1. Transient cortico‐cortical disconnection during psychogenic nonepileptic seizures (PNES)
- Author
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Marie Arthuis, Stanislas Lagarde, Tanguy Madec, Fabrice Bartolomei, Aileen McGonigal, C. G. Bénar, Institut de Neurosciences des Systèmes (INS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Service de neurophysiologie clinique [Hôpital de la Timone - APHM], Hôpital de la Timone [CHU - APHM] (TIMONE), and Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)
- Subjects
Adult ,0301 basic medicine ,Drug Resistant Epilepsy ,Prefrontal Cortex ,Posterior parietal cortex ,Electroencephalography ,Hippocampus ,Stereoelectroencephalography ,Young Adult ,03 medical and health sciences ,Epilepsy ,0302 clinical medicine ,Seizures ,Parietal Lobe ,Neural Pathways ,Humans ,Medicine ,Ictal ,Prefrontal cortex ,ComputingMilieux_MISCELLANEOUS ,Cerebral Cortex ,Temporal cortex ,medicine.diagnostic_test ,business.industry ,[SCCO.NEUR]Cognitive science/Neuroscience ,Amygdala ,medicine.disease ,Temporal Lobe ,030104 developmental biology ,Conversion Disorder ,Neurology ,Female ,Orbitofrontal cortex ,Electrocorticography ,Neurology (clinical) ,business ,Neuroscience ,030217 neurology & neurosurgery - Abstract
Psychogenic nonepileptic seizures (PNES) are paroxysmal clinical events that are often misdiagnosed as epileptic seizures, but which are not associated with electrographic discharge. Brain connectivity changes occurring during PNES are not known. We studied functional connectivity (Fc) in two patients with drug-resistant epilepsy, explored by stereotactic electroencephalography (EEG), in whom we recorded both epileptic seizures (ES) and PNES. Functional connectivity using pair-wise nonlinear correlation was computed between signals from seven brain areas: amygdala, hippocampus, lateral temporal cortex, anterior insula, orbitofrontal cortex, prefrontal cortex, and lateral parietal cortex. We assessed changes in global Fc during PNES in comparison with a background period. During PNES, a global decrease of Fc occurred between the different brain regions studied, compared with the interictal period. In both patients, decreased Fc was prominent in connections involving the anterior insula and parietal cortex. In conclusion, some PNES are associated with ictal functional disconnection between brain areas, particularly involving the parietal cortices and the anterior insula.
- Published
- 2020
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