机构：[1]Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China重点科室诊疗科室神经外科神经外科首都医科大学附属天坛医院[2]Beijing Key Laboratory of Neurostimulation, Beijing, China[3]Epilepsy Center, Peking University First Hospital Fengtai Hospital, Beijing, China[4]Stereotactic and Functional Neurosurgery Laboratory, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China研究所北京市神经外科研究所首都医科大学附属天坛医院[5]Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China重点科室诊疗科室神经病学中心神经病学中心首都医科大学附属天坛医院
Objective Oroalimentary automatisms (OAAs) are common clinical manifestations of medial temporal lobe epilepsy. Nevertheless, the location of the symptomatogenic zone of OAAs remains unclear. The generation mechanism of OAAs also has not been clarified. We attempt to explain these problems by analyzing interictal [F-18]-fluorodeoxyglucose positron emission tomography ((18)FDG-PET) imaging and ictal stereo-electroencephalography (SEEG) recordings in patients with medial temporal lobe epilepsy. Methods Fifty-seven patients with mesial temporal lobe epilepsy were analyzed retrospectively. All underwent anterior temporal lobectomy (ATL) and were seizure-free. The patients were divided into OAA (+) and OAA (-) groups according to the occurrence of consistent stereotyped OAAs. The interictal PET data were compared with those of 18 healthy controls and were then compared between groups using statistical parametric mapping (SPM). Functional connectivity using linear regression analysis was performed between the target brain regions. To clarify the network of OAAs, ictal epileptogenicity index (EI) values, and the nonlinear correlation method h(2) were performed with SEEG on patients. Results Compared to OAAs (-), the rolandic operculum was the only area with significant differences. Hippocampus and rolandic operculum showed significant correlations in the OAA (+) group (y = 0.758x+0.470, R-2 = 0.456, P = 0.000). No correlation was found in the OAA (-) group (P = 0.486). The EI values of the OAA (+) group (median 0.20) were significantly higher (P < 0.0001) than those of the OAA (-) group (median 0). The h(2) in the OAA (+) group (h(2) = 0.23 +/- 0.13) showed stronger functional connectivity (t = 6.166, P < 0.0001) than that of the OAA (-) group (h(2) = 0.08 +/- 0.05). Significance The rolandic operculum is most likely to be the symptomatogenic zone of OAAs. In medial temporal lobe epilepsy, unilateral functional connection from the hippocampus to the rolandic operculum during seizure onset is the basis for the generation of OAAs.
基金：
Beijing Municipal Science & Technology CommissionBeijing Municipal Science & Technology Commission [Z161100000216130]; National Natural Science Foundation of ChinaNational Natural Science Foundation of China [81701276, 81471327]
第一作者机构：[1]Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
通讯作者：
通讯机构：[1]Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China[2]Beijing Key Laboratory of Neurostimulation, Beijing, China[*1]Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
推荐引用方式(GB/T 7714)：
Wang Yao,Wang Xiu,Mo Jia-jie,et al.Symptomatogenic zone and network of oroalimentary automatisms in mesial temporal lobe epilepsy[J].EPILEPSIA.2019,60(6):1150-1159.doi:10.1111/epi.15457.
APA：
Wang, Yao,Wang, Xiu,Mo, Jia-jie,Sang, Lin,Zhao, Bao-tian...&Zhang, Kai.(2019).Symptomatogenic zone and network of oroalimentary automatisms in mesial temporal lobe epilepsy.EPILEPSIA,60,(6)
MLA：
Wang, Yao,et al."Symptomatogenic zone and network of oroalimentary automatisms in mesial temporal lobe epilepsy".EPILEPSIA 60..6(2019):1150-1159
医学