神经动力学时变网络分析在癫痫诊治的评价作用  

Evaluation role of neurodynamic time-varying network analysis in the diagnosis and treatment of epilepsy

作　　者：罗娟 陈欣 余思逊 树海峰 Luo Juan;Chen Xin;Yu Sixun;Shu Haifeng(Department of Neurosurgery.Affiliated Hospital of Southwest Medical University,Luzhou,Sichuan 646000,China;Department of Neurosurgery,General Hospital of the Western Theater Command,Chengdu,Sichuan 610083,China)

机构地区：[1]西南医科大学附属医院神经外科,四川泸州646000 [2]西部战区总医院神经外科,四川成都610083

出　　处：《中国微侵袭神经外科杂志》2024年第6期331-339,共9页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的探讨基于神经动力学的时变网络分析方法在难治性癫痫(refractory epilepsy,RE)患者的术前评估及预后判断的作用。方法回顾性分析18例RE病例资料,研究同步化和非同步化的立体定向脑电图(stereotactic electroencephalogra‐phy,SEEG)数据;18例RE患者接受术前多模态评估后均行射频热凝治疗。结果SEEG同步化与非同步化指标呈现相反趋势。同步化与非同步化的受试者工作特征(receiver operating characteristic,ROC)曲线以及曲线下面积(area under the curve,AUC)结果提示:从癫痫发作前进入到癫痫发作状态时,随着致痫区同侧同步性增加,非同步性会相对减弱;随着致痫区同侧同步性减弱,非同步性会增加。随访3~18个月,经过射频热凝治疗的RE患者,随着致痫区同侧的非同步化活动增强,同步化活动减弱,预后会更好;随着致痫区同侧的同步化活动增强,非同步化活动减弱,预后会变差。结论根据神经动力学时变网络分析方法得到致痫区同步化和非同步化活动强弱变化,以此确定射频热凝靶点,能极大程度改善患者预后。Objective To explore the role of time-varying network analysis based on neurodynamics in the preoperative assessment and prognosis prediction for patients with refractory epilepsy(RE).Methods The clinical data of 18 patients with RE were analyzed retrospectively.Synchronized and desynchronized stereotactic electroencephalography(SEEG)data were studied.All the 18 patients with RE underwent radiofrequency thermocoagulation(RF-TC)treatment after preoperative multimodal assessment.Results SEEG synchronization and desynchronization indices showed opposite trends.The results of receiver operating characteristic(ROC)curve and area under the curve(AUC)for synchronization and desynchronization indicated that as the ipsilateral synchrony of the epileptogenic zone increases when transitioning from pre-seizure to seizure state,desynchronization will relatively weaken;as the ipsilateral synchrony of the epileptogenic zone weakens,desynchronization will increase.During the 3-18 months of follow-up,patients with RE who underwent RF-TC showed improved prognosis with increase of desynchronized activity on the ipsilateral side of the epileptogenic zone and decrease of synchronized activity.Conversely,prognosis worsened with increase of synchronized activity on the ipsilateral side of the epileptogenic zone and decrease of desynchronized activity.Conclusions Determination of RF-TC targets based on the changes in synchronization and desynchronization activities in the epileptogenic zone,as derived from the time-varying network analysis method based on neurodynamics,can significantly improve patient prognosis.

关 键 词：癫痫 难治性 立体定向脑电图 时变网络分析 同步化 

分 类 号：R742.1[医药卫生—神经病学与精神病学]