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Title: Epileptic network of hypothalamic hamartoma: An EEG-fMRI study.
Authors: Usami, Kiyohide  kyouindb  KAKEN_id  orcid (unconfirmed)
Matsumoto, Riki  kyouindb  KAKEN_id  orcid (unconfirmed)
Sawamoto, Nobukatsu  kyouindb  KAKEN_id
Murakami, Hiroatsu
Inouchi, Morito
Fumuro, Tomoyuki
Shimotake, Akihiro  kyouindb  KAKEN_id
Kato, Takeo
Mima, Tatsuya
Shirozu, Hiroshi
Masuda, Hiroshi
Fukuyama, Hidenao
Takahashi, Ryosuke  kyouindb  KAKEN_id
Kameyama, Shigeki
Ikeda, Akio  kyouindb  KAKEN_id  orcid (unconfirmed)
Author's alias: 宇佐美, 清英
松本, 理器
澤本, 伸克
下竹, 昭寛
美馬, 達哉
福山, 秀直
高橋, 良輔
池田, 昭夫
Keywords: Gelastic seizure
Epileptic encephalopathy
Subcortical epilepsy
Issue Date: Sep-2016
Publisher: Elsevier B.V.
Journal title: Epilepsy research
Volume: 125
Start page: 1
End page: 9
Abstract: <Objective>To investigate the brain networks involved in epileptogenesis/encephalopathy associated with hypothalamic hamartoma (HH) by EEG with functional MRI (EEG-fMRI), and evaluate its efficacy in locating the HH interface in comparison with subtraction ictal SPECT coregistered to MRI (SISCOM). <Methods>Eight HH patients underwent EEG-fMRI. All had gelastic seizures (GS) and 7 developed other seizure types. Using a general linear model, spike-related activation/deactivation was analyzed individually by applying a hemodynamic response function before, at, and after spike onset (time-shift model = −8–+4 s). Group analysis was also performed. The sensitivity of EEG-fMRI in identifying the HH interface was compared with SISCOM in HH patients having unilateral hypothalamic attachment. <Results>EEG-fMRI revealed activation and/or deactivation in subcortical structures and neocortices in all patients. 6/8 patients showed activation in or around the hypothalamus with the HH interface with time-shift model before spike onset. Group analysis showed common activation in the ipsilateral hypothalamus, brainstem tegmentum, and contralateral cerebellum. Deactivation occurred in the default mode network (DMN) and bilateral hippocampi. Among 5 patients with unilateral hypothalamic attachment, activation in or around the ipsilateral hypothalamus was seen in 3 using EEG-fMRI, whereas hyperperfusion was seen in 1 by SISCOM. <Significance>Group analysis of this preliminary study may suggest that the commonly activated subcortical network is related to generation of GS and that frequent spikes lead to deactivation of the DMN and hippocampi, and eventually to a form of epileptic encephalopathy. Inter-individual variance in neocortex activation explains various seizure types among patients. EEG-fMRI enhances sensitivity in detecting the HH interface compared with SISCOM.
Rights: © 2016. This manuscript version is made available under the CC-BY-NC-ND 4.0 license / The full-text file will be made open to the public on 1 September 2017 in accordance with publisher's 'Terms and Conditions for Self-Archiving' / This is not the published version. Please cite only the published version. この論文は出版社版でありません。引用の際には出版社版をご確認ご利用ください。
DOI(Published Version): 10.1016/j.eplepsyres.2016.05.011
PubMed ID: 27295078
Appears in Collections:Journal Articles

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