Epileptic Neuronal Networks: Methods of Identification and Clinical Relevance

Stefan, Hermann; Silva, Fernando Henrique Lopes da

doi:10.3389/fneur.2013.00008

Cited by 127 publications

(95 citation statements)

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“…This is further corroborated by recent studies that, using modern imaging techniques, generalized seizures can be tracked down to local neuronal networks [18].…”

Section: Discussionsupporting

confidence: 74%

Focal epilepsy in Glucose transporter type 1 (Glut1) defects: case reports and a review of literature

et al. 2014

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Mutations in SLC2A1, encoding the glucose transporter type 1 (Glut1), cause a wide range of neurological disorders: (1) classical Glut1 deficiency syndrome (Glut1-DS) with an early onset epileptic encephalopathy including a severe epilepsy, psychomotor delay, ataxia and microcephaly, (2) paroxysmal exercise-induced dyskinesia (PED) and (3) various forms of idiopathic/genetic generalized epilepsies such as different forms of absence epilepsies. Up to now, focal epilepsy was not associated with SLC2A1 mutations. Here, we describe four cases in which focal seizures present the main or at least initial category of seizures. Two patients suffered from a classical Glut1-DS, whereas two individuals presented with focal epilepsy related to PED. We identified three novel SLC2A1 mutations in these unrelated individuals. Our study underscores that focal epilepsy can be caused by SLC2A1 mutations or that focal seizures may present the main type of seizures. Patients with focal epilepsy and PED should undergo genetic testing and can benefit from a ketogenic diet. But also individuals with pharmaco-resistant focal epilepsy and cognitive impairment might be candidates for genetic testing in SLC2A1.

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“…This is further corroborated by recent studies that, using modern imaging techniques, generalized seizures can be tracked down to local neuronal networks [18].…”

Section: Discussionsupporting

confidence: 74%

Focal epilepsy in Glucose transporter type 1 (Glut1) defects: case reports and a review of literature

et al. 2014

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“…These human LFB connectivity findings have significant implications for future studies of homeostatic dysfunction in neurologic diseases. Temporal lobe epilepsy, for example, is postulated to be a disorder of the limbic system (Bartolomei et al, 2001;Bonilha et al, 2012;Spencer, 2002), and seizure disorders are increasingly conceptualized as network disorders (Blumenfeld, 2014;Stefan and Lopes da Silva, 2013). Seizures originating in temporal sites have been shown to spread along established axonal pathways (Mraovitch and Calando, 1999;Yoo et al, 2014), allowing the seizure activity to propagate to subcortical arousal nuclei necessary for cortical activation.…”

Section: Human Central Homeostatic Network 195 Discussionmentioning

confidence: 99%

The Structural Connectome of the Human Central Homeostatic Network

et al. 2016

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Homeostatic adaptations to stress are regulated by interactions between the brainstem and regions of the forebrain, including limbic sites related to respiratory, autonomic, affective, and cognitive processing. Neuroanatomic connections between these homeostatic regions, however, have not been thoroughly identified in the human brain. In this study, we perform diffusion spectrum imaging tractography using the MGH-USC Connectome MRI scanner to visualize structural connections in the human brain linking autonomic and cardiorespiratory nuclei in the midbrain, pons, and medulla oblongata with forebrain sites critical to homeostatic control. Probabilistic tractography analyses in six healthy adults revealed connections between six brainstem nuclei and seven forebrain regions, several over long distances between the caudal medulla and cerebral cortex. The strongest evidence for brainstem-homeostatic forebrain connectivity in this study was between the brainstem midline raphe and the medial temporal lobe. The subiculum and amygdala were the sampled forebrain nodes with the most extensive brainstem connections. Within the human brainstem-homeostatic forebrain connectome, we observed that a lateral forebrain bundle, whose connectivity is distinct from that of rodents and nonhuman primates, is the primary conduit for connections between the brainstem and medial temporal lobe. This study supports the concept that interconnected brainstem and forebrain nodes form an integrated central homeostatic network (CHN) in the human brain. Our findings provide an initial foundation for elucidating the neuroanatomic basis of homeostasis in the normal human brain, as well as for mapping CHN disconnections in patients with disorders of homeostasis, including sudden and unexpected death, and epilepsy.

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“…Recent interest in brain epilepsy networks has motivated the application of graph theory concepts as well as modeling of brain connectivity using DTI, fMRI and EEG (Richardson, 2012;Bernhardt et al, 2013;Stefan and Lopes da Silva, 2013). Brain networks can be defined at multiple spatial and temporal scales, ranging from synapses to large brain regions, and microseconds to hours.…”

Section: Introductionmentioning

confidence: 99%