The Ictal Signature of Thalamus and Basal Ganglia in Focal Epilepsy

作者：Francesca Pizzo, Nicolas Roehri, Bernard Giusiano, Stanislas Lagarde, Romain Carron, Didier Scavarda, Aileen McGonigal, Cristina Filipescu, Isabelle Lambert, Francesca Bonini, Agnès Trébuchon, Christian Bénar, Fabrice Bartoloméi · 发表于：Neurology · 年份：2020 · DOI：10.1212/wnl.0000000000011003 · 被引用次数：133 · 研究领域：Epilepsy research and treatment、EEG and Brain-Computer Interfaces、Functional Brain Connectivity Studies

Objective To determine the involvement of subcortical regions in human epilepsy by analyzing direct recordings from these regions during epileptic seizures using stereo-EEG (SEEG). Methods We studied the SEEG recordings of a large series of patients (74 patients, 157 seizures) with an electrode sampling the thalamus and in some cases also the basal ganglia (caudate nucleus, 22 patients; and putamen, 4 patients). We applied visual analysis and signal quantification methods (Epileptogenicity Index [EI]) to their ictal recordings and compared electrophysiologic with clinical data. Results We found that in 86% of patients, thalamus was involved during seizures (visual analysis) and 20% showed high values of epileptogenicity (EI >0.3). Basal ganglia may also disclose high values of epileptogenicity (9% in caudate nucleus) but to a lesser degree than thalamus (p < 0.01). We observed different seizure onset patterns including low voltage high frequency activities. We found high values of thalamic epileptogenicity in different epilepsy localizations, including opercular and motor epilepsies. We found no difference between epilepsy etiologies (cryptogenic vs malformation of cortical development, p = 0.77). Thalamic epileptogenicity was correlated with the extension of epileptogenic networks (p = 0.02, ρ 0.32). We found a significant effect (p < 0.05) of thalamic epileptogenicity regarding the postsurgical outcome (higher thalamic EI corresponding to higher probability of surgical fail...