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開催日 2014/9/13
時間 10:00 - 11:00
会場 Room I(311+312)
Chairperson(s) 寺田 清人 / Kiyohito Terada (NHO静岡てんかん・神経医療センター / NHO Shizuoka Institute of Epilepsy and Neurological Disorders, Japan)
三國 信啓 / Nobuhiro Mikuni (札幌医科大学 脳神経外科 / Department of Neurosurgery, Sapporo Medical University, Japan)

Intracranially-recorded ictal direct current shifts may precede high frequency oscillations in human epilepsy

  • O3-I-2-2
  • 金澤 恭子 / Kyoko Kanazawa:1,5 松本 理器 / Riki Matsumoto:2 今村 久司 / Hisaji Imamura:6 松橋 眞生 / Masao Matsuhashi:4 菊池 隆幸 / Takayuki Kikuchi:3 國枝 武治 / Takeharu Kunieda:3 三國 信啓 / Nobuhiro Mikuni:7 宮本 享 / Susumu Miyamoto:3 高橋 良輔 / Ryosuke Takahashi:1 池田 昭夫 / Akio Ikeda:2 
  • 1:京都大学 神経内科 / Department of Neurology, Kyoto University, Kyoto, Japan 2:京都大学 てんかん・運動異常生理学 / Department of Epilepsy, Movement Disorders and Physiology, Kyoto University, Kyoto, Japan 3:京都大学 脳神経外科 / Department of Neurosurgery, Kyoto University, Kyoto, Japan 4:京都大学 高次脳機能センター / Human Brain Research Center, Kyoto University, Kyoto, Japan 5:武田総合病院 神経内科 / Department of Neurology, Takeda General Hospital, Kyoto, Japan 6:福井赤十字病院 神経内科 / Department of Neurology, Fukui Red Cross Hospital, Fukui, Japan 7:札幌医科大学 脳神経外科 / Department of Neurological Surgery, Sapporo Medical University, Hokkaido, Japan 

Introduction: We assessed the temporal-spatial characteristics of ictal direct current (DC) shifts (or infraslow activity) and high frequency oscillations (HFOs) in 16 patients with intractable focal epilepsy. Methods: The underlying etiology consisted of cortical dysplasia, glioma, hippocampal sclerosis and low-grade neuroepithelial tumor in nine, four, two and one patients, respectively. The median number of analyzed seizure events was 8.0 per patient (range: 2-10). Chronic electrocorticographic recording was performed with (1) a band-pass filter of 0.016-600 Hz (or 0.016-300 Hz) and a sampling rate of 2,000 Hz (or 1000 Hz). Results: Ictal DC shifts and a sustained form of ictal HFOs were observed in 75.0% and 50.0% of the patients, and 71.3% and 46.3% of the analyzed seizures. Visual assessment revealed that the onset of ictal DC shifts preceded that of ictal HFOs with statistical significance in 5/7 patients. The spatial extent of ictal DC shifts or HFOs was smaller than that of the conventionally defined seizure onset zone in 9/12 patients. Additionally, acute antiepileptic drug (AED) loading affected ictal DC shifts and HFOs differently in duration for 1 patient. Discussion: Both ictal DC shifts and HFOs might represent the core of tissue generating seizures. Early occurrence of ictal DC shifts warrants further studies to determine the role of glia (possibly mediating ictal DC shifts) in seizure generation. Acutely loaded AED may influence differently on glial and neuronal activity.

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