丙泊酚对成年癫痫患者左侧大脑新皮质与边缘系统立体定向脑电图的影响  

Effect of propofol on the stereotactic electroencephalography of the left cerebral neocortex and limbic system in adult patients with epilepsy

作　　者：张蕊[1] 谢致 郭辉[2] 龚德山 陆月梅 王军[1] 周旭卿 ZHANG Rui;XIE Zhi;GUO Hui;GONG Deshan;LU Yuemei;WANG Jun;ZHOU Xuqing(Department of Anesthesiology,Shanghai Deji Hospital,Qingdao University,Shanghai 200331,China)

机构地区：[1]青岛大学上海临床医学院,上海德济医院麻醉科,上海200331 [2]青岛大学上海临床医学院,上海德济医院神经外科,上海200331 [3]青岛大学上海临床医学院,上海德济医院神经电生理中心,上海200331

出　　处：《精准医学杂志》2024年第6期509-513,共5页Journal of Precision Medicine

基　　金：上海市卫生健康委员会科研课题(202040069)。

摘　　要：目的探究不同效应室浓度丙泊酚对成年癫痫患者左侧大脑新皮质与边缘系统立体定向脑电图(SEEG)的影响。方法选择2021年1月—2022年12月于我院癫痫外科行机器人立体定向辅助左侧颅内电极植入术后择期电极拔除的患者14例,根据植入电极位置将患者分为新皮质组和边缘系统组,记录并比较两组患者术中丙泊酚效应室浓度分别为0、2、3、4、5 mg/L(后简称D1~D5浓度)时SEEG的δ、θ、α、β、γ波各波段功率范围和功率百分比,以及δ-γ、θ-γ、α-γ、β-γ相位幅度耦合(PAC)的调制指数(MI)。结果D2~D5浓度时,边缘系统组和新皮质组患者立体定向脑电图γ波功率范围显著低于D1浓度时(F=15.13、20.33,t=4.33~8.72,P<0.05);D3浓度时,边缘系统组患者α波功率百分比显著高于D1、D2浓度时(F=23.38,t=5.52、9.38,P<0.05);D3~D5浓度时,边缘组患者θ-γ、α-γPAC MI均显著低于D1浓度时(F=13.64、18.77,t=7.62~17.68,P<0.05)。结论丙泊酚可以引发成年癫痫患者左侧大脑新皮质及边缘系统的SEEGγ波功率范围降低以及边缘系统SEEGθ-γ、α-γ的PAC降低。Objective To investigate the effect of different effect compartment concentrations of propofol on the ste-reotactic electroencephalography(SEEG)of the left cerebral neocortex and limbic system in adult patients with epilepsy.Me-thods Fourteen patients undergoing elective electrode removal following robot-guided stereotactic implantation of left intracerebral electrodes in the Department of Epilepsy Surgery at our hospital from January 2021 to December 2022 were selected.Patients were divided into neocortex group and limbic system group according to the location of electrodes in the brain.The power range and percentage ofδ,θ,α,β,andγwaves on SEEG at the intraoperative effect compartment concentrations of propofol of 0,2,3,4,and 5 mg/L(concentrations of D1-D5)as well as the modulation index(MI)of phase-amplitude coupling(PAC)in the wave bands ofδ-γ,θ-γ,α-γ,andβ-γwere recorded and compared between the two groups.Results The power ranges ofγwave on SEEG of the left limbic system and cerebral neocortex were significantly lower at the concentrations of D2-D5 than at the concentration of D1(F=15.13,20.33,t=4.33-8.72,P<0.05).The power percentage ofαwave in the left limbic system was significantly higher at the concentration of D3 than at the concentrations of D1 and D2(F=23.38,t=5.52,9.38,P<0.05).The MI of PAC inθ-γandα-γin the left limbic system decreased significantly at the concentrations of D3-D5 compared with at the concentration of D1(F=13.64,18.77,t=7.62-17.68,P<0.05).Conclusion Propofol decreases the power range ofγwave on SEEG of the left cerebral neocortex and limbic system and lowers PAC ofθ-γandα-γon SEEG of the left limbic system in adult patients with epilepsy.

关 键 词：癫痫 二异丙酚 脑皮层电图 边缘系统 电极 植入 立体定位技术 脑电描记术 

分 类 号：R741.04[医药卫生—神经病学与精神病学] R742.1[医药卫生—临床医学]