Evidence of thalamocortical network activation during epileptic spasms: A thalamic stereotactic EEG study

作者：Atsuro Daida, Saarang Panchavati, Shingo Oana, Sotaro Kanai, Yipeng Zhang, Yuanyi Ding, Rajaraman R. Rajsekar, Noriko Salamon, Raman Sankar, Aria Fallah, Shaun A. Hussain, Vwani Roychowdhury, William Speier, Hiroki Nariai · 发表于：Epilepsia · 年份：2025 · DOI：10.1111/epi.18349 · 被引用次数：7 · 研究领域：Epilepsy research and treatment、Functional Brain Connectivity Studies、EEG and Brain-Computer Interfaces

OBJECTIVE: Although the role of subcortical structures in the generation of epileptic spasms has been proposed, supporting evidence remains limited. This study aimed to provide neurophysiological evidence of thalamocortical network involvement during epileptic spasms. METHODS: We analyzed four patients (ages 2.7-16.9 years) with epileptic spasms who underwent intracranial electroencephalography (EEG) monitoring with thalamic sampling in preparation for potential neurostimulation. Epileptic spasms were initially assessed using visual inspection and time-frequency analysis. We then evaluated undirected connectivity through coherence analysis and directed connectivity using spectral Granger causality analysis between the thalamus and the seizure-onset zone, focusing on ictal connectivity changes in both slow (0.5-10 Hz) and fast (10-80 Hz) frequency bands. In addition, phase-amplitude coupling was assessed with a modulation index to examine the interaction between ictal slow and fast band activities. RESULTS: A total of 84 epileptic spasms were analyzed. Ictal EEG changes of slow wave complex were visually confirmed in the thalamic channels. There was an increase in signal power in both the slow and fast bands at the thalamus. Undirected (coherence) and directed (spectral Granger causality) connectivity analyses showed a significant increase in connectivity between the thalamus and seizure-onset zone in both the slow and fast bands compared to baseline. Directed connectivity in ...