颅内脑电图应用于致痫区定位的研究进展

                                                         转载自“浙江癫痫论坛” 作者：王爽，Norman So

    近年来，癫痫外科得到多学科团队的支撑后迅速发展，人们对癫痫发病的了解也不断深入。随之，颅内脑电图（iEEG)也飞速发展：包括宽频带记录与分析，脑电图定量分析，更好的肉眼分析iEEG。这使得癫痫灶切除会更精准，会提升癫痫手术的疗效。

    我们总结了最近十五年国际上iEEG的研究进展。文章刊登于今年6月份的Neuroscience Bulletin。与大家分享并请同道们指正。

    我们也提出了iEEG研究存在的问题。iEEG病例在单个癫痫中心的数量通常不会很大，但是各个中心的iEEG分析习惯不同(EEG判读本身存在一定的主观性），这使得多中心大样本的研究受限。如果今后能够规范iEEG的命名和分类无疑将能够克服这种障碍。

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Advances of Intracranial Electroencephalography in Localizing the Epileptogenic Zone.

Abstract

Intracranial electroencephalography (iEEG) provides the best precision in estimating the location and boundary of an epileptogenic zone. Analysis of iEEG in the routine EEG frequency range (0.5-70 Hz) remains the basis in clinical practice. Low-voltage fast activity is the most commonly reported ictal onset pattern in neocortical epilepsy, and low-frequency high-amplitude repetitive spiking is the most commonly reported ictal onset pattern in mesial temporal lobe epilepsy. Recent studies using wideband EEG recording have demonstrated that examining higher (80-1000 Hz) and lower (0.016-0.5 Hz) EEG frequencies can provide additional diagnostic information and help to improve the surgical outcome. In addition, novel computational techniques of iEEG signal analysis have provided new insights into the epileptic network. Here, we review some of these recent advances. Although these sophisticated and advanced techniques of iEEG analysis show promise in localizing the epileptogenic zone, their utility needs to be further validated in larger studies.

Neurosci Bull. 2016 May 19. [Epub ahead of print]