基于癫痫颅内外同步脑电高低频耦合的致痫区精准定位研究

Epilepsy is characterized by sudden abnormal discharge of neurons in the brain, resulting in a transient functional disorder of the brain. Repetitive seizures cause great harm to patients physically and mentally. There are two to three million drug refractory epilepsy patients in our country, and about 5000 patients are treated by surgical resection. At present, the cure rate of epileptic surgery is less than 70%, and the main cause of the failure of surgery is the missing of EZ and the inaccurate boundary marking. In this project, the goal is to locate EZ precisely, and we propose a two-step EZ localization scheme. By analyzing the coupling between the EEG high frequency and low frequency rhythms during seizures, we will study accurately extracting mechanism scalp high frequency oscillations (HFOs) under coupling condition, and develop a non-invasive global EZ localization method based on scalp HFOs. Further, by constructing high frequency and low frequency network based on simultaneous EEG, the coupling mode between the high and low frequency network will be studied, and we will realize the EZ boundary precise marking based on fusion of the results from scalp HFOs and epileptic coupled network. The main research contents of this project has not been seen in other studies, and the results will reveal the mechanism of EZ localization mechanism based on coupling feature of high and low frequency rhythms. This research will provide a new way for determining the placement of intracranial electrodes and surgical regions.

癫痫是大脑神经元突发性异常放电，导致短暂的大脑功能性障碍的疾病，其反复发作给患者身心带来极大伤害。我国有200-300万药物难治性癫痫患者，每年约5000人接受手术治疗。癫痫手术总治愈率约70%，致痫区定位是当前难题，而手术失败主要原因是致痫区定位遗漏和边界标记不准确。本项目以致痫区精准定位为目标，提出基于颅内外同步脑电图的致痫区两步定位方案。通过分析癫痫发作期脑电高频和低频节律的耦合规律，研究耦合条件下头皮脑电高频振荡(HFO)的精确提取机制，实现利用头皮HFO的致痫区无损全局定位方法；进一步，基于同步脑电图构建癫痫脑电高频和低频网络，研究癫痫高低频网络间耦合模式，融合头皮HFO和癫痫高低频耦合网络的定位结果，实现致痫区边界的精准定位。本项目的主要研究内容在国内外尚未见到，其成果将揭示脑电高低频耦合特征定位致痫区的机理，为临床确定颅内电极植入位置和手术区域提供新的途径。

癫痫是大脑神经元突发性异常放电，导致短暂的大脑功能性障碍的疾病。药物无法控制的难治性癫痫可通过手术治愈。我国约有900万癫痫患者，每年约5000名难治性癫痫患者接受手术，其中约30%患者不能治愈，实现精准的致痫区定位是手术成功关键。本项目基于患者术前颅内颅外脑电图数据，通过对脑电图高频振荡信号、高低频相位-幅度耦合特征，和跨频率癫痫网络进行研究，实现了致痫区精准定位方法。项目执行期间，项目团队发表了11篇研究论文。主要研究结果有：1）实现了癫痫脑电图高频振荡信号提取方法，建立颞叶癫痫长时程高频振荡信号与致痫区关联；2）将脑网络分析方法应用于难治性颞叶癫痫的致痫区定位；3）在癫痫网络研究和脑电图跨频率耦合分析基础上，提出并实现了跨频率癫痫网络构建方法，开发了软件工具，并应用于手术患者脑电图的分析，实现致痫区准确定位。上述研究深化了对癫痫网络的认识，本项目中提出的方法为癫痫外科精准定位致痫区提供了新方法，并为癫痫神经调控研究中确定靶点提供了基础。