Abuse of amphetamine-based stimulants is a primary public health concern.Recent studies have underscored a troubling escalation in the inappropriate use of prescription amphetamine-based stimulants.However,the neuroph...Abuse of amphetamine-based stimulants is a primary public health concern.Recent studies have underscored a troubling escalation in the inappropriate use of prescription amphetamine-based stimulants.However,the neurophysiological mechanisms underlying the impact of acute methamphetamine exposure(AME)on sleep homeostasis remain to be explored.This study employed non-human primates and electroencephalogram(EEG)sleep staging to evaluate the influence of AME on neural oscillations.The primary focus was on alterations in spindles,delta oscillations,and slow oscillations(SOs)and their interactions as conduits through which AME influences sleep stability.AME predominantly diminishes sleep-spindle waves in the non-rapid eye movement 2(NREM2)stage,and impacts SOs and delta waves differentially.Furthermore,the competitive relationships between SO/delta waves nesting with sleep spindles were selectively strengthened by methamphetamine.Complexity analysis also revealed that the SO-nested spindles had lost their ability to maintain sleep depth and stability.In summary,this finding could be one of the intrinsic electrophysiological mechanisms by which AME disrupted sleep homeostasis.展开更多
Brain stimulation provides an alternative,reversible,and adjustable treatment option for patients with drugresistant epilepsy(DRE).Deep brain stimulation(DBS)and responsive neural stimulation(RNS)have been applied in ...Brain stimulation provides an alternative,reversible,and adjustable treatment option for patients with drugresistant epilepsy(DRE).Deep brain stimulation(DBS)and responsive neural stimulation(RNS)have been applied in patients in the past decade,partly filling an essential gap for patients with DRE who are ineligible or unwilling to receive irreversible surgical treatments.Another new type of brain stimulation,chronic subthreshold cortical stimulation(CSCS),also deserves attention.In the past decade,clinical data about those therapies’longterm safety and efficacy have been accumulated,and their clinical effectiveness has been further confirmed.Nonetheless,the therapeutic mechanisms of brain stimulation have been found far more complicated than the original design.The clinical effects of different stimulation targets of DBS and the indications for patient selection remain to be further demonstrated and clarified.There is a growing consensus that the efficacy of RNS is likely due to a long-term neuromodulatory effect on the epileptogenic network,rather than only arresting seizures.Triggering strategy(open-loop versus closed-loop)could not be seen as the essential difference between DBS and RNS in the neuromodulation mechanism for epilepsy.In addition to excitability inhibition and desynchronization for the epileptogenic zone,stimulation-induced modification of the connection and plasticity of the distributed network were identified.Further in-depth understanding of the modulatory mechanism will contribute to creating novel modulation systems and improving the efficacy of brain stimulation in the treatment of epilepsy.展开更多
Background:Frontal lobe epilepsy(FLE),the second most common refractory focal epilepsy,of which focal cortical dysplasia(FCD)is a common etiology.Electrophysiological analysis offers crucial insights into FCD subtype ...Background:Frontal lobe epilepsy(FLE),the second most common refractory focal epilepsy,of which focal cortical dysplasia(FCD)is a common etiology.Electrophysiological analysis offers crucial insights into FCD subtype differentiation.Thus,we aim to evaluate scalp electroencephalography(EEG)and stereoelectroencephalography(SEEG)features,clinical characteristics,and postsurgical outcomes in a uniform series of patients with pathologically confirmed FCD type I or II who underwent FLE surgery.Methods:Thirty-four consecutive patients were retrospectively analyzed.The interictal and ictal EEG and SEEG features,clinical characteristics,and surgical outcomes were evaluated.Results:Six interictal EEG patterns were identified.Focal continuous fast epileptiform discharges were only encountered in FCD II,with a high specificity of 100%.Continuous periodic spikes were predominantly observed in FCD II,with a high specificity of 94.4%;while repetitive discharges were largely observed in FCD I,with a specificity of 94.4%.Patients with a shorter epilepsy duration were more likely to show continuous irregular slowing(P=0.034).Five EEG ictal onset patterns(IOPs)were identified.Spikes and slow waves were observed only in the FCD I group,whereas alpha activity was observed only in the FCD II group.Four interictal SEEG patterns were identified.Continuous periodic spikes were most frequently observed in the FCD II group(P=0.044).Seven SEEG IOPs values were identified.Slow-wave or baseline shift followed by low-voltage fast activity(LVFA)and delta brush were observed only in FCD I.In contrast,preictal spiking followed by LVFA was mostly observed in the FCD II.Fast activity was observed only in the FCD I group.The average follow-up time was 1.8 years,and favorable surgical outcomes were observed more often in patients with FCD II(66.7%)than in those with FCD I(44.4%)but without significance(P?0.315).Conclusion:FCD subtypes share distinct EEG and SEEG signatures,and some special patterns may be indicative of specific subtypes.展开更多
基金supported by the National Natural Science Foundation of China(No.82271515)the SJTU Trans-Med Awards Research(No.2019015)+4 种基金the Scientific and Technological Innovation Action Plan of Shanghai(No.KY20211478)the Shanghai Municipal Science and Technology Major Project(No.2021SHZDZX)the Nursing Development Program of Shanghai Jiao Tong University School of Medicine(No.SJTUHLXK2022)the 2024 Shanghai Ruijin Hospital Nursing Research Fund(No.RJHK-2024-001)the Shanghai Nursing Association Funding(No.2024MS-B13),China。
文摘Abuse of amphetamine-based stimulants is a primary public health concern.Recent studies have underscored a troubling escalation in the inappropriate use of prescription amphetamine-based stimulants.However,the neurophysiological mechanisms underlying the impact of acute methamphetamine exposure(AME)on sleep homeostasis remain to be explored.This study employed non-human primates and electroencephalogram(EEG)sleep staging to evaluate the influence of AME on neural oscillations.The primary focus was on alterations in spindles,delta oscillations,and slow oscillations(SOs)and their interactions as conduits through which AME influences sleep stability.AME predominantly diminishes sleep-spindle waves in the non-rapid eye movement 2(NREM2)stage,and impacts SOs and delta waves differentially.Furthermore,the competitive relationships between SO/delta waves nesting with sleep spindles were selectively strengthened by methamphetamine.Complexity analysis also revealed that the SO-nested spindles had lost their ability to maintain sleep depth and stability.In summary,this finding could be one of the intrinsic electrophysiological mechanisms by which AME disrupted sleep homeostasis.
基金supported by Science,Technology and Innovation(STI)2030-Major Projects(No.2021ZD0201605)Research and Development(R&D)Program of Beijing Municipal Education Commission(No.KZ202110025036)National Natural Science Foundation of China(No.82271494).
文摘Brain stimulation provides an alternative,reversible,and adjustable treatment option for patients with drugresistant epilepsy(DRE).Deep brain stimulation(DBS)and responsive neural stimulation(RNS)have been applied in patients in the past decade,partly filling an essential gap for patients with DRE who are ineligible or unwilling to receive irreversible surgical treatments.Another new type of brain stimulation,chronic subthreshold cortical stimulation(CSCS),also deserves attention.In the past decade,clinical data about those therapies’longterm safety and efficacy have been accumulated,and their clinical effectiveness has been further confirmed.Nonetheless,the therapeutic mechanisms of brain stimulation have been found far more complicated than the original design.The clinical effects of different stimulation targets of DBS and the indications for patient selection remain to be further demonstrated and clarified.There is a growing consensus that the efficacy of RNS is likely due to a long-term neuromodulatory effect on the epileptogenic network,rather than only arresting seizures.Triggering strategy(open-loop versus closed-loop)could not be seen as the essential difference between DBS and RNS in the neuromodulation mechanism for epilepsy.In addition to excitability inhibition and desynchronization for the epileptogenic zone,stimulation-induced modification of the connection and plasticity of the distributed network were identified.Further in-depth understanding of the modulatory mechanism will contribute to creating novel modulation systems and improving the efficacy of brain stimulation in the treatment of epilepsy.
基金supported by grants from the Capital Medical University Natural Foundation(No.PYZ20119)Epilepsy Research Fund of the China Association against Epilepsy(No.CU-B-2021-24)Beijing Natural Science Foundation(No.L182015).
文摘Background:Frontal lobe epilepsy(FLE),the second most common refractory focal epilepsy,of which focal cortical dysplasia(FCD)is a common etiology.Electrophysiological analysis offers crucial insights into FCD subtype differentiation.Thus,we aim to evaluate scalp electroencephalography(EEG)and stereoelectroencephalography(SEEG)features,clinical characteristics,and postsurgical outcomes in a uniform series of patients with pathologically confirmed FCD type I or II who underwent FLE surgery.Methods:Thirty-four consecutive patients were retrospectively analyzed.The interictal and ictal EEG and SEEG features,clinical characteristics,and surgical outcomes were evaluated.Results:Six interictal EEG patterns were identified.Focal continuous fast epileptiform discharges were only encountered in FCD II,with a high specificity of 100%.Continuous periodic spikes were predominantly observed in FCD II,with a high specificity of 94.4%;while repetitive discharges were largely observed in FCD I,with a specificity of 94.4%.Patients with a shorter epilepsy duration were more likely to show continuous irregular slowing(P=0.034).Five EEG ictal onset patterns(IOPs)were identified.Spikes and slow waves were observed only in the FCD I group,whereas alpha activity was observed only in the FCD II group.Four interictal SEEG patterns were identified.Continuous periodic spikes were most frequently observed in the FCD II group(P=0.044).Seven SEEG IOPs values were identified.Slow-wave or baseline shift followed by low-voltage fast activity(LVFA)and delta brush were observed only in FCD I.In contrast,preictal spiking followed by LVFA was mostly observed in the FCD II.Fast activity was observed only in the FCD I group.The average follow-up time was 1.8 years,and favorable surgical outcomes were observed more often in patients with FCD II(66.7%)than in those with FCD I(44.4%)but without significance(P?0.315).Conclusion:FCD subtypes share distinct EEG and SEEG signatures,and some special patterns may be indicative of specific subtypes.
