皮层高<italic style="font-style: italic">γ</italic>振荡对致痫灶的定位价值分析

练欢; 但炜; 魏钰; 谢延风; 石全红; 詹彦; 孙晓川

doi:10.16016/j.1000-5404.202102036

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皮层高γ振荡对致痫灶的定位价值分析

神经科学 | 更新时间：2026-02-13

- 皮层高γ振荡对致痫灶的定位价值分析
- Value of cortical high-frequency gamma oscillations with electrocorticography in location of epileptogenic zone
- 第三军医大学学报 2021年43卷第15期页码：1465-1470
- 作者机构：
  
  400016 重庆，重庆医科大学附属第一医院神经外科
- 作者简介：
  
  [但炜，E-mail: 1187403442@qq.com DAN Wei, E-mail: 1187403442@qq.com
- 基金信息：
  
  国家临床重点专科建设项目经费资助((2011)170号);重庆市卫生局重点课题(2012-1-008)
- DOI：10.16016/j.1000-5404.202102036
  中图分类号： R741.044;R742.1
- 收稿：2021-02-05，
  
  修回：2021-04-30，
  
  纸质出版：2021-08-15
- 稿件说明：
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练欢, 但炜, 魏钰, 等. 皮层高γ振荡对致痫灶的定位价值分析[J]. 第三军医大学学报, 2021,43(15):1465-1470.

Huan LIAN, Wei DAN, Yu WEI, et al. Value of cortical high-frequency gamma oscillations with electrocorticography in location of epileptogenic zone[J]. Journal of Third Military Medical University, 2021, 43(15): 1465-1470.
练欢, 但炜, 魏钰, 等. 皮层高γ振荡对致痫灶的定位价值分析[J]. 第三军医大学学报, 2021,43(15):1465-1470. DOI： 10.16016/j.1000-5404.202102036.

Huan LIAN, Wei DAN, Yu WEI, et al. Value of cortical high-frequency gamma oscillations with electrocorticography in location of epileptogenic zone[J]. Journal of Third Military Medical University, 2021, 43(15): 1465-1470. DOI： 10.16016/j.1000-5404.202102036.

摘要

目的

通过比较难治性颞叶癫痫患者术中皮层脑电图(electrocorticography

ECoG)中高

振荡(65~100 Hz)振荡活动与棘尖波在激惹区内外及病灶区、病周区及远离病灶区的出现率及分布特点，探讨皮层高频振荡对致痫灶的定位价值。

方法

回顾性分析本院2013年1月至2019年1月21例难治性颞叶癫痫患者的术中皮层脑电图，将发作间期癫痫样放电(interictal epileptiform discharges，IEDs)出现的导联定义为激惹区，无IEDs出现的导联定为非激惹区，结合术前影像学检查、术中导航及神经外科医师判断将监测皮层区

域分为病灶区、病周区及远离病灶区。比较IEDs(滤波范围: 1~30 Hz)和高

振荡(滤波范围: 65~100 Hz)的出现率及分布特点，激惹区内、外高

振荡的分布及病灶周围高

振荡的发生率。

结果

① 21例患者IEDs和高

振荡的总出现率均为100.0%(21/21)，IEDs、高

振荡、Gamma+IEDs的导联数分别为(9.50±2.80)、(8.14±2.93)、(6.60±2.40)，经RM单向方差分析，IEDs的导联数显著高于高

振荡和Gamma+IEDs。②激惹区和非激惹区中高

振荡的导联数分别为(6.60±2.40)、(1.50±1.30)，事件率分别为(0.42±0.30)、(0.20±0.20)，经配对

检验，激惹区大于非激惹区。③病灶区、病周区及远离病灶区中高

振荡事件数分别为(46.00±42.00)、(33.40±32.90)、(8.40±9.40)，事件率分别为(0.40±0.30)、(0.37±0.38)、(0.10±0.10)。经两两配对

检验，病灶区及病周区中高

振荡事件数及事件率差异无统计学意义，病灶区及病周区中高

振荡30 s事件数及事件率分别显著高于远离病灶区。

结论

术中ECoG中传统IEDs目前仍是指导癫痫手术切除范围的重要标识，而高

振荡与棘尖波及病灶具有高度一致性，且对于致痫灶识别比棘尖波更精确。IEDs结合高

振荡可能具有更高的定位致痫灶价值。

Abstract

Objective

To investigate the value of high-gamma oscillations (65~100 Hz) in epileptogenic foci localization by analyzing the intraoperative electrocorticography (ECoG) in patients with refractory temporal lobe epilepsy

along with comparing the occurrence rate and distribution characteristics of high-gamma activity as well as spike wave inside and outside the irritative zone and around the foci.

Methods

A retrospective analysis was carried out on the intraoperative ECoG data of 21 patients with refractory temporal lobe epilepsy in our hospital from January 2013 to January 2019. The channels with interictal epileptiform discharges (IEDs) were defined as irritated area

and those without IEDs as non-irritated area. Based on the preoperative imaging data

intraoperative navigation combined with neurosurgeon's judgment

the monitoring cortical area was divided into focal area

perifocal area and the area away from the focus. Then the occurrence rate and distribution characteristics of IEDs (filter range: 1~30 Hz) and high-gamma were compared

and the distribution of high-gamma activity inside and outside the irritated area

and the incidence of high-gamma around the foci were analyzed.

Results

① The overall incidence of IEDs and of high-gamma in the 21 patients were both 100.0% (21/21)

and the average number of channels for IEDs

high-gamma and gamma+IEDs was 9.50±2.80

8.14±2.93 and 6.60±2.40

respectively

indicating notably more IEDs channels than the other 2

by RM one-way ANOVA (

0.05). ②The channel numbers of high-gamma were 6.60±2.40 and 1.50±1.30 in the irritated and non-irritated areas respectively

and the event rates were 0.42±0.30 and 0.20±0.20 respectively

showing significant difference between the 2 areas (

0.01). ③The event numbers of high-gamma activity were 46.00±42.00

33.40±32.90 and 8.40±9.40 in the focal area

the perifocal area and the area away from the focus

respectively

with the corresponding event rate of 0.40±0.30

0.37±0.38 and 0.10±0.10

respectively. There were no significant differences in the event numbers and rates between the focal and perifocal area

though they were both significantly higher than that of the area away from the focus

by paired

-test (

0.05).

Conclusion

Traditional IEDs of ECoG are still an important marker to guide the range of resection intra-operatively in epilepsy surgery

while high-gamma presents great consistency with both IEDs and foci

with more accurate identification of epileptogenic zone than IEDs. Therefore

IEDs combined with high-gamma may have greater value in the localization of epileptogenic zone.

关键词

Keywords

references

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皮层高γ振荡对致痫灶的定位价值分析

Value of cortical high-frequency gamma oscillations with electrocorticography in location of epileptogenic zone

DOI：10.16016/j.1000-5404.202102036

摘要

Abstract

关键词

Keywords

references