Spreading photoparoxysmal EEG response is associated with an abnormal cortical excitability pattern

被引:52
作者
Siniatchkin, Michael
Groppa, Sergey
Jerosch, Bettina
Muhle, Hiltrud
Kurth, Christoph
Shepherd, Alex J.
Siebner, Hartwig
Stephani, Ulrich
机构
[1] Univ Kiel, Neuropediat Dept, D-24098 Kiel, Germany
[2] Univ Kiel, Dept Neurol, D-24098 Kiel, Germany
[3] Epilepsy Ctr, Kehl, Germany
[4] Univ London Birkbeck Coll, Sch Psychol, London WC1E 7HX, England
关键词
cortical excitability; motor cortex; photosensitivity; transcranial magnetic stimulation; visual cortex;
D O I
10.1093/brain/awl306
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Photosensitivity or photoparoxysmal response (PPR) is a highly heritable electroencephalographic trait characterized by an abnormal cortical response to intermittent photic stimulation (IPS). In PPR-positive individuals, IPS induces spikes, spike-waves or intermittent slow waves. The PPR may be restricted to posterior visual areas (i.e. local PPR with occipital spikes only) or spread to anterior non-visual cortical regions (i.e. PPR with propagation). The mechanisms underlying the PPR and causing its spread remain to be clarified. In unmedicated PPR-positive individuals and PPR-negative control participants without any history of previous seizures, we used focal transcranial magnetic stimulation (TMS) to investigate the excitability of the visual or primary motor cortex (M1). In the first experiment [18 healthy control subjects (i.e. without PPR in electroencephalography: 6 females, mean age 26.5 +/- 7.34 years) and 17 healthy participants with PPR (7 females, mean age 25.18 +/- 12.2 years) were studied], occipital TMS was used to elicit phosphenes or to suppress the visual perception of letter trigrams. PPR-positive individuals with propagation had lower phosphene thresholds and steeper stimulus-response curves than individuals without PPR or with occipital spikes only. Occipital TMS also induced a stronger suppression of visual perception in PPR-positive subjects with propagation relative to subjects without PPR or with occipital spikes. In the second experiment, we applied TMS over the right M1 without concurrent IPS and measured the motor threshold, the stimulus response curve, and the duration of the cortical silent period (CSP) in PPR positive individuals with propagation and in PPR-negative control participants [15 right-handed healthy subjects without PPR (3 males, mean age 17.7 +/- 3.6 years) and 14 right-handed healthy individuals showing a PPR with propagation (3 males, mean age 17.4 +/- 3.9 years)]. PPR-positive individuals showed no changes in these excitability measures relative to the PPR-negative control participants. We also measured the modifiability of the CSP by continuous IPS at a frequency of 18 or 50 Hz. While IPS reduced the duration of the CSP in PPR-negative control subjects, IPS had no effect on the duration of the CSP in PPR-positive individuals. Our results provide first time evidence that the propagation of the PPR is associated with increased excitability of the occipital but not the motor cortex. The stronger inhibitory effect of TMS on visual perception and the failure of IPS to shorten the CSP in PPR-positive participants may possibly reflect adaptive changes that prevent the provocation of seizures during the PPR.
引用
收藏
页码:78 / 87
页数:10
相关论文
共 58 条
[1]   SUPPRESSION OF VISUAL-PERCEPTION BY MAGNETIC COIL STIMULATION OF HUMAN OCCIPITAL CORTEX [J].
AMASSIAN, VE ;
CRACCO, RQ ;
MACCABEE, PJ ;
CRACCO, JB ;
RUDELL, A ;
EBERLE, L .
ELECTROENCEPHALOGRAPHY AND CLINICAL NEUROPHYSIOLOGY, 1989, 74 (06) :458-462
[2]   Manipulation of phosphene thresholds by transcranial direct current stimulation in man [J].
Antal, A ;
Kincses, TZ ;
Nitsche, MA ;
Paulus, W .
EXPERIMENTAL BRAIN RESEARCH, 2003, 150 (03) :375-378
[3]   Cortical inhibition is reduced in chronic and episodic migraine and demonstrates a spectrum of illness [J].
Aurora, SK ;
Barrodale, P ;
Chronicle, EP ;
Mulleners, WM .
HEADACHE, 2005, 45 (05) :546-552
[4]   MECHANISMS OF EPILEPTOGENESIS IN PHOTOSENSITIVE EPILEPSY IMPLIED BY THE EFFECTS OF MOVING PATTERNS [J].
BINNIE, CD ;
FINDLAY, J ;
WILKINS, AJ .
ELECTROENCEPHALOGRAPHY AND CLINICAL NEUROPHYSIOLOGY, 1985, 61 (01) :1-6
[5]   Enhanced excitability of the human visual cortex induced by short-term light deprivation [J].
Boroojerdi, B ;
Bushara, KO ;
Corwell, B ;
Immisch, I ;
Battaglia, F ;
Muellbacher, W ;
Cohen, LG .
CEREBRAL CORTEX, 2000, 10 (05) :529-534
[6]   Reduction of human visual cortex excitability using 1-Hz transcranial magnetic stimulation [J].
Boroojerdi, B ;
Prager, A ;
Muellbacher, W ;
Cohen, LG .
NEUROLOGY, 2000, 54 (07) :1529-1531
[7]   Modulation of phosphene perception during saccadic eye movements: a transcranial magnetic stimulation study of the human visual cortex [J].
Boulay, C ;
Paus, T .
EXPERIMENTAL BRAIN RESEARCH, 2005, 167 (02) :297-300
[8]   Photosensitive epilepsy studied by functional magnetic resonance imaging and magnetic resonance spectroscopy [J].
Chiappa, KH ;
Hill, RA ;
Huang-Hellinger, F ;
Jenkins, BG .
EPILEPSIA, 1999, 40 :3-7
[9]   Timing of activity in early visual cortex as revealed by transcranial magnetic stimulation [J].
Corthout, E ;
Uttl, B ;
Walsh, V ;
Hallett, M ;
Cowey, A .
NEUROREPORT, 1999, 10 (12) :2631-2634
[10]   The physiological basis of transcranial motor cortex stimulation in conscious humans [J].
Di Lazzaro, V ;
Oliviero, A ;
Pilato, F ;
Saturno, E ;
Dileone, M ;
Mazzone, P ;
Insola, A ;
Tonali, PA ;
Rothwell, JC .
CLINICAL NEUROPHYSIOLOGY, 2004, 115 (02) :255-266