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Centrotemporal spikes during NREM sleep: The promoting action of thalamus revealed by simultaneous EEG and fMRI coregistration.

Mirandola L, Cantalupo G, Vaudano AE, Avanzini P, Ruggieri A, Pisani F, Cossu G, Tassinari CA, Nichelli PF, Benuzzi F, Meletti S - Epilepsy Behav Case Rep (2013)

Bottom Line: In this patient, who fulfilled neither the diagnostic criteria for BECTS nor that for electrical status epilepticus in sleep (ESES), the transition from wakefulness to sleep was related to the involvement of a widespread cortical-subcortical network related to CTS.In particular, the involvement of a thalamic-perisylvian neural network similar to the one previously observed in patients with ESES suggests a common sleep-related network dysfunction even in cases with milder phenotypes without seizures.This finding, if confirmed in a larger cohort of patients, could have relevant therapeutic implication.

View Article: PubMed Central - PubMed

Affiliation: Department of Biomedical Sciences, Metabolism, and Neuroscience, University of Modena and Reggio Emilia, Italy.

ABSTRACT
Benign childhood epilepsy with centrotemporal spikes (BECTS) has been investigated through EEG-fMRI with the aim of localizing the generators of the epileptic activity, revealing, in most cases, the activation of the sensory-motor cortex ipsilateral to the centrotemporal spikes (CTS). In this case report, we investigated the brain circuits hemodynamically involved by CTS recorded during wakefulness and sleep in one boy with CTS and a language disorder but without epilepsy. For this purpose, the patient underwent EEG-fMRI coregistration. During the "awake session", fMRI analysis of right-sided CTS showed increments of BOLD signal in the bilateral sensory-motor cortex. During the "sleep session", BOLD increments related to right-sided CTS were observed in a widespread bilateral cortical-subcortical network involving the thalamus, basal ganglia, sensory-motor cortex, perisylvian cortex, and cerebellum. In this patient, who fulfilled neither the diagnostic criteria for BECTS nor that for electrical status epilepticus in sleep (ESES), the transition from wakefulness to sleep was related to the involvement of a widespread cortical-subcortical network related to CTS. In particular, the involvement of a thalamic-perisylvian neural network similar to the one previously observed in patients with ESES suggests a common sleep-related network dysfunction even in cases with milder phenotypes without seizures. This finding, if confirmed in a larger cohort of patients, could have relevant therapeutic implication.

No MeSH data available.


Related in: MedlinePlus

EEG–fMRI results. Left panel. Wakefulness: A color-coded overlay of SPM{T} (red: positive BOLD response; blue: negative BOLD response)-HRF related (P < 0.05 corrected for multiple comparison) onto the patient's T1 slice overlay showing BOLD signal increases related to right CTS in the bilateral sensory–motor cortex. BOLD signal changes for left-sided CTS and a decrease in clusters for both right and left CTS were not detected. Right panel. “Sleep”: A color-coded overlay of SPM{T} (red: positive BOLD response; blue: negative BOLD response)-HRF related (P < 0.05 corrected for multiple comparison) onto the patient's T1 slice overlay showing BOLD signal increases related to right CTS involving the bilateral thalamus, basal ganglia, sensory–motor cortex, perisylvian cortex, paracentral lobule, cingulated cortex, and cerebellum. fMRI data analysis regarding TD and DD did not demonstrate any significant hemodynamic changes both in the awake and asleep sessions. No BOLD signal decreases were detected.
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f0010: EEG–fMRI results. Left panel. Wakefulness: A color-coded overlay of SPM{T} (red: positive BOLD response; blue: negative BOLD response)-HRF related (P < 0.05 corrected for multiple comparison) onto the patient's T1 slice overlay showing BOLD signal increases related to right CTS in the bilateral sensory–motor cortex. BOLD signal changes for left-sided CTS and a decrease in clusters for both right and left CTS were not detected. Right panel. “Sleep”: A color-coded overlay of SPM{T} (red: positive BOLD response; blue: negative BOLD response)-HRF related (P < 0.05 corrected for multiple comparison) onto the patient's T1 slice overlay showing BOLD signal increases related to right CTS involving the bilateral thalamus, basal ganglia, sensory–motor cortex, perisylvian cortex, paracentral lobule, cingulated cortex, and cerebellum. fMRI data analysis regarding TD and DD did not demonstrate any significant hemodynamic changes both in the awake and asleep sessions. No BOLD signal decreases were detected.

Mentions: During the “awake session”, fMRI analysis of right-sided CTS showed increments of BOLD signal in the bilateral sensory–motor cortex (Fig. 2, left panel). No BOLD signal changes were detected for left-sided CTS. During the “sleep session”, BOLD increments related to right-sided CTS were observed in a widespread bilateral cortical–subcortical network involving the thalamus, basal ganglia, sensory–motor cortex, perisylvian cortex, paracentral lobule, anterior cingulated cortex, and cerebellum (Fig. 2, right panel). The same results were obtained in relation to the left-sided CTS, although with less statistical power (not shown). No decrements in BOLD signal were detected in both sessions.


Centrotemporal spikes during NREM sleep: The promoting action of thalamus revealed by simultaneous EEG and fMRI coregistration.

Mirandola L, Cantalupo G, Vaudano AE, Avanzini P, Ruggieri A, Pisani F, Cossu G, Tassinari CA, Nichelli PF, Benuzzi F, Meletti S - Epilepsy Behav Case Rep (2013)

EEG–fMRI results. Left panel. Wakefulness: A color-coded overlay of SPM{T} (red: positive BOLD response; blue: negative BOLD response)-HRF related (P < 0.05 corrected for multiple comparison) onto the patient's T1 slice overlay showing BOLD signal increases related to right CTS in the bilateral sensory–motor cortex. BOLD signal changes for left-sided CTS and a decrease in clusters for both right and left CTS were not detected. Right panel. “Sleep”: A color-coded overlay of SPM{T} (red: positive BOLD response; blue: negative BOLD response)-HRF related (P < 0.05 corrected for multiple comparison) onto the patient's T1 slice overlay showing BOLD signal increases related to right CTS involving the bilateral thalamus, basal ganglia, sensory–motor cortex, perisylvian cortex, paracentral lobule, cingulated cortex, and cerebellum. fMRI data analysis regarding TD and DD did not demonstrate any significant hemodynamic changes both in the awake and asleep sessions. No BOLD signal decreases were detected.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4150635&req=5

f0010: EEG–fMRI results. Left panel. Wakefulness: A color-coded overlay of SPM{T} (red: positive BOLD response; blue: negative BOLD response)-HRF related (P < 0.05 corrected for multiple comparison) onto the patient's T1 slice overlay showing BOLD signal increases related to right CTS in the bilateral sensory–motor cortex. BOLD signal changes for left-sided CTS and a decrease in clusters for both right and left CTS were not detected. Right panel. “Sleep”: A color-coded overlay of SPM{T} (red: positive BOLD response; blue: negative BOLD response)-HRF related (P < 0.05 corrected for multiple comparison) onto the patient's T1 slice overlay showing BOLD signal increases related to right CTS involving the bilateral thalamus, basal ganglia, sensory–motor cortex, perisylvian cortex, paracentral lobule, cingulated cortex, and cerebellum. fMRI data analysis regarding TD and DD did not demonstrate any significant hemodynamic changes both in the awake and asleep sessions. No BOLD signal decreases were detected.
Mentions: During the “awake session”, fMRI analysis of right-sided CTS showed increments of BOLD signal in the bilateral sensory–motor cortex (Fig. 2, left panel). No BOLD signal changes were detected for left-sided CTS. During the “sleep session”, BOLD increments related to right-sided CTS were observed in a widespread bilateral cortical–subcortical network involving the thalamus, basal ganglia, sensory–motor cortex, perisylvian cortex, paracentral lobule, anterior cingulated cortex, and cerebellum (Fig. 2, right panel). The same results were obtained in relation to the left-sided CTS, although with less statistical power (not shown). No decrements in BOLD signal were detected in both sessions.

Bottom Line: In this patient, who fulfilled neither the diagnostic criteria for BECTS nor that for electrical status epilepticus in sleep (ESES), the transition from wakefulness to sleep was related to the involvement of a widespread cortical-subcortical network related to CTS.In particular, the involvement of a thalamic-perisylvian neural network similar to the one previously observed in patients with ESES suggests a common sleep-related network dysfunction even in cases with milder phenotypes without seizures.This finding, if confirmed in a larger cohort of patients, could have relevant therapeutic implication.

View Article: PubMed Central - PubMed

Affiliation: Department of Biomedical Sciences, Metabolism, and Neuroscience, University of Modena and Reggio Emilia, Italy.

ABSTRACT
Benign childhood epilepsy with centrotemporal spikes (BECTS) has been investigated through EEG-fMRI with the aim of localizing the generators of the epileptic activity, revealing, in most cases, the activation of the sensory-motor cortex ipsilateral to the centrotemporal spikes (CTS). In this case report, we investigated the brain circuits hemodynamically involved by CTS recorded during wakefulness and sleep in one boy with CTS and a language disorder but without epilepsy. For this purpose, the patient underwent EEG-fMRI coregistration. During the "awake session", fMRI analysis of right-sided CTS showed increments of BOLD signal in the bilateral sensory-motor cortex. During the "sleep session", BOLD increments related to right-sided CTS were observed in a widespread bilateral cortical-subcortical network involving the thalamus, basal ganglia, sensory-motor cortex, perisylvian cortex, and cerebellum. In this patient, who fulfilled neither the diagnostic criteria for BECTS nor that for electrical status epilepticus in sleep (ESES), the transition from wakefulness to sleep was related to the involvement of a widespread cortical-subcortical network related to CTS. In particular, the involvement of a thalamic-perisylvian neural network similar to the one previously observed in patients with ESES suggests a common sleep-related network dysfunction even in cases with milder phenotypes without seizures. This finding, if confirmed in a larger cohort of patients, could have relevant therapeutic implication.

No MeSH data available.


Related in: MedlinePlus