic dyskinesia (PKD) is conventionally regarded as a movement disorder (MD) and characterized by episodic hyperkinesia by sudden movements. However, patients of PKD often have sensory aura and respond excellently to antiepileptic agents. PRRT2 mutations, the most common genetic etiology of PKD, could cause epilepsy syndromes as well. Standing in the twilight zone between MDs and epilepsy, the pathogenesis of PKD is unclear. Gamma oscillations arise from the inhibitory interneurons which are crucial in the thalamocortical circuits. The role of synchronized gamma oscillations in sensory gating is an important mechanism of automatic cortical inhibition. The patterns of gamma oscillations have been used to characterize neurophysiological features of many neurological diseases, including epilepsy and MDs. This study was aimed to investigate the features of gamma synchronizations in PKD. In the paired-pulse electrical-stimulation task, we recorded the magnetoencephalographic data with distributed source modeling and time-frequency analysis in 19 patients of newly-diagnosed PKD without receiving pharmacotherapy and 18 healthy controls. In combination with the magnetic resonance imaging, the source of gamma oscillations was localized in the primary somatosensory cortex. Somatosensory evoked fields of PKD patients had a reduced peak frequency (p < 0.001 for the first and the second response) and a prolonged peak latency (the first response p = 0.02, the second response p = 0.002), indicating the synchronization of gamma oscillation is significantly attenuated. The power ratio between two responses was much higher in the PKD group (p = 0.013), indicating the incompetence of activity suppression. Aberrant gamma synchronizations revealed the defective sensory gating of the somatosensory area contributes the pathogenesis of PKD. Our findings documented disinhibited cortical function is a pathomechanism common to PKD and epilepsy, thus rationalized the clinical overlaps of these two diseases and the therapeutic effect of antiepileptic agents for PKD. There is a greater reduction of the peak gamma frequency in PRRT2-related PKD than the non-PRRT PKD group (p = 0.028 for the first response, p = 0.004 for the second response). Loss-of-function PRRT2 mutations could lead to synaptic dysfunction. The disinhibiton change on neurophysiology reflected the impacts of PRRT2 mutations on human neurophysiology.
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Affiliation(s)
- Yo-Tsen Liu
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Yi-Chieh Chen
- Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan.,Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan
| | - Shang-Yeong Kwan
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chien-Chen Chou
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Hsiang-Yu Yu
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Der-Jen Yen
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Kwong-Kum Liao
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Wei-Ta Chen
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Yung-Yang Lin
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Department of Critical Care Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Rou-Shayn Chen
- Department of Neurology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Kang-Yang Jih
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Shu-Fen Lu
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yu-Te Wu
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan.,Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan
| | - Po-Shan Wang
- Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan.,Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan.,Department of Neurology, Taipei Municipal Gan-Dau Hospital, Taipei, Taiwan
| | - Fu-Jung Hsiao
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan
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Mideksa KG, Santillan-Guzman A, Japaridze N, Galka A, Stephani U, Deuschl G, Heute U, Muthuraman M. Validating the effect of muscle artifact suppression in localizing focal epilepsy. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2015; 2014:3841-4. [PMID: 25570829 DOI: 10.1109/embc.2014.6944461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Source localization of an epileptic seizure is becoming an important diagnostic tool in pre-surgical evaluation of epileptic patients. However, for localizing the epileptogenic zone precisely, the epileptic activity needs to be isolated from other activities that are not related to the epileptic source. In this study, we aim at an investigation of the effect of muscle artifact suppression by using a low-pass filter (LPF), independent component analysis (ICA), and a combination of ICA-LPF prior to source localization in focal epilepsy. These techniques were applied on the EEG data obtained from a left-temporal lobe epileptic patient by artificially contaminating the isolated spike interval, present in the four left-temporal electrodes, with a muscle artifact. The results show that the muscle artifact was fully suppressed. Applying the dipole and current-density reconstruction (CDR) source-analysis algorithms on the filtered data, we were able to identify the location of the epileptogenic zone similar to that of the original undistorted data.
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Mideksa KG, Hellriegel H, Hoogenboom N, Krause H, Schnitzler A, Deuschl G, Raethjen J, Heute U, Muthuraman M. Dipole source analysis for readiness potential and field using simultaneously measured EEG and MEG signals. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2013; 2013:1362-5. [PMID: 24109949 DOI: 10.1109/embc.2013.6609762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Various source localization techniques have indicated the generators of each identifiable component of movement-related cortical potentials, since the discovery of the surface negative potential prior to self-paced movement by Kornhuber and Decke. Readiness potentials and fields preceding self-paced finger movements were recorded simultaneously using multichannel electroencephalography (EEG) and magnetoencephalography (MEG) from five healthy subjects. The cortical areas involved in this paradigm are the supplementary motor area (SMA) (bilateral), pre-SMA (bilateral), and contralateral motor area of the moving finger. This hypothesis is tested in this paper using the dipole source analysis independently for only EEG, only MEG, and both combined. To localize the sources, the forward problem is first solved by using the boundary-element method for realistic head models and by using a locally-fitted-sphere approach for spherical head models consisting of a set of connected volumes, typically representing the scalp, skull, and brain. In the source reconstruction it is to be expected that EEG predominantly localizes radially oriented sources while MEG localizes tangential sources at the desired region of the cortex. The effect of MEG on EEG is also observed when analyzing both combined data. When comparing the two head models, the spherical and the realistic head models showed similar results. The significant points for this study are comparing the source analysis between the two modalities (EEG and MEG) so as to assure that EEG is sensitive to mostly radially orientated sources while MEG is only sensitive to only tangential sources, and comparing the spherical and individual head models.
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