Ailiang Miao1, Lu Tang1, Jing Xiang2, Qingshan Guan1, Huaiting Ge1, Hongxing Liu1, Ting Wu3, Qiqi Chen3, Lu Yang3, Xiaopeng Lu4, Zheng Hu4, Xiaoshan Wang5. 1. Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, China. 2. MEG Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45220, USA. 3. MEG Center, Nanjing Brain Hospital, Nanjing, Jiangsu 210029, China. 4. Department of Neurology, Nanjing Children's Hospital, Nanjing, Jiangsu 210029, China. 5. Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, China. Electronic address: lidou2005@126.com.
Abstract
PURPOSE: The present study aims to determine the initialization and propagation of typical absence seizures using magnetoencephalography (MEG). METHOD: Fourteen drug-naïve children with childhood absence epilepsy (CAE) were studied using a 275-Channel MEG system. The spectral signatures of epileptic activity were assessed using Morlet continuous wavelet transform. Magnetic sources were volumetrically localized using dynamic magnetic source imaging (dMSI) with a slide window at a millisecond temporal resolution. RESULT: The initial portion of ictal activity was predominantly located to the left frontal and posterior cortices. The frontal sources were in the left medial prefrontal cortex (MPFC), the pre-supplementary motor area (pre-SMA), the primary motor cortex, and the lateral prefrontal cortex. The posterior cortical sources were predominantly localized to the left precuneus (pC) and the medial occipital cortices (MOC). The ictal activity after the initialization showed involvement of the MPFC and pC of all patients (14/14) and recursive propagation between the frontal (MPFC) and posterior cortices (pC and MOC) via either the medial portion of the brain (9/14) or the thalamus (5/14), respectively. CONCLUSION: The left frontal and posterior (pC and MOC) cortices play a key role in the initialization of epileptic activity in absence seizures. The thalamus plays a key role in the propagation of absence seizures between the frontal and posterior cortical sources. Considering the MPFC and pC are the nodes of the default mode network (DMN), our results support involvement of the DMN in absence seizures.
PURPOSE: The present study aims to determine the initialization and propagation of typical absence seizures using magnetoencephalography (MEG). METHOD: Fourteen drug-naïve children with childhood absence epilepsy (CAE) were studied using a 275-Channel MEG system. The spectral signatures of epileptic activity were assessed using Morlet continuous wavelet transform. Magnetic sources were volumetrically localized using dynamic magnetic source imaging (dMSI) with a slide window at a millisecond temporal resolution. RESULT: The initial portion of ictal activity was predominantly located to the left frontal and posterior cortices. The frontal sources were in the left medial prefrontal cortex (MPFC), the pre-supplementary motor area (pre-SMA), the primary motor cortex, and the lateral prefrontal cortex. The posterior cortical sources were predominantly localized to the left precuneus (pC) and the medial occipital cortices (MOC). The ictal activity after the initialization showed involvement of the MPFC and pC of all patients (14/14) and recursive propagation between the frontal (MPFC) and posterior cortices (pC and MOC) via either the medial portion of the brain (9/14) or the thalamus (5/14), respectively. CONCLUSION: The left frontal and posterior (pC and MOC) cortices play a key role in the initialization of epileptic activity in absence seizures. The thalamus plays a key role in the propagation of absence seizures between the frontal and posterior cortical sources. Considering the MPFC and pC are the nodes of the default mode network (DMN), our results support involvement of the DMN in absence seizures.
Authors: Birgit Frauscher; Fabrice Bartolomei; Katsuhiro Kobayashi; Jan Cimbalnik; Maryse A van 't Klooster; Stefan Rampp; Hiroshi Otsubo; Yvonne Höller; Joyce Y Wu; Eishi Asano; Jerome Engel; Philippe Kahane; Julia Jacobs; Jean Gotman Journal: Epilepsia Date: 2017-06-30 Impact factor: 5.864