Elucidation of brain networks in epilepsy after pediatric acute encephalopathy using simultaneous EEG-fMRI

2023 Fiscal Year Final Research Report

• Project/Area Number: 22K20853
• Research Category: Grant-in-Aid for Research Activity Start-up
• Allocation Type: Multi-year Fund
• Review Section: 0902:General internal medicine and related fields
• Research Institution: Nagoya University
• Principal Investigator: Ito Yuji 名古屋大学, 医学部附属病院, 医員 (80964783)
• Project Period (FY): 2022-08-31 – 2024-03-31
• Keywords: EEG-fMRI / 急性脳症後てんかん / AESD / 脳内ネットワーク / 脳梁離断術

Outline of Final Research Achievements

Two patients (three records in total) with post-AESD epilepsy were included in the analysis. Positive BOLD signals were observed in subcortical structures as well as in the bilateral frontotemporal lobes, the lesions of the acute encephalopathy. The one of two patients underwent total corpus callosotomy for epileptic spasms. After corpus callosotomy, the positive BOLD signal in the cerebral cortex was localized in the unilateral temporal lobe, and the positive BOLD signal in the subcortical structures had disappeared.
Post-AESD epilepsy appears to involve multiple epileptic foci and extensive epileptic networks, including subcortical structures. Corpus callosotomy may be effective in disconnecting this epileptic network.

Free Research Field

小児てんかんの脳波・画像解析

Academic Significance and Societal Importance of the Research Achievements

AESD後てんかんに共通するてんかん性の脳内ネットワークの機能異常を同定し、発作に対する治療効果との関連性を確認した。また、てんかん焦点の推定も行い、その後に脳梁離断術に至った症例については、術前後でBOLD信号変化のみられた領域を比較し、術後成績との関連性を確認することができた。これにより、難治な経過をとることが多いAESD後てんかんにおいて、その治療効果の指標としてのEEG-fMRI所見が確立され、焦点切除術や脳梁離断術を含めた外科的治療の可能性が開かれることに寄与できたと考える。