Name: network analysis of foramen ovale electrode recordings in drug-resistant temporal lobe epilepsy patients
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Description: Watch this Scientific Journal Video about Network Analysis of Foramen Ovale Electrode Recordings in Drug-resistant Temporal Lobe Epilepsy Patients at JoVE.com

这项工作是由来自德研究所Salud的卡洛斯三世赠款，通过PI10 / 00160和PI12 / 02839，部分被FEDER和穆图阿Madrileña支持。 AS-G。从穆图阿Madrileña一个博士后奖学金的获得者。三维仿真采用Bio数码Human软件（创建<a href="http://www.biodigital.com">www.biodigital.com</a> ）和ZygoteBody Professional软件（www.zygotebody.com）

在下面描述的协议中，步骤1,2和3属于两个研究和临床方案，这两者都是严格从仅通过临床标准选择的每个近中TLE候选切除手术，随后。步骤4和5专属于研究协议。这两个程序都是按照医院德拉公主伦理委员会的指导方针。 1.预植入程序<ol><li>解释了实验过程的参与者，指定哪个点对应的研究，哪些是适用于临床实践，陈述了研究过程中没有办法修改临床操作。要特别注意解释的电极植入手术的潜在风险。获取签署知情同意书的参与者。 </li><li>对于所有候选人切除手术，术前进行神经学和神经心理学EXAminations 18。 <ol><li> 20个国际系统与莫兹利的-根据10评估通过发作间期单光子发射计算机断层显像（SPECT）与99锝HMPAO，磁共振成像使用25头皮电极（MRI）1.5 T和视频脑电图（V-EEG）病人协议18。 </li><li>在手术前V形脑电图记录期间，逐步锥度从第二天的抗癫痫药物到第四天（每天的剂量大约三分之一）。 </li></ol></li></ol> 2.植入程序（手术） <ol><li>施用抗癫痫药预可操作，并在全身麻醉下进行手术（3毫克/公斤异丙酚丸剂，接着0.2 - 0.3毫克/千克芬太尼和0.5毫克/千克罗库溴铵）。 </li><li>将两个六敌人接触用1厘米的中心到中心的距离为双侧使用克氏针技术19周围的蓄水池。 <ol><li>将病人Øn个手术台仰卧位，与颈部在15度轻轻地延长。与碘溶液制备患者的面颊，开始在切口部位和向外盘旋，并悬垂立即切口部位周围的区域。 </li><li>根据哈特尔的地标20与20号脊椎针头穿刺皮肤:一个入口点约3cm侧向朝向一个点口服合缝立即劣于前-后平面同侧瞳孔和点大致的同侧2.5厘米前在横向平面外耳道。 </li><li>推进朝针透视下卵圆孔的区域。使用由透视图像提供横向的观点来确定针尖端的位置。当针通过卵圆孔，取出针芯，用电极取代它，并提前入环池（ 图1A </STRONG&gt;）。 </li></ol></li><li>评估通过在手术室21荧光透视成像正确注入;排除渗透到颅底，中椎间孔这一点很重要，如眶下裂（位于前部的卵圆孔）和颈静脉孔（位于后部的话）。这样的错位插管可能会导致严重的神经血管损伤22。 </li><li>一旦电极被正确地定位在环境蓄水池，它们固定到与窗帘皮肤。醒来后病人，并导致他或她的恢复室。 </li></ol> 3.录音FOE收购<ol><li>返回病人到V-脑电图室逗留约5.2±2.4天（平均值±SD）。 </li><li>根据国际10-20体系放置19电极。 <ol><li>用卷尺测量鼻根（鼻梁）和INION（枕骨粗隆）之间的距离，d标记与标记在中间点（锆石电极的位置）。测量并标记点的鼻根（所述FPZ电极的位置）以上的距离的10％。 <ol><li>重复同样的步骤为INION（盎司电极的位置），标志着距离从锆石20％，在鼻根和INION方向（分别为Fz的和PZ电极的位置）两者。 </li></ol></li><li>同时测量耳前点之间的距离，并标记的距离的左和右耳前点（T3和T4的电极，分别）在10％以上。然后，标记的距离的20％都T3和T4在直拉方向以上以获得C3和C4的位置。 </li><li>使用卷尺到FPZ和盎司在两个电极以上在前面和在01（左）和O2（右）在后面的距离在FP1（左）和FP2（右）的5％链接创建一个圆周上。 </li><li>在同一圆周上，在INION方向添加的距离的10％上升至OBT泉F7的位置，加10％，达到T3（它应位于耳前点之间的线的上方），并添加另外10％，得到的T5（O1电极）。标记各电极位置，并重复同样的程序为右（偶数）的电极。 </li><li>测量和标记中途F7和Fz的，并在F3方向从FP1向上距离的20％之间的交集（F3电极位置）。重复此过程中的头部的每个象限获得F4（前右位置），P3（左后位置）和P4（背左位置）。 </li><li>清洁和干燥皮肤。放置火棉胶的温和量与在各电极杯导电凝胶，并在坦然区域电极定位。干后用吹风机的火棉胶。 </li></ol></li><li>全部由电​​线电极（头皮和敌人）的连接电极中，这已经是连接到一个electroencephalographer。确保电极信号都不错，并验证头皮电极IMPE舞蹈是在使用electroencephalographer为10kΩ。 </li><li>获取数字头皮脑电图（EEG）数据和FOE-数据1,024赫兹使用视频同步electroencephalographer（ⅴ脑电图），和利用带通滤波器在0.5过滤数据 - 100赫兹和一个陷波滤波器（50赫兹）与electroencephalographer。 </li><li>逐步消除来自第二抗癫痫药物第四天（每天的剂量约三分之一），以增加癫痫发作的可能性。此步骤取决于每个病人的特定的药物处方。 </li><li>同时使用发作阵发性发作活动约通过识别电极/频道里癫痫元素出现23，包括慢复合波，多峰，快速棘波，尖波，尖和慢复合波的运行定位ictogenic区慢尖波，尖峰和棘慢波。记录发作起始和结束的时间，以及一个Y以外的临床症状或出现相关的研究。有在患者的头部的电极的位置和在其允许解剖识别所述致癫痫活性的显示位置脑电图软件的头部模型之间的一对一的映射。 </li><li>当研究完成后，轻轻地向外拉出来，而病人的口腔保持半开除去在V-EEG单位的敌人。 FOE删除后没有系统地进行拍摄，当出现神经系统症状时除外。在这样的情况下，执行紧急计算机断层扫描（CT）扫描。 </li></ol> 4. FOE信号预处理<ol><li>导出在200Hz上存储electroencephalographer ASCII格式以适合于大约30分钟癫痫发作活动的（已经由专家神经生理学家标识）（ 图1C）的数值分析历元中的数据。避免含工件历元，如饱和电活动，肌肉活动，以及electrode位移。 </li><li>打开使用任何UNIX流编辑器导出的文件，并从导出的数据文件中删除所有的非数字字符，只留下时间戳和通道电压。除进一步的数值分析，修改后的文件。 注:从现在起，执行使用R封装从R库或自制码（ 表1）所有计算。 </li><li>基于R软件，安装所需的R程序包，以及修改后的数据文件加载到第r环境。订购的所有通道，指定每一个到包含的所有数据，消除空渠道，他们引用的平均中线的参考法（FZ +锆+ Pz的）/ 3阵列的特定列。 <ol><li>使用快速傅立叶变换算法（R函数:FFT）并绘制得到的变量，以检查有效去除线频率（大约50Hz）的。使用频域来过滤其他杂散FRequencies可能污染信号。 </li></ol></li><li>加载的数据转换为一个多元时间序列对象28列（MTS） - 16头皮和12的敌人-使用R功能的TS。划分MTS对象成每次5秒（在200赫兹1000个数据点）的非重叠时间窗口以减少文件大小和优化计算时间。 </li></ol> 5.后处理计算（复杂网络分析） 注:计算在每个时间窗口下面所述的措施，开始痉挛发作（60窗口）前5分钟，在痉挛发作后5分钟（60窗口）结束，用可视化的时空演化的目的。 <ol><li>计算单变量的措施，光谱功率，兴奋性和谱熵为每个列/通道不考虑不同时间序列之间的关系。 <ol><li>计算兴奋（S）为各V使用根据迅达24提出的公式自制代码电压活动时间系列（见补充文件）。 S&gt; 2.5被认为是癫痫，经验确定的阈值17,25,26。 </li><li> （ - 7赫兹4），阿尔法（7 - 14赫兹），β（14 - 30赫兹为每个活动的时间序列，使用自制的代码为德尔塔（&gt; 0.5赫兹和&lt;4赫兹），西塔计算功率谱密度）和伽玛（&gt; 30）。 </li><li>计算香农熵使用每个时间序列代替的相应概率的时间序列的功率谱密度的自制代码。平均超过一组电极每一个信道得到的各个频谱熵（SE）的值。香农熵在补充文件中说明。 注:在SE的减少应该被解释为在光谱的频率的数量的减少，因为SE是光谱的熵。 </li></ol></li><li> 网络措施 不E:本节评估不同的时间序列的电极之间的相互作用。 <ol><li>利用在零延迟（:CCF R函数）计算出的线性交叉相关系数的绝对值计算在每个时间窗口中的每对电压的时间序列之间的功能连接。 注:要消除同步的非代表值，建立了基于以往的研究17,25,26的阈值。在这种特殊情况下使用的0.5的阈值。 </li><li>安装的igraph - [R包27。创建一个从邻接矩阵的IGRAPH对象（R功能:graph.adjacency）。使用在先前步骤中获得的相关矩阵，指定的图形被加权和无向。 </li><li>在每个时间窗口中计算整个网络（头皮+ FOE）平均路径长度（APL）（R函数average.path.length），并为每个所述四个子网络:左头皮，右头皮，左FOE和正确的敌人。在电子Xactly公司以同样的方式，计算链接密度（DOL）（R功能:graph.density），模块化（MOD）（R功能:模块化），平均聚集系数（ACC）（R功能:传递）。 </li><li>重复使用相位同步（自制R代码里面 ），为功能连接，而不是互相关函数的估计的先前步骤5.2.1至5.2.3。 </li></ol></li><li>来表示变量的大小变化的影响，计算出标准化平均差（SMD）（R函数从包MBESS:SMD），所述preictal和发作阶段之间以及preictal和发作后阶段之间。 <ol><li>服用preictal为基线，选择30秒钟（6个值），五分钟前发作起始标志，作为preictal值。可以在癫痫发作过程中以量化的变化，对于preictal阶段，通过使用SMD选择的30个类似的时间窗口。 </li><lI&gt;以类似的方式，发作结束5分钟后，以量化在发作后阶段（在相对于preictal阶段）的变化选择的30秒的时间窗口。 </li></ol></li></ol>

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The authors have no conflicts of interest to disclose.

传统上，癫痫是一种面向区域的方法，其中分离出特定领域，基本上是发作起始区的重要性，因为癫痫发作的病因独特涉猎。最近，一种强调皮层区之间相互作用的重要性一个真正的网络方法已被青睐在经典的面向区域的透视13-17,28。然而，癫痫作为网络疾病的证据目前身体仍然高度分散，而且需要更多的研究。目前的工作旨在通过重新分析传统方法作为FOE提供的数据，复杂的网络方式下。这里介绍的协议描述一个循序渐进的方法步骤，在TLE患者进行半创记录的复杂网络和频谱分析。 上面描述的技术的应用已表明了网络的方法的有用性是与更传统的禄相比alized或面向区域的观点。在最近的作品17,29已表明，使用同样的步骤，这里所描述的，在近中连接在耐火TLE患者的不平衡是显而易见的。近中连接在同侧无论是在发作间期29和发作17,29阶段减少。这个结果不能仅仅通过在那里的致癫痫活性发生的地区寻找可以预见。这在某种程度上令人惊讶的结果也利用功能磁共振成像上信号30,31网络理论描述。此外，FOE +网络理论的组合技术的应用已经显示出近中活动的等价期间发作和下致癫痫活性的启动子的影响，因为它是依托咪酯32的药理学施用。 此处所描述的技术能够在短间期录音检测近中网络不平衡至多一个O持久- [R2小时29。以这种方式，在分析中的时间和病人住院时间大幅减少，可以实现的。另外，从治疗的角度看，在TLE患者现有的不平衡可以通过使用长期植入（由神经外科医生）设备，多，因为它是在深部脑刺激做的方式"解决"。 要使用在本协议中提供的信息，取得最佳的效果，有些问题应提前考虑。首先，电极植入应由有经验的神经外科医生来进行，因为他们的不正确的位置可能会产生严重的神经系统的后果和误导性的记录。此外，为进一步分析相应时期的选择完全依赖于原始脑电图的神经生理学家的解释;因此，在临床脑电图分析方面的经验是强制性的。从脑电图导出文件的数据格式取决于汉邦丘拉尔品牌;因此，需要良好的编程技能相适应的脚本以不同的数据格式。最后，为了确保数据的可靠性，质量控制应该被应用到的结果。过度估计和误报可能具有大量的相关性的工作时出现。在这种情况下，统计方法，以提高灵敏度，应使用。在这方面，必须建立在相关性的阈值丢弃并不代表真正的底层同步的值是重要的。因此，在该协议中，节点i和j之间的边缘将仅视为存在如果这些节点之间的相关性的绝对值大于0.5，以前使用17,26的标准。在0.2至0.8的范围内的其他的阈值应该被用来验证相似的结果，并确保从一个阈值到以下阈值的平滑过渡。除了阈值，其他methodologie之间可以用于获得可靠的结果，如Bonferroni校正或替代数据的测试。此外，脑电图数据时，必须记住，大脑网络与非线性动力学复杂的系统是非常重要的;因此，除了线性相关，应使用其它非线性同步措施，以确保结果，诸如交互信息或相位同步33的质量。 直接从头皮上的电极连接的计算，因为它是在这项工作完成了一部分可能会带来一定的风险。主要的问题，休息，由于体积传导，总是存在用头皮记录污染的效果。克服这个问题的一种方式是通过在源的空间，由许多研究中采用的吸引人的选择工作。另一种方法要求使用同步措施的影响幅度污染降至最低。通过使用相位同步（也称为相大号ocking值）我们最小化体积传导的影响，因为它是在几个作品34证实。 如在其他侵入性神经生理技术，从FOE记录不能从对照受试者得到，这一事实严重地限制使用某些研究协议。从FOE录音数据提供有关内侧颞叶活动17,29,35有价值的信息，尤其是不对称的致痫侧颞叶癫痫病人33时。与侵入技术相比，FOE技术是非外伤性的脑并涉及相对简单的操作，其记录的高品质在一段11长时间。相较于MRI，FOE录音提供electrocortical活动更好的时间分辨率。此外，存在许多可能性，探索比在这项工作中使用的其他措施。这些事实也增加了一些分析生物医学记录的可能性同时。 FOE录音用复杂的网络和频谱分析相结合的这些优点使得该技术对癫痫研究与临床实践中的应用潜力的强大工具。

癫痫是一种致残性疾病，影响1 - 世界人口的2％。在大多数情况下，癫痫发作 - 癫痫的标志 - 可以完全控制或者与抗癫痫药物废除。然而，癫痫专利约30％的难治性药物治疗。在最常见的类型癫痫，颞叶癫痫（TLE）1，幸运的是手术是改善病人的状况的有效替代。从荟萃分析的结果表明，几乎三分之二耐药TLE患者是无癫痫发作在切除手术2,3后的第一个两到三年，虽然这一比例在几个因素而变化，最值得注意的是，海马的类型硬化2。对于一个成功的结果的一个关键步骤是所谓的癫痫病灶的准确定位，皮层区负责发作的产生，其通常位于梅西亚颞叶l的面积。然而，即使在癫痫病灶已在手术过程中被正确识别和切除的情况下，患者的一个显著少数或者与手术后癫痫保持或必须在严格的抗癫痫药治疗控制发作被放置。因此，一个新的观点却出现了注意力不再仅仅关注偏远地区，而不是皮质的相互作用构成了目前的根本问题。这种"网络"方法在连接组概念4，重点关注在不同区域之间的神经连接，而不是突出条块结构的作用接地。这一新的模式是在图论，专门用于图形拓扑和统计特性研究的一个数学框架中发现，适当的工具来表达它的基本结论。根据这种观点，大脑被认为是通过链路互连的一组节点<suP&gt; 5-9，使得节点通过由电极和它们之间的链路所覆盖的皮层区域被同步的程度定表示。因此，该网络的方法已在侵入电极记录的分析中使用，并提供了新的信息，以促进发作产生和传播的作用机制的理解。 在世界上大多数的癫痫中心常规采用的众多微创神经生理学技术，卵圆孔电极（FOE）尤为显着。 FOE是半侵入性技术，因为没有必要执行开颅，这减少了手术相关的并发症10。此外，FOE在环池11的位置，使它们从参与发作产生和传播几个皮质结构，如内嗅皮层记录近中活性特别方便。因此，它因为使用它的外观是耐药TLE患者的术前评估普遍。传统上，这种技术用于定位在发作癫痫尖峰和尖锐波的形式刺激活性，更重要的是，要准确地识别近中发作起始的区域。 从委员会提议的分类和术语从对癫痫国际联盟（ILAE）的新定义表明，癫痫发作起源于特定网络12内的一些点。此外，几个研究已经证明，癫痫发作是由异常的网络活动，而不是由一个孤立的病变区域13-16引起的。显然，这个新的角度使用新的数值的方法，如复杂的网络方法需要的先前获得的信息再分析。虽然这些分析的实际使用是在临床实践中仍然初期，几项研究已经证实其值13-17。 下面描述的协议是对耐药TLE癫痫病人常规进行与网络分析的新技术在临床实践的结合。该方法允许对近中的网络参数的时间演化的评估。 FOE的双边插入环池在颞叶的几个领域近中同时记录electrocortical活动。施加到记录时间序列的网络的做法既interictally和癫痫发作期间跟踪近中网络的时间演化。以这种方式，所提出的协议提供了可视化和量化考虑几个近中区域之间的关系的措施的独特方式。

<table><tbody><tr><td>Foramen Ovale Electrodes</td><td>AD-Tech, Racine,&lt;br/&gt; USA</td><td>FO06K-SP10X-000</td><td>Six-contact platinum&amp;nbsp;</td></tr><tr><td>Electroencephalograph</td><td>XLTEK, Canada</td><td>XLT-EEG32T</td><td>Natus XLTEK</td></tr><tr><td>MRI machine</td><td>General Electric</td><td></td><td></td></tr><tr><td>SPEC machine</td><td>General Electric</td><td></td><td></td></tr></tbody></table>

network analysis of foramen ovale electrode recordings in drug-resistant temporal lobe epilepsy patients

癫痫患者的约30％是难治抗癫痫药。在这些情况下，外科手术是消除/控制癫痫发作的唯一选择。但是，患者的一个显著少数继续显示手术后癫痫，即使在癫痫发作的可疑源已被正确本地化和切除这些情况。这里介绍的协议相结合的颞叶癫痫（TLE）的患者的术前评价与网络分析的新技术中常规使用的临床过程。该方法允许对近中的网络参数的时间演化的评估。卵圆孔电极（FOE）的双边插入环池在颞叶数近中区域同时记录electrocortical活性。此外，施加到记录时间系列网络方法跟踪近中网络的时间演化既interictally并在癫痫发作。以这种方式，所提出的协议提供了可视化和量化考虑几个近中的区域，而不是一个单一的区域之间的关系的措施的独特方式。

的FOE的最终位置是在环池，如在轴向和矢状MRI（ 图1A上图 ）看出。仇敌记录电活动从颞叶（ 图1A下图 ）的几个近中结构的接触。手术（ 图1B左图 ）后，患者被调度到视频脑电图室，头皮电极与10根据置于- 20系统（ 图1B右侧 ）。期间留在视频脑电图室，病人被连续监视，保存用于进一步分析头皮和FOE-录音，以及视频和重要常数。一个典型的原始头皮和FOE信号（ 图1C）显示了扣押左侧FOE的外观和其散布于头皮和右FOE联系人。 通过使用致痫活动的表示兴奋性的（S）从preictal到发作和发作后时期的过渡过程中对应于从图1C，原始脑电图记录（ 图2）。发作起始标记用实垂直线和时间（x轴）都提到这一点。 S（兴奋）&gt;的值2.5表示刺激性或致癫痫活性17,25,26。兴奋性较高（偏红色调）与左侧FOE触点（LFOE）较高的强度首先出现。作为由专家神经生理学家获悉这一结果是一致的左颞叶癫痫。 的几个网络措施时间动态以及从preictal到发作和发作后的阶段，对应于图1C和图2中显示的相同的发作在过渡期间的频谱熵（ 图3）。发作起始标有一个坚实的VERTI校准线和时间（x轴）都提到这一点。在这种情况下，该网络在全组电极，包括头皮和FOE-建造。 DOL和ACC值癫痫发作时均较高，随着APL和MOD的下降，表明整体连通的增加。在此期间还进行了观察和持续的兴奋性（垂直虚线）消失后SE水平较低。 的网络措施ACC，DOLS和APL和SE每个FOE（右和左）（ 图4）从preictal到发作和发作后阶段的过渡期间，分析。发作起始标记用实垂直线和时间（x轴）都提到这一点。这种措施的演进对应于相同的发作图1，图2和3。同侧（左）近中ACC，DOLS和APL提出较早，较contrala高变化或双侧的值，这可能是由在发作起始区的位置在左颞叶进行说明。在这种情况下，国防部不能计算，因为没有细分可用。 功能连接相同扣押图1，2，3时（ 图5），4代表视频呈现只是痉挛发作（时间0）后的一个关键的变化。在这一点，所有电极之间的连接显着增加，如通过增加的链路的数目和厚度（强度）的可见的那个边缘。这种增加左FOE之间开始于时间0.1和0.2，并在到达整个网络之前扩散到对侧。 <table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always"><tbody><tr><td> FFT </td><td> 4.3 </td><td> （统计包）计算快速傅立叶TR的信号的ansform。 </td></tr><tr><td> TS </td><td> 4.4 </td><td> （统计包）创建一个多元时间序列对象（MTS）。应提供的采样频率。 </td></tr><tr><td>刺激性</td><td> 5.1.1 </td><td>基于差异 R函数（自制）的功能。计算的信号的斜率的绝对值，然后将它规范化为标准偏差短基线时期。应提供的阈值。 </td></tr><tr><td>功率谱密度和谱熵</td><td> 5.1.2 </td><td>基于频谱和熵 R里面的函数（自制）的功能。计算归一化的功率谱和归一化的功率谱的香农熵</td></tr><tr><td> CCF </td><td> 5.2.1 </td><td> （基本软件包）通过使用Pearson相关零滞后，产生一个相关矩阵计算山对象的线性互相关。绝对值应该演算ated。 </td></tr><tr><td> graph.adjacency </td><td> 5.2.2 </td><td> （IGRAPH包）创建的igraph图，通过以下的igraph功能使用的基本对象</td></tr><tr><td> average.path.length </td><td> 5.2.3 </td><td> （的igraph包）确定的曲线图的平均路径长度，通过所有网络节点的计算的沿最短路径的步骤的平均数目。 </td></tr><tr><td> graph.density </td><td> 5.2.3 </td><td> （的igraph封装）通过计算链接的实际数量和网络的所有可能的链路之间的比率计算的曲线图的链接的密度。 </td></tr><tr><td> 模块化 </td><td> 5.2.3 </td><td> （的igraph包）确定图形的模块化，其中节点组更它们之间连接比与网络的其他节点计算</td></tr><tr><td> 传递 </td><td> 5。2.3 </td><td> （的igraph包）确定的曲线图的平均聚类系数，通过计算也彼此的邻居的相邻节点的比例</td></tr><tr><td>相位同步</td><td> 5.2.4 </td><td> （自制）函数基于在计算平均相位相干性来0和1之间获得的值的fft R函数</td></tr><tr><td> SMD </td><td> 5.3 </td><td> （MBESS包）确定标准平均差-size effects-通过计算相对集中的差异群体之间平均的差异</td></tr></tbody></table> 表1:R功能，用于数据处理。 <img alt="图1" src="/files/ftp_upload/54746/54746fig1.jpg" /> 图1:卵圆孔电极。 （A）的最终位置FOE进入环池。上图显示的轴向（左）和矢状（右图）MRI图像显示FOE接触位置（白色箭头）。一个人体标本（尸体）与插入的FOE（下图，标有白色箭头触点）。 （B）FOE和头皮电极设置。患者只是FOE插入手术（左图）之后和视频脑电图住宿（右图）中的头。 （C）FOE和头皮录音。从左侧颞叶癫痫患者复杂部分性发作（5分钟后痉挛发作之前）。 RFOE1-RFOE6手段右FOE＃1至＃6和LFOE1-LFOE6手段左FOE＃1至＃6。发作起始由垂直红线和白色箭头标注的头。 <a href="http://ecsource.jove.com/files/ftp_upload/54746/54746fig1large.jpg" target="_blank">请点击此处查看该图的放大版本。</a> <img alt="图2" src="/files/ftp_upload/54746/54746fig2.jpg" /> 图2:从兴奋量化为左颞叶癫痫病人的一个复杂部分发作的表示。色阶量化每个电极的兴奋性电平（S）。右卵圆孔电极（RFOE）和左卵圆孔电极（LFOE）分别代表的右触点和左卵圆孔电极（y轴）。 x轴标志着时间（分钟）相对于痉挛发作（粗垂直线）由专家确定的神经生理学家。 <a href="http://ecsource.jove.com/files/ftp_upload/54746/54746fig2large.jpg" target="_blank">请点击此处查看该图的放大版本。</a> <img alt="图3" src="/files/ftp_upload/54746/54746fig3.jpg" /> 图3: 整个网络（头皮+ FOE）从图2的平均聚集系数（ACC），平均路径长度同一患者同一和扣押措施 （APL），链接（DOLS），模块化（MOD）和整个网络（头皮+ FOE）谱熵（SE）密度表示。垂直虚线表示的兴奋性（S）。 x轴标志着时间相对痉挛发作（垂直粗实线）。在连续十窗户移动平均线是由一个厚厚的黑色实线表示。 <a href="http://ecsource.jove.com/files/ftp_upload/54746/54746fig3large.jpg" target="_blank">请点击此处查看该图的放大版本。</a> <img alt="图4" src="/files/ftp_upload/54746/54746fig4.jpg" /> 图4:从图2和3的平均聚集系数（ACC），平均路径长度（APL） 同一患者的近中的措施 ，为左和右孔两条链路（DOLS）和频谱熵（SE）密度未闭的电极（敌人）。垂直虚线标记的兴奋性。 x轴相对于与s的时间标记eizure发作（垂直粗实线）。在连续十窗户移动平均线是由一个厚厚的黑色实线表示。 <a href="http://ecsource.jove.com/files/ftp_upload/54746/54746fig4large.jpg" target="_blank">请点击此处查看该图的放大版本。</a> <img alt="图5" src="/files/ftp_upload/54746/54746fig5.jpg" /> 图5: 动态连接模式的复杂部分发作期间。链接强度由边缘的厚度来表示。时报讯（数字越小），是相对于痉挛发作（时间0）。每一帧是5秒长。左，右卵圆孔电极（L1-L6和R1-R6）是由珊瑚和蓝色圆圈，分别代表。左，右头皮电极由橙色和青色圆圈，分别代表。 <a href="http://ecsource.jove.com/files/ftp_upload/54746/Figure_5.mp4" target="_blank">请点击此处到D</a>ownload这部电影。

Watch this Scientific Journal Video about Network Analysis of Foramen Ovale Electrode Recordings in Drug-resistant Temporal Lobe Epilepsy Patients at JoVE.com

Network Analysis of Foramen Ovale Electrode Recordings in Drug-resistant Temporal Lobe Epilepsy Patients

This protocol describes a procedure to track the evolution of mesial network measures in temporal lobe epilepsy (TLE) patients. It is based on the combination of intracranial recordings with a novel numerical technique for data analysis. Specifically, we present a protocol for network analyses of foramen ovale recordings.

在耐药性颞叶癫痫患者卵圆孔电极记录的网络分析

Approximately 30% of epilepsy patients are refractory to antiepileptic drugs. In these cases, surgery is the only alternative to eliminate/control ...

network-analysis-foramen-ovale-electrode-recordings-drug-resistant

Research

Education

JoVE Core

JoVE Journal

Pharmacology

Medicine

Unit 1

Pharmacotherapy of the Epilepsies

SCIENTISTS IN ACTION

12.1K 次观看.  Instituto de Investigación Sanitaria Hospital de la Princesa. This protocol describes a procedure to track the evolution of mesial network measures in temporal lobe epilepsy (TLE) patients. It is based on the combination of intracranial recordings with a novel numerical technique for data analysis. Specifically, we present a protocol for network analyses of foramen ovale recordings.

视频: Network Analysis of Foramen Ovale Electrode Recordings in Drug-resistant Temporal Lobe Epilepsy Patients

Performing Behavioral Tasks in Subjects with Intracranial Electrodes

Patients having stereo-electroencephalography (SEEG) electrode, subdural grid or depth electrode implants have a multitude of electrodes implanted in different areas of their brain for the localization of their seizure focus and eloquent areas. After implantation, the patient must remain in the hospital until the pathological area of brain is found and possibly resected. During this time, these patients offer a unique opportunity to the research community because any number of behavioral paradigms can be performed to uncover the neural correlates that guide behavior. Here we present a method for recording brain activity from intracranial implants as subjects perform a behavioral task designed to assess decision-making and reward encoding. All electrophysiological data from the intracranial electrodes are recorded during the behavioral task, allowing for the examination of the many brain areas involved in a single function at time scales relevant to behavior. Moreover, and unlike animal studies, human patients can learn a wide variety of behavioral tasks quickly, allowing for the ability to perform more than one task in the same subject or for performing controls. Despite the many advantages of this technique for understanding human brain function, there are also methodological limitations that we discuss, including environmental factors, analgesic effects, time constraints and recordings from diseased tissue. This method may be easily implemented by any institution that performs intracranial assessments; providing the opportunity to directly examine human brain function during behavior.

Patients implanted with intracranial electrodes provide a unique opportunity to record neurological data from multiple areas of the brain while the patient performs behavioral tasks. Here, we present a method of recording from implanted patients that can be reproducible at other institutions with access to this patient population.

执行任务的行为与颅内电极主题

Patients having stereo-electroencephalography (SEEG) electrode, subdural grid or depth electrode implants have a multitude of electrodes implanted in ...

科研

行为学

Network Analysis of the Default Mode Network Using Functional Connectivity MRI in Temporal Lobe Epilepsy

Functional connectivity MRI (fcMRI) is an fMRI method that examines the connectivity of different brain areas based on the correlation of BOLD signal fluctuations over time. Temporal Lobe Epilepsy (TLE) is the most common type of adult epilepsy and involves multiple brain networks. The default mode network (DMN) is involved in conscious, resting state cognition and is thought to be affected in TLE where seizures cause impairment of consciousness. The DMN in epilepsy was examined using seed based fcMRI. The anterior and posterior hubs of the DMN were used as seeds in this analysis. The results show a disconnection between the anterior and posterior hubs of the DMN in TLE during the basal state. In addition, increased DMN connectivity to other brain regions in left TLE along with decreased connectivity in right TLE is revealed. The analysis demonstrates how seed-based fcMRI can be used to probe cerebral networks in brain disorders such as TLE.

The Default Mode Network (DMN) in Temporal Lobe Epilepsy (TLE) is analyzed in the resting state of the brain using seed-based functional connectivity MRI (fcMRI).

使用功能性磁共振成像连接在颞叶癫痫默认模式网络的网络分析

Functional connectivity MRI (fcMRI) is an fMRI method that examines the connectivity of different brain areas based on the correlation of BOLD signal ...

医学

Multi-electrode Array Recordings of Human Epileptic Postoperative Cortical Tissue

Epilepsy, affecting about 1% of the population, comprises a group of neurological disorders characterized by the periodic occurrence of seizures, which disrupt normal brain function. Despite treatment with currently available antiepileptic drugs targeting neuronal functions, one third of patients with epilepsy are pharmacoresistant. In this condition, surgical resection of the brain area generating seizures remains the only alternative treatment. Studying human epileptic tissues has contributed to understand new epileptogenic mechanisms during the last 10 years. Indeed, these tissues generate spontaneous interictal epileptic discharges as well as pharmacologically-induced ictal events which can be recorded with classical electrophysiology techniques. Remarkably, multi-electrode arrays (MEAs), which are microfabricated devices embedding an array of spatially arranged microelectrodes, provide the unique opportunity to simultaneously stimulate and record field potentials, as well as action potentials of multiple neurons from different areas of the tissue. Thus MEAs recordings offer an excellent approach to study the spatio-temporal patterns of spontaneous interictal and evoked seizure-like events and the mechanisms underlying seizure onset and propagation. Here we describe how to prepare human cortical slices from surgically resected tissue and to record with MEAs interictal and ictal-like events ex vivo.

We here describe how to perform multi-electrode array recordings of human epileptic cortical tissue. Epileptic tissue resection, slice preparation and multi-electrode array recordings of interictal and ictal events are demonstrated in detail.

人类癫痫术后皮层组织的多电极阵列录音

Epilepsy, affecting about 1% of the population, comprises a group of neurological disorders characterized by the periodic occurrence of seizures, which ...

Investigating the Function of Deep Cortical and Subcortical Structures Using Stereotactic Electroencephalography: Lessons from the Anterior Cingulate Cortex

Stereotactic Electroencephalography (SEEG) is a technique used to localize seizure foci in patients with medically intractable epilepsy. This procedure involves the chronic placement of multiple depth electrodes into regions of the brain typically inaccessible via subdural grid electrode placement. SEEG thus provides a unique opportunity to investigate brain function. In this paper we demonstrate how SEEG can be used to investigate the role of the dorsal anterior cingulate cortex (dACC) in cognitive control. We include a description of the SEEG procedure, demonstrating the surgical placement of the electrodes. We describe the components and process required to record local field potential (LFP) data from consenting subjects while they are engaged in a behavioral task. In the example provided, subjects play a cognitive interference task, and we demonstrate how signals are recorded and analyzed from electrodes in the dorsal anterior cingulate cortex, an area intimately involved in decision-making. We conclude with further suggestions of ways in which this method can be used for investigating human cognitive processes.

Stereotactic Electroencephalography (SEEG) is an operative technique used in epilepsy surgery to help localize seizure foci. It also affords a unique opportunity to investigate brain function. Here we describe how SEEG can be used to investigate cognitive processes in human subjects.

调查深皮层的功​​能和皮层下结构采用立体定向脑电图:由前扣带皮层的经验教训

Stereotactic Electroencephalography (SEEG) is a technique used to localize seizure foci in patients with medically intractable epilepsy. This procedure ...

神经科学

Interictal High Frequency Oscillations Detected with Simultaneous Magnetoencephalography and Electroencephalography as Biomarker of Pediatric Epilepsy

Crucial to the success of epilepsy surgery is the availability of a robust biomarker that identifies the Epileptogenic Zone (EZ). High Frequency Oscillations (HFOs) have emerged as potential presurgical biomarkers for the identification of the EZ in addition to Interictal Epileptiform Discharges (IEDs) and ictal activity. Although they are promising to localize the EZ, they are not yet suited for the diagnosis or monitoring of epilepsy in clinical practice. Primary barriers remain: the lack of a formal and global definition for HFOs; the consequent heterogeneity of methodological approaches used for their study; and the practical difficulties to detect and localize them noninvasively from scalp recordings. Here, we present a methodology for the recording, detection, and localization of interictal HFOs from pediatric patients with refractory epilepsy. We report representative data of HFOs detected noninvasively from interictal scalp EEG and MEG from two children undergoing surgery.
The underlying generators of HFOs were localized by solving the inverse problem and their localization was compared to the Seizure Onset Zone (SOZ) as this was defined by the epileptologists. For both patients, Interictal Epileptogenic Discharges (IEDs) and HFOs were localized with source imaging at concordant locations. For one patient, intracranial EEG (iEEG) data were also available. For this patient, we found that the HFOs localization was concordant between noninvasive and invasive methods. The comparison of iEEG with the results from scalp recordings served to validate these findings. To our best knowledge, this is the first study that presents the source localization of scalp HFOs from simultaneous EEG and MEG recordings comparing the results with invasive recordings. These findings suggest that HFOs can be reliably detected and localized noninvasively with scalp EEG and MEG. We conclude that the noninvasive localization of interictal HFOs could significantly improve the presurgical evaluation for pediatric patients with epilepsy.

High Frequency Oscillations (HFOs) have emerged as presurgical biomarkers for the identification of the epileptogenic zone in pediatric patients with medically refractory epilepsy. A methodology for the noninvasive recording, detection, and localization of HFOs with simultaneous scalp electroencephalography (EEG) and magnetoencephalography (MEG) is presented.

同时用脑磁图和脑电图为小儿癫痫的生物标志物检测发作间期高频振动

Crucial to the success of epilepsy surgery is the availability of a robust biomarker that identifies the Epileptogenic Zone (EZ). High Frequency ...

Concurrent Recording of Co-localized Electroencephalography and Local Field Potential in Rodent

Although electroencephalography (EEG) is widely used as a non-invasive technique for recording neural activities of the brain, our understanding of the neurogenesis of EEG is still very limited. Local field potentials (LFPs) recorded via a multi-laminar microelectrode can provide a more detailed account of simultaneous neural activity across different cortical layers in the neocortex, but the technique is invasive. Combining EEG and LFP measurements in a pre-clinical model can greatly enhance understanding of the neural mechanisms involved in the generation of EEG signals, and facilitate the derivation of a more realistic and biologically accurate mathematical model of EEG. A simple procedure for acquiring concurrent and co-localized EEG and multi-laminar LFP signals in the anesthetized rodent is presented here. We also investigated whether EEG signals were significantly affected by a burr hole drilled in the skull for the insertion of a microelectrode. Our results suggest that the burr hole has a negligible impact on EEG recordings.

This protocol describes a simple method for concurrent recording of co-localized electroencephalography (EEG) and multi-laminar local field potential in an anesthetized rat. A burr hole drilled in the skull for the insertion of a microelectrode is shown to produce negligible distortion of the EEG signal.

啮齿动物联合局部脑电图和局部电位的同步记录

Although electroencephalography (EEG) is widely used as a non-invasive technique for recording neural activities of the brain, our understanding of the ...

Recording and Modulation of Epileptiform Activity in Rodent Brain Slices Coupled to Microelectrode Arrays

Temporal lobe epilepsy (TLE) is the most common partial complex epileptic syndrome and the least responsive to medications. Deep brain stimulation (DBS) is a promising approach when pharmacological treatment fails or neurosurgery is not recommended. Acute brain slices coupled to microelectrode arrays (MEAs) represent a valuable tool to study neuronal network interactions and their modulation by electrical stimulation. As compared to conventional extracellular recording techniques, they provide the added advantages of a greater number of observation points and a known inter-electrode distance, which allow studying the propagation path and speed of electrophysiological signals. However, tissue oxygenation may be greatly impaired during MEA recording, requiring a high perfusion rate, which comes at the cost of decreased signal-to-noise ratio and higher oscillations in the experimental temperature. Electrical stimulation further stresses the brain tissue, making it difficult to pursue prolonged recording/stimulation epochs. Moreover, electrical modulation of brain slice activity needs to target specific structures/pathways within the brain slice, requiring that electrode mapping be easily and quickly performed live during the experiment. Here, we illustrate how to perform the recording and electrical modulation of 4-aminopyridine (4AP)-induced epileptiform activity in rodent brain slices using planar MEAs. We show that the brain tissue obtained from mice outperforms rat brain tissue and is thus better suited for MEA experiments. This protocol guarantees the generation and maintenance of a stable epileptiform pattern that faithfully reproduces the electrophysiological features observed with conventional field potential recording, persists for several hours, and outlasts sustained electrical stimulation for prolonged epochs. Tissue viability throughout the experiment is achieved thanks to the use of a small-volume custom recording chamber allowing for laminar flow and quick solution exchange even at low (1 mL/min) perfusion rates. Quick MEA mapping for real-time monitoring and selection of stimulating electrodes is performed by a custom graphic user interface (GUI).

We illustrate how to perform recording and electrical modulation of 4-aminopyridine-induced epileptiform activity in rodent brain slices using microelectrode arrays. A custom recording chamber maintains tissue viability throughout prolonged experimental sessions. Live electrode mapping and selection of stimulating pairs are performed by a custom graphical user interface.

鼠脑切片偶联微电极阵列癫痫活性的记录与调控

Temporal lobe epilepsy (TLE) is the most common partial complex epileptic syndrome and the least responsive to medications. Deep brain stimulation (DBS) ...

Recording Network Activity in Spinal Nociceptive Circuits Using Microelectrode Arrays

The roles and connectivity of specific types of neurons within the spinal cord dorsal horn (DH) are being delineated at a rapid rate to provide an increasingly detailed view of the circuits underpinning spinal pain processing. However, the effects of these connections for broader network activity in the DH remain less well understood because most studies focus on the activity of single neurons and small microcircuits. Alternatively, the use of microelectrode arrays (MEAs), which can monitor electrical activity across many cells, provides high spatial and temporal resolution of neural activity. Here, the use of MEAs with mouse spinal cord slices to study DH activity induced by chemically stimulating DH circuits with 4-aminopyridine (4-AP) is described. The resulting rhythmic activity is restricted to the superficial DH, stable over time, blocked by tetrodotoxin, and can be investigated in different slice orientations. Together, this preparation provides a platform to investigate DH circuit activity in tissue from na&#239;ve animals, animal models of chronic pain, and mice with genetically altered nociceptive function. Furthermore, MEA recordings in 4-AP-stimulated spinal cord slices can be used as a rapid screening tool to assess the capacity of novel antinociceptive compounds to disrupt activity in the spinal cord DH.

The combined use of microelectrode array technology and 4-aminopyridine-induced chemical stimulation for investigating network-level nociceptive activity in the spinal cord dorsal horn is outlined.

使用微电极阵列记录脊髓伤害感受回路中的网络活动

The roles and connectivity of specific types of neurons within the spinal cord dorsal horn (DH) are being delineated at a rapid rate to provide an ...

<meta charset="utf8"></head><body>将 MEG 和 HD-EEG 整合到儿科癫痫定位中

Electromagnetic Source Imaging in Presurgical Evaluation of Children with Drug-Resistant Epilepsy

For children with drug-resistant epilepsy (DRE), seizure freedom relies on the delineation and resection (or ablation/disconnection) of the epileptogenic zone (EZ) while preserving the eloquent brain areas. The development of a reliable and noninvasive localization method that provides clinically useful information for the localization of the EZ is, therefore, crucial to achieving successful surgical outcomes. Electric and magnetic source imaging (ESI and MSI) have been increasingly utilized in the presurgical evaluation of these patients showing promising findings in the delineation of epileptogenic as well as eloquent brain areas. Moreover, the combination of ESI and MSI into a single solution, namely electromagnetic source imaging (EMSI), performed on simultaneous high-density electroencephalography (HD-EEG) and magnetoencephalography (MEG) recordings has shown higher source localization accuracy than either modality alone. Despite these encouraging findings, such techniques are performed in only a few tertiary epilepsy centers, are rarely recorded simultaneously, and are underutilized in pediatric cohorts. This study illustrates the experimental setup for recording simultaneous MEG and HD-EEG data as well as the methodological framework for analyzing these data aiming to localize the irritative zone, the seizure onset zone, and eloquent brain areas in children with DRE. More specifically, the experimental setups are presented for (i) recording and localizing interictal and ictal epileptiform activity during sleep and (ii) recording visual-, motor-, auditory-, and somatosensory-evoked responses and mapping relevant eloquent brain areas (i.e., visual, motor, auditory, and somatosensory) during visuomotor task, as well as auditory and somatosensory stimulations. Detailed steps of the data analysis pipeline are further presented for performing EMSI as well as individual ESI and MSI using equivalent current dipole (ECD) and dynamic statistical parametric mapping (dSPM).

<meta charset="utf8"></head><body>作者聚焦:通过新型生物标志物和增强定位推进儿童癫痫手术

Magnetoencephalography (MEG) and high-density electroencephalography (HD-EEG) are rarely recorded simultaneously, although they yield confirmatory and complementary information. Here, we illustrate the experimental setup for recording simultaneous MEG and HD-EEG and the methodology for analyzing these data aiming to localize epileptogenic and eloquent brain areas in children with drug-resistant epilepsy.

电磁源显像在儿童耐药性癫痫术前评估中的应用

For children with drug-resistant epilepsy (DRE), seizure freedom relies on the delineation and resection (or ablation/disconnection) of the epileptogenic ...

在耐药性颞叶癫痫患者卵圆孔电极记录的网络分析

摘要

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此视频中的章节

执行任务的行为与颅内电极主题

使用功能性磁共振成像连接在颞叶癫痫默认模式网络的网络分析

人类癫痫术后皮层组织的多电极阵列录音

调查深皮层的功能和皮层下结构采用立体定向脑电图:由前扣带皮层的经验教训

同时用脑磁图和脑电图为小儿癫痫的生物标志物检测发作间期高频振动

啮齿动物联合局部脑电图和局部电位的同步记录

鼠脑切片偶联微电极阵列癫痫活性的记录与调控

使用微电极阵列记录脊髓伤害感受回路中的网络活动

电磁源显像在儿童耐药性癫痫术前评估中的应用

电磁源显像在儿童耐药性癫痫术前评估中的应用

在耐药性颞叶癫痫患者卵圆孔电极记录的网络分析

摘要

探索更多视频

此视频中的章节

执行任务的行为与颅内电极主题

使用功能性磁共振成像连接在颞叶癫痫默认模式网络的网络分析

人类癫痫术后皮层组织的多电极阵列录音

调查深皮层的功​​能和皮层下结构采用立体定向脑电图:由前扣带皮层的经验教训

同时用脑磁图和脑电图为小儿癫痫的生物标志物检测发作间期高频振动

啮齿动物联合局部脑电图和局部电位的同步记录

鼠脑切片偶联微电极阵列癫痫活性的记录与调控

使用微电极阵列记录脊髓伤害感受回路中的网络活动

电磁源显像在儿童耐药性癫痫术前评估中的应用

电磁源显像在儿童耐药性癫痫术前评估中的应用

调查深皮层的功能和皮层下结构采用立体定向脑电图:由前扣带皮层的经验教训