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Semiologic subgroups of insulo-opercular seizures based on connectional architecture atlas
Wang, Haixiang1; McGonigal, Aileen2,3; Zhang, Kai4; Guo, Qiang5; Zhang, Bingqing1; Wang, Xiu5; Wang, Xiao6; Lin, Jiuluan1; Song, Xiancheng1; Feng, Qian1; Wang, Siyu1; Wang, Mengyang6; Shao, Xiaoqiu7; Liu, Xiaoyan8; Wang, Liang9,10; Zhou, Wenjing1
第一作者Wang, Haixiang
通讯作者邮箱closejeo@hotmail.com ; lwang@psych.ac.cn
摘要

Objective Insulo-opercular seizures are characterized by diverse semiology, related to the insula's multiple functional roles and extensive connectivity. We aimed to identify semiologic subgroups and correlate these with insulo-opercular subregions based on connectional architecture. Methods We retrospectively collected a large series of 37 patients with insulo-opercular seizures explored by stereoelectroencephalography (SEEG) from three epilepsy centers. A new human brain atlas (Brainnetome Atlas, BNA) based on both anatomic and functional connections was employed to segment insulo-opercular cortex. Semiology and SEEG changes were carefully reviewed and quantified. Principal component analysis and cluster analysis were used to correlate semiologic characteristics with insulo-opercular subregions. Results Four main semiologic subgroups were identified, organized along an anteroventral to posterodorsal axis based on BNA. Group 1 was characterized by epigastric sensation and/or integrated gestural motor behaviors with or without feelings of fear or rage, involving the anteroventral insular regions and mesial temporal lobes. Group 2 was characterized by auditory sensations and symmetric proximal/axial tonic signs involving the posteroventral temporal operculum. The characteristics of group 3 were orofacial and laryngeal signs, involving the intermediate insulo-opercular regions. The features of group 4 were somatosensory signs followed by nonintegrated gestural motor behaviors and/or asymmetric tonic signs involving the posterodorsal insulo-opercular regions with propagation to the mesial frontal lobes. Thus anteroventral seizure organizations predominantly showed limbic system semiology, whereas more posterodorsal regions were associated with semiology involving mainly the sensorimotor system. Subjective symptoms proved to be particularly discriminating factors. Significance Insulo-opercular seizures can be categorized in terms of clinical semiology and correlate with connectional architecture subregions along an anteroventral-posterodorsal axis in line with the cytoarchitectonic gradient rather than the gyral anatomy of the insula cortex. This provides new insights into facilitating differential diagnosis and presurgical localization but also highlights the importance of considering connectional architecture in determining neural correlates of complex semiologic patterns.

关键词Brainnetome Atlas cluster analysis insular seizure semiology stereoelectroencephalography
2020-04-21
DOI10.1111/epi.16501
发表期刊EPILEPSIA
ISSN0013-9580
页码11
收录类别SCI
资助项目Natural Science Foundation of China[31771255] ; Natural Science Foundation of China[Z171100000117014] ; Natural Science Foundation of China[XDB32010300] ; Beijing Municipal Science and Technology Commission ; Strategic Priority Research Program of Chinese Academy of Science
出版者WILEY
WOS关键词LOBE EPILEPSY ; CHILDHOOD ; CORTEX
WOS研究方向Neurosciences & Neurology
WOS类目Clinical Neurology
WOS记录号WOS:000527035700001
WOS分区Q1
Q分类Q1
资助机构Natural Science Foundation of China ; Beijing Municipal Science and Technology Commission ; Strategic Priority Research Program of Chinese Academy of Science
引用统计
被引频次:21[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.psych.ac.cn/handle/311026/31534
专题中国科学院心理健康重点实验室
通讯作者Wang, Liang; Zhou, Wenjing
作者单位1.Tsinghua Univ, Epilepsy Ctr, Yuquan Hosp, 5 Shijingshan Rd, Beijing, Peoples R China
2.Aix Marseille Univ, INSERM, INS, Marseille, France
3.Timone Hosp, AP HM, Clin Neurophysiol & Epileptol Dept, Marseille, France
4.Capital Med Univ, Beijing Tiantan Hosp, Dept Neurosurg, Beijing, Peoples R China
5.Guangdong Sanjiu Brain Hosp, Epilepsy Ctr, Guangzhou, Peoples R China
6.Capital Med Univ, Beijing Sanbo Brain Hosp, Dept Neurol, Beijing, Peoples R China
7.Capital Med Univ, Beijing Tiantan Hosp, Dept Neurol, Beijing, Peoples R China
8.Peking Univ, Hosp 1, Dept Pediat, Beijing, Peoples R China
9.Inst Psychol, CAS Key Lab Mental Hlth, 16 Lincui Rd, Beijing, Peoples R China
10.Univ Chinese Acad Sci, Dept Psychol, Beijing, Peoples R China
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GB/T 7714
Wang, Haixiang,McGonigal, Aileen,Zhang, Kai,et al. Semiologic subgroups of insulo-opercular seizures based on connectional architecture atlas[J]. EPILEPSIA,2020:11.
APA Wang, Haixiang.,McGonigal, Aileen.,Zhang, Kai.,Guo, Qiang.,Zhang, Bingqing.,...&Zhou, Wenjing.(2020).Semiologic subgroups of insulo-opercular seizures based on connectional architecture atlas.EPILEPSIA,11.
MLA Wang, Haixiang,et al."Semiologic subgroups of insulo-opercular seizures based on connectional architecture atlas".EPILEPSIA (2020):11.
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