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首页> 外文期刊>The European Journal of Neuroscience >Increased discharge threshold after an interictal spike in human focal epilepsy.
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Increased discharge threshold after an interictal spike in human focal epilepsy.

机译：在人类局灶性癫痫发作发作间期峰值后，放电阈值增加。

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摘要

It is commonly assumed that interictal spikes (ISs) in focal epilepsies set off a period of inhibition that transiently reduces tissue excitability. Post-spike inhibition was described in experimental models but was never demonstrated in the human epileptic cortex. In the present study post-spike excitability was retrospectively evaluated on intracerebral stereo-electroencephalographic recordings performed in the epileptogenic cortex of five patients suffering from drug-resistant focal epilepsy secondary to Taylor-type neocortical dysplasias. Patients typically presented with highly periodic interictal spiking activity at 2.33 +/- 0.87 Hz (mean +/- SD) in the dysplastic region. During the stereo-electroencephalographic procedure, low-frequency stimulation at 1 Hz was systematically performed for diagnostic purposes to identify the epileptogenic zone. The probability of evoking an IS during the interspike period in response to 1-Hz stimuli delivered close to the ictal-onset zone was examined. Stimuli that occurred early after a spontaneous IS (within 70% of the inter-IS period) had a very low probability of generating a further IS. On the contrary, stimuli delivered during the late inter-IS period had the highest probability of evoking a further IS. The generation of stimulus-evoked ISs is occluded for several hundred milliseconds after the occurrence of a preceding spike discharge. As previously shown in animal models, these findings suggest that, during focal, periodic interictal spiking, human neocortical excitability is phasically controlled by post-spike inhibition.
机译：通常认为局灶性癫痫发作的发作期尖峰（ISs）会引起一段抑制作用，该抑制作用会暂时降低组织的兴奋性。实验模型中描述了穗后抑制，但从未在人类癫痫皮质中得到证实。在本研究中，对五例患有泰勒型新皮层发育不良的耐药性局灶性癫痫患者的癫痫发生皮层中进行的脑内立体脑电图记录进行了回顾性的评估，评估了穗后兴奋性。患者通常在增生异常区域以2.33 +/- 0.87 Hz（平均+/- SD）表现出高度周期性的尖峰活动。在立体脑电图过程中，出于诊断目的，系统地执行了1 Hz的低频刺激，以识别致癫痫区。检查了在尖峰间期响应于接近发作发作区的1 Hz刺激诱发IS的可能性。自发性IS发生后早期（IS间期的70％之内）发生的刺激产生新IS的可能性很小。相反，在IS间后期提供的刺激引起进一步IS发生的可能性最高。在前面的尖峰放电发生后，激发诱发的IS的产生被阻塞了几百毫秒。如先前在动物模型中显示的，这些发现表明，在局灶性，周期性发作性发作期间，人新皮层的兴奋性受峰值后抑制的控制。

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