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Steinbrenner M, McDowell A, Centeno M, Moeller F, Perani S, Lorio S, Maziero D, Carmichael DW. Camera-based Prospective Motion Correction in Paediatric Epilepsy Patients Enables EEG-fMRI Localization Even in High-motion States. Brain Topogr 2023; 36:319-337. [PMID: 36939987 PMCID: PMC10164016 DOI: 10.1007/s10548-023-00945-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 02/14/2023] [Indexed: 03/21/2023]
Abstract
BACKGROUND EEG-fMRI is a useful additional test to localize the epileptogenic zone (EZ) particularly in MRI negative cases. However subject motion presents a particular challenge owing to its large effects on both MRI and EEG signal. Traditionally it is assumed that prospective motion correction (PMC) of fMRI precludes EEG artifact correction. METHODS Children undergoing presurgical assessment at Great Ormond Street Hospital were included into the study. PMC of fMRI was done using a commercial system with a Moiré Phase Tracking marker and MR-compatible camera. For retrospective EEG correction both a standard and a motion educated EEG artefact correction (REEGMAS) were compared to each other. RESULTS Ten children underwent simultaneous EEG-fMRI. Overall head movement was high (mean RMS velocity < 1.5 mm/s) and showed high inter- and intra-individual variability. Comparing motion measured by the PMC camera and the (uncorrected residual) motion detected by realignment of fMRI images, there was a five-fold reduction in motion from its prospective correction. Retrospective EEG correction using both standard approaches and REEGMAS allowed the visualization and identification of physiological noise and epileptiform discharges. Seven of 10 children had significant maps, which were concordant with the clinical EZ hypothesis in 6 of these 7. CONCLUSION To our knowledge this is the first application of camera-based PMC for MRI in a pediatric clinical setting. Despite large amount of movement PMC in combination with retrospective EEG correction recovered data and obtained clinically meaningful results during high levels of subject motion. Practical limitations may currently limit the widespread use of this technology.
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Affiliation(s)
- Mirja Steinbrenner
- School of Biomedical Engineering and Imaging Sciences, King's College London, St. Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK.,Department of Neurology and Experimental Neurology, Epilepsy Center Berlin-Brandenburg, Charité-Universitätsmedizin Berlin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Amy McDowell
- Developmental Imaging and Biophysics, UCL Institute of Child Health, University College London, 30 Guilford St, London, WC1N 1EH, UK
| | - Maria Centeno
- Developmental Imaging and Biophysics, UCL Institute of Child Health, University College London, 30 Guilford St, London, WC1N 1EH, UK.,Epilepsy Unit, Neurology Department, Hospital Clinic Barcelona/IDIBAPS, Villarroel 170., Barcelona, 08036, Spain
| | - Friederike Moeller
- Department of Clinical Neurophysiology, Great Ormond Street Hospital, Great Ormond Street, London, WC1N 3JH, UK
| | - Suejen Perani
- Department of Basic and Clinical Neuroscience, KCL Institute of Psychiatry, Psychology & Neuroscience, 16 De Crespigny Park, London, SE5 8AF, UK
| | - Sara Lorio
- School of Biomedical Engineering and Imaging Sciences, King's College London, St. Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Danilo Maziero
- Department of Radiation Medicine & Applied Sciences, University of California, San Diego Health, San Diego, CA, USA
| | - David W Carmichael
- School of Biomedical Engineering and Imaging Sciences, King's College London, St. Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK. .,Developmental Imaging and Biophysics, UCL Institute of Child Health, University College London, 30 Guilford St, London, WC1N 1EH, UK.
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2
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Maki Y, Natsume J, Ito Y, Okai Y, Bagarinao E, Yamamoto H, Ogaya S, Takeuchi T, Fukasawa T, Sawamura F, Mitsumatsu T, Maesawa S, Saito R, Takahashi Y, Kidokoro H. Involvement of the Thalamus, Hippocampus, and Brainstem in Hypsarrhythmia of West Syndrome: Simultaneous Recordings of Electroencephalography and fMRI Study. AJNR Am J Neuroradiol 2022; 43:1502-1507. [PMID: 36137665 PMCID: PMC9575537 DOI: 10.3174/ajnr.a7646] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 07/27/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND AND PURPOSE West syndrome is a developmental and epileptic encephalopathy characterized by epileptic spasms, neurodevelopmental regression, and a specific EEG pattern called hypsarrhythmia. Our aim was to investigate the brain activities related to hypsarrhythmia at onset and focal epileptiform discharges in the remote period in children with West syndrome using simultaneous electroencephalography and fMRI recordings. MATERIALS AND METHODS Fourteen children with West syndrome underwent simultaneous electroencephalography and fMRI at the onset of West syndrome. Statistically significant blood oxygen level-dependent responses related to hypsarrhythmia were analyzed using an event-related design of 4 hemodynamic response functions with peaks at 3, 5, 7, and 9 seconds after the onset of each event. Six of 14 children had focal epileptiform discharges after treatment and underwent simultaneous electroencephalography and fMRI from 12 to 25 months of age. RESULTS At onset, positive blood oxygen level-dependent responses were seen in the brainstem (14/14 patients), thalami (13/14), basal ganglia (13/14), and hippocampi (13/14), in addition to multiple cerebral cortices. Group analysis using hemodynamic response functions with peaks at 3, 5, and 7 seconds showed positive blood oxygen level-dependent responses in the brainstem, thalamus, and hippocampus, while positive blood oxygen level-dependent responses in multiple cerebral cortices were seen using hemodynamic response functions with peaks at 5 and 7 seconds. In the remote period, 3 of 6 children had focal epileptiform discharge-related positive blood oxygen level-dependent responses in the thalamus, hippocampus, and brainstem. CONCLUSIONS Positive blood oxygen level-dependent responses with hypsarrhythmia appeared in the brainstem, thalamus, and hippocampus on earlier hemodynamic response functions than the cerebral cortices, suggesting the propagation of epileptogenic activities from the deep brain structures to the neocortices. Activation of the hippocampus, thalamus, and brainstem was still seen in half of the patients with focal epileptiform discharges after adrenocorticotropic hormone therapy.
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Affiliation(s)
- Y Maki
- From the Departments of Pediatrics (Y.M., J.N., Y.I., Y.O., H.Y., F.S., T.M., Y.T., H.K.)
| | - J Natsume
- From the Departments of Pediatrics (Y.M., J.N., Y.I., Y.O., H.Y., F.S., T.M., Y.T., H.K.)
- Developmental Disability Medicine (J.N.)
- Brain and Mind Research Center (J.N., Y.I., Y.O., E.B., H.Y., S.M., H.K.), Nagoya University, Nagoya, Japan
| | - Y Ito
- From the Departments of Pediatrics (Y.M., J.N., Y.I., Y.O., H.Y., F.S., T.M., Y.T., H.K.)
- Brain and Mind Research Center (J.N., Y.I., Y.O., E.B., H.Y., S.M., H.K.), Nagoya University, Nagoya, Japan
- Department of Pediatrics (Y.I.), Aichi Prefectural Mikawa Aoitori Medical and Rehabilitation Center, Okazaki, Japan
| | - Y Okai
- From the Departments of Pediatrics (Y.M., J.N., Y.I., Y.O., H.Y., F.S., T.M., Y.T., H.K.)
- Brain and Mind Research Center (J.N., Y.I., Y.O., E.B., H.Y., S.M., H.K.), Nagoya University, Nagoya, Japan
- Department of Pediatric Neurology (Y.O.), Toyota Municipal Child Development Center, Toyota, Japan
| | - E Bagarinao
- Brain and Mind Research Center (J.N., Y.I., Y.O., E.B., H.Y., S.M., H.K.), Nagoya University, Nagoya, Japan
| | - H Yamamoto
- From the Departments of Pediatrics (Y.M., J.N., Y.I., Y.O., H.Y., F.S., T.M., Y.T., H.K.)
- Brain and Mind Research Center (J.N., Y.I., Y.O., E.B., H.Y., S.M., H.K.), Nagoya University, Nagoya, Japan
| | - S Ogaya
- Department of Pediatric Neurology (S.O.), Aichi Developmental Disability Center Central Hospital, Kasugai, Japan
| | - T Takeuchi
- Department of Pediatrics (T.T.), Japanese Red Cross Nagoya First Hospital
| | - T Fukasawa
- Nagoya, Japan; and Department of Pediatrics (T.F.), Anjo Kosei Hospital, Anjo, Japan
| | - F Sawamura
- From the Departments of Pediatrics (Y.M., J.N., Y.I., Y.O., H.Y., F.S., T.M., Y.T., H.K.)
| | - T Mitsumatsu
- From the Departments of Pediatrics (Y.M., J.N., Y.I., Y.O., H.Y., F.S., T.M., Y.T., H.K.)
| | - S Maesawa
- Neurosurgery (S.M., R.S.), Nagoya University Graduate School of Medicine, Nagoya, Japan
- Brain and Mind Research Center (J.N., Y.I., Y.O., E.B., H.Y., S.M., H.K.), Nagoya University, Nagoya, Japan
| | - R Saito
- Neurosurgery (S.M., R.S.), Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Y Takahashi
- From the Departments of Pediatrics (Y.M., J.N., Y.I., Y.O., H.Y., F.S., T.M., Y.T., H.K.)
| | - H Kidokoro
- From the Departments of Pediatrics (Y.M., J.N., Y.I., Y.O., H.Y., F.S., T.M., Y.T., H.K.)
- Brain and Mind Research Center (J.N., Y.I., Y.O., E.B., H.Y., S.M., H.K.), Nagoya University, Nagoya, Japan
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Li X, Zhang H, Lai H, Wang J, Wang W, Yang X. High-Frequency Oscillations and Epileptogenic Network. Curr Neuropharmacol 2022; 20:1687-1703. [PMID: 34503414 PMCID: PMC9881061 DOI: 10.2174/1570159x19666210908165641] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 08/26/2021] [Accepted: 08/31/2021] [Indexed: 11/22/2022] Open
Abstract
Epilepsy is a network disease caused by aberrant neocortical large-scale connectivity spanning regions on the scale of several centimeters. High-frequency oscillations, characterized by the 80-600 Hz signals in electroencephalography, have been proven to be a promising biomarker of epilepsy that can be used in assessing the severity and susceptibility of epilepsy as well as the location of the epileptogenic zone. However, the presence of a high-frequency oscillation network remains a topic of debate as high-frequency oscillations have been previously thought to be incapable of propagation, and the relationship between high-frequency oscillations and the epileptogenic network has rarely been discussed. Some recent studies reported that high-frequency oscillations may behave like networks that are closely relevant to the epileptogenic network. Pathological highfrequency oscillations are network-driven phenomena and elucidate epileptogenic network development; high-frequency oscillations show different characteristics coincident with the epileptogenic network dynamics, and cross-frequency coupling between high-frequency oscillations and other signals may mediate the generation and propagation of abnormal discharges across the network.
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Affiliation(s)
- Xiaonan Li
- Bioland Laboratory, Guangzhou, China; ,Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China
| | | | | | - Jiaoyang Wang
- Bioland Laboratory, Guangzhou, China; ,Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China
| | - Wei Wang
- Bioland Laboratory, Guangzhou, China; ,Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China
| | - Xiaofeng Yang
- Bioland Laboratory, Guangzhou, China; ,Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China,Address correspondence to this author at the Bioland Laboratory, Guangzhou, China; Tel: 86+ 18515855127; E-mail:
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Ikemoto S, von Ellenrieder N, Gotman J. EEG-fMRI of epileptiform discharges: non-invasive investigation of the whole brain. Epilepsia 2022; 63:2725-2744. [PMID: 35822919 DOI: 10.1111/epi.17364] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 07/08/2022] [Accepted: 07/11/2022] [Indexed: 02/01/2023]
Abstract
Simultaneous EEG-fMRI is a unique and non-invasive method for investigating epileptic activity. Interictal epileptiform discharge-related EEG-fMRI provides cortical and subcortical blood oxygen level-dependent (BOLD) signal changes specific to epileptic discharges. As a result, EEG-fMRI has revealed insights into generators and networks involved in epileptic activity in different types of epilepsy, demonstrating-for instance-the implication of the thalamus in human generalized spike and wave discharges and the role of the Default Mode Network (DMN) in absences and focal epilepsy, and proposed a mechanism for the cortico-subcortical interactions in Lennox-Gastaut syndrome discharges. EEG-fMRI can find deep sources of epileptic activity not available to scalp EEG or MEG and provides critical new information to delineate the epileptic focus when considering surgical treatment or electrode implantation. In recent years, methodological advances, such as artifact removal and automatic detection of events have rendered this method easier to implement, and its clinical potential has since been established by evidence of the impact of BOLD response on clinical decision-making and of the relationship between concordance of BOLD responses with extent of resection and surgical outcome. This review presents the recent developments in EEG-fMRI methodology and EEG-fMRI studies in different types of epileptic disorders as follows: EEG-fMRI acquisition, gradient and pulse artifact removal, statistical analysis, clinical applications, pre-surgical evaluation, altered physiological state in generalized genetic epilepsy, and pediatric EEG-fMRI studies.
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Affiliation(s)
- Satoru Ikemoto
- Montreal Neurological Institute and Hospital, 3801 Rue University, Montreal, QC, Canada.,The Jikei University School of Medicine, Department of Pediatrics, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, Japan
| | | | - Jean Gotman
- Montreal Neurological Institute and Hospital, 3801 Rue University, Montreal, QC, Canada
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Sadjadi SM, Ebrahimzadeh E, Shams M, Seraji M, Soltanian-Zadeh H. Localization of Epileptic Foci Based on Simultaneous EEG-fMRI Data. Front Neurol 2021; 12:645594. [PMID: 33986718 PMCID: PMC8110922 DOI: 10.3389/fneur.2021.645594] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 03/11/2021] [Indexed: 02/01/2023] Open
Abstract
Combining functional magnetic resonance imaging (fMRI) and electroencephalography (EEG) enables a non-invasive investigation of the human brain function and evaluation of the correlation of these two important modalities of brain activity. This paper explores recent reports on using advanced simultaneous EEG–fMRI methods proposed to map the regions and networks involved in focal epileptic seizure generation. One of the applications of EEG and fMRI combination as a valuable clinical approach is the pre-surgical evaluation of patients with epilepsy to map and localize the precise brain regions associated with epileptiform activity. In the process of conventional analysis using EEG–fMRI data, the interictal epileptiform discharges (IEDs) are visually extracted from the EEG data to be convolved as binary events with a predefined hemodynamic response function (HRF) to provide a model of epileptiform BOLD activity and use as a regressor for general linear model (GLM) analysis of the fMRI data. This review examines the methodologies involved in performing such studies, including techniques used for the recording of EEG inside the scanner, artifact removal, and statistical analysis of the fMRI signal. It then discusses the results reported for patients with primary generalized epilepsy and patients with different types of focal epileptic disorders. An important matter that these results have brought to light is that the brain regions affected by interictal epileptic discharges might not be limited to the ones where they have been generated. The developed methods can help reveal the regions involved in or affected by a seizure onset zone (SOZ). As confirmed by the reviewed literature, EEG–fMRI provides information that comes particularly useful when evaluating patients with refractory epilepsy for surgery.
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Affiliation(s)
- Seyyed Mostafa Sadjadi
- Control and Intelligent Processing Center of Excellence (CIPCE), School of Electrical and Computer Engineering, College of Engineering, University of Tehran, Tehran, Iran
| | - Elias Ebrahimzadeh
- Control and Intelligent Processing Center of Excellence (CIPCE), School of Electrical and Computer Engineering, College of Engineering, University of Tehran, Tehran, Iran.,Neuroimage Signal and Image Analysis Group, School of Cognitive Sciences, Institute for Research in Fundamental Sciences (IPM), Tehran, Iran
| | - Mohammad Shams
- Neural Engineering Laboratory, Department of Electrical and Computer Engineering, George Mason University, Fairfax, VA, United States
| | - Masoud Seraji
- Center for Molecular and Behavioral Neuroscience, Rutgers University, Newark, NJ, United States.,Behavioral and Neural Sciences Graduate Program, Rutgers University, Newark, NJ, United States
| | - Hamid Soltanian-Zadeh
- Control and Intelligent Processing Center of Excellence (CIPCE), School of Electrical and Computer Engineering, College of Engineering, University of Tehran, Tehran, Iran.,Neuroimage Signal and Image Analysis Group, School of Cognitive Sciences, Institute for Research in Fundamental Sciences (IPM), Tehran, Iran.,Medical Image Analysis Laboratory, Departments of Radiology and Research Administration, Henry Ford Health System, Detroit, MI, United States
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Ueda R, Kaga Y, Takeichi H, Iwasaki M, Takeshita E, Shimizu-Motohashi Y, Ishiyama A, Saito T, Nakagawa E, Sugai K, Sasaki M, Inagaki M. Association between lack of functional connectivity of the frontal brain region and poor response inhibition in children with frontal lobe epilepsy. Epilepsy Behav 2020; 113:107561. [PMID: 33232894 DOI: 10.1016/j.yebeh.2020.107561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 10/07/2020] [Accepted: 10/07/2020] [Indexed: 11/19/2022]
Abstract
PURPOSE We investigated the relationship between electroencephalographic (EEG) functional connectivity and executive function in children with frontal lobe epilepsy (FLE). METHODS We enrolled 24 children with FLE (mean age, 11.0 years; 13 boys) and 22 sex-, age-, and intelligence-matched typically developing children (TDC) to undergo 19-channel EEG during light sleep. We estimated functional connectivity using the phase lag index (PLI) that captures the synchronization of EEG. We also performed continuous performance tests (CPTs) on the children and obtained questionnaire responses on attention deficit hyperactivity disorder and oppositional defiant disorder (ODD). RESULTS The average gamma PLI was lower in the FLE group than in the TDC group, especially between long-distance frontoparietal pairs, between interhemispheric frontal pairs, and between interhemispheric parietotemporal pairs. Gamma PLIs with long-distance frontoparietal and interhemispheric frontal pairs were positively associated with inattention, ODD scores, omission error, and reaction time in the FLE group but not in the TDC group. Conversely, they were negatively associated with age, hyperactivity score, and commission error. CONCLUSIONS A lack of functional connectivity of the frontal brain regions in children with FLE was associated with poor response inhibition.
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Affiliation(s)
- Riyo Ueda
- Department of Developmental Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8553, Japan.
| | - Yoshimi Kaga
- Department of Developmental Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8553, Japan.
| | - Hiroshige Takeichi
- Department of Developmental Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8553, Japan.
| | - Masaki Iwasaki
- Department of Neurosurgery, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8551, Japan.
| | - Eri Takeshita
- Department of Child Neurology, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira 187-8551, Tokyo, Japan.
| | - Yuko Shimizu-Motohashi
- Department of Child Neurology, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira 187-8551, Tokyo, Japan.
| | - Akihiko Ishiyama
- Department of Child Neurology, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira 187-8551, Tokyo, Japan.
| | - Takashi Saito
- Department of Child Neurology, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira 187-8551, Tokyo, Japan.
| | - Eiji Nakagawa
- Department of Child Neurology, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira 187-8551, Tokyo, Japan.
| | - Kenji Sugai
- Department of Child Neurology, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira 187-8551, Tokyo, Japan.
| | - Masayuki Sasaki
- Department of Child Neurology, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira 187-8551, Tokyo, Japan.
| | - Masumi Inagaki
- Department of Developmental Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8553, Japan.
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7
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Leng X, Xiang J, Yang Y, Yu T, Qi X, Zhang X, Wu S, Wang Y. Frequency-specific changes in the default mode network in patients with cingulate gyrus epilepsy. Hum Brain Mapp 2020; 41:2447-2459. [PMID: 32096905 PMCID: PMC7268086 DOI: 10.1002/hbm.24956] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 11/25/2019] [Accepted: 02/11/2020] [Indexed: 12/13/2022] Open
Abstract
To identify abnormal functional connectivity of the default mode network in cingulate gyrus epilepsy, which may yield new information about the default mode network and suggest a new cingulate gyrus epilepsy biomarker. Fifteen patients with cingulate gyrus epilepsy (mean age = 21 years) and 15 healthy controls (mean age = 24 years) were studied in the resting state using magnetoencephalography. Twelve brain areas of interest in the default mode network were extracted and investigated with multifrequency signals that included alpha (α, 8–13 Hz), beta (β, 14–30 Hz), and gamma (γ, 31–80 Hz) band oscillations. Patients with cingulate gyrus epilepsy had significantly greater connectivity in all three frequency bands (α, β, γ). A frequency‐specific elevation of functional connectivity was found in patients compared to controls. The greater functional connectivity in the γ band was significantly more prominent than that of the α and β bands. Patients with cingulate gyrus epilepsy and controls differed significantly in functional connectivity between the left angular gyrus and left posterior cingulate cortex in the α, β, and γ bands. The results of the node degree analysis were similar to those of the functional connectivity analysis. Our findings reveal for the first time that brain activity in the γ band may play a key role in the default mode network in cingulate gyrus epilepsy. Altered functional connectivity of the left angular gyrus and left posterior cingulate cortex may be a new biomarker for cingulate gyrus epilepsy.
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Affiliation(s)
- Xuerong Leng
- Department of Pediatrics, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Jing Xiang
- MEG Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Yingxue Yang
- Department of Neurology, Xuanwu Hospital Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neuromodulation, Beijing, China.,Center of Epilepsy, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China
| | - Tao Yu
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xiaohong Qi
- Department of Pediatrics, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Xiating Zhang
- Department of Neurology, Xuanwu Hospital Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neuromodulation, Beijing, China.,Center of Epilepsy, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China
| | - Siqi Wu
- Department of Neurology, Xuanwu Hospital Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neuromodulation, Beijing, China.,Center of Epilepsy, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China
| | - Yuping Wang
- Department of Neurology, Xuanwu Hospital Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neuromodulation, Beijing, China.,Center of Epilepsy, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China
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Cao J, Lin XX, Ma XM, Liu H. The efficacy and safety of lamotrigine for absence seizures in children and adolescents: A systematic review and meta-analysis. J Clin Neurosci 2019; 71:199-204. [PMID: 31466903 DOI: 10.1016/j.jocn.2019.08.043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 08/05/2019] [Indexed: 11/28/2022]
Abstract
AIMS This systematic review and meta-analysis of randomized controlled trials (RCTs) systematically explored the effectiveness and safety of lamotrigine for absence seizures in children and adolescents. METHODS Keywords searches were conducted in Pubmed Embase Cochrane Central Register of Controlled Trials Wanfang CNKI from inception through March 2019. The RCTs comparing lamotrigine with other drugs and/or placebo for the treatment of absence seizures in children and adolescents were considered in this study. The study was conducted adhering to PRISMA guidelines. RESULTS Eight RCTs (n = 787) were included in our study. Among these studies, one study (N = 45 patients) used placebo as a control and seven studies (N = 742 patients) used positive drug controls. For effectiveness, there was significant difference between lamotrigine and valproate [OR = 0.42, 95%CI (0.28-0.63), I2 = 0%] or ethosuximide [OR = 0.34, 95%CI (0.22-0.53), I2 = 0%]. For adverse effects (AEs), there was no significant difference between lamotrigine and valproate [OR = 1.17, 95%CI (0.59, 2.32), I2 = 0%] or ethosuximide [OR = 0.75, 95%CI (0.47, 1.19), I2 = 92%], and the most common adverse effects of lamotrigine were Rash (7.88%), Fatigue (6.50%) and Headache (6.50%). CONCLUSIONS According to current evidence, LTG is less effective than VPA and ESM, however, based on its relative safety, LTG might be reasonably tried as initial therapy in children and adolescents at risk of significant adverse effects from VPA and ESM, and future well-designed studies are needed to confirm our findings.
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Affiliation(s)
- Jing Cao
- Department of Traditional Chinese Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiao-Xiao Lin
- Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China; Nanjing Medical University, Nanjing, China
| | | | - Huanzhong Liu
- Chaohu Hospital of Anhui Medical University, Anhui, China.
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