Please use this identifier to cite or link to this item:
Full metadata record
DC FieldValueLanguage
dc.contributor.authorWarren, Aaron E L-
dc.contributor.authorHarvey, A Simon-
dc.contributor.authorVogrin, Simon J-
dc.contributor.authorBailey, Catherine-
dc.contributor.authorDavidson, Andrew-
dc.contributor.authorJackson, Graeme D-
dc.contributor.authorAbbott, David F-
dc.contributor.authorArcher, John S-
dc.identifier.citationNeurology 2019; 93(3): e215-e226en_US
dc.description.abstractTo identify brain regions underlying interictal generalized paroxysmal fast activity (GPFA), and their causal interactions, in children and adults with Lennox-Gastaut syndrome (LGS). Concurrent scalp EEG-fMRI was performed in 2 separately analyzed patient groups with LGS: 10 children (mean age 8.9 years) scanned under isoflurane-remifentanil anesthesia and 15 older patients (mean age 31.7 years) scanned without anesthesia. Whole-brain event-related analysis determined GPFA-related activation in each group. Results were used as priors in a dynamic causal modeling (DCM) analysis comparing evidence for different neuronal hypotheses describing initiation and propagation of GPFA between cortex, thalamus, and brainstem. A total of 1,045 GPFA events were analyzed (cumulative duration 1,433 seconds). In both pediatric and older groups, activation occurred in distributed association cortical areas, as well as the thalamus and brainstem (p < 0.05, corrected for family-wise error). Activation was similar across individual patients with structural, genetic, and unknown etiologies of epilepsy, particularly in frontoparietal cortex. In both groups, DCM revealed that GPFA was most likely driven by prefrontal cortex, with propagation occurring first to the brainstem and then from brainstem to thalamus. We show reproducible evidence of a cortically driven process within the epileptic network of LGS. This network is present early (in children) and late (in older patients) in the course of the syndrome and across diverse etiologies of epilepsy, suggesting that LGS reflects shared "secondary network" involvement. A cortical-to-subcortical hierarchy is postulated whereby GPFA rapidly propagates from prefrontal cortex to the brainstem via extrapyramidal corticoreticular pathways, whereas the thalamus is engaged secondarily.en_US
dc.titleThe epileptic network of Lennox-Gastaut syndrome: Cortically driven and reproducible across age.en_US
dc.typeJournal Articleen_US
dc.identifier.affiliationDepartments of Neurology, Royal Children's Hospital, Victoria, Australiaen_US
dc.identifier.affiliationMurdoch Children's Research Instituteen_US
dc.identifier.affiliationDepartment of Paediatrics, University of Melbourneen_US
dc.identifier.affiliationThe Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australiaen_US
dc.identifier.affiliationAnaesthesia and Pain Management, Royal Children's Hospital, Victoria, Australiaen_US
dc.identifier.affiliationDepartment of Medicine, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australiaen_US
dc.identifier.affiliationDepartment of Neurology, Austin Health, Heidelberg, Victoria, Australiaen_US
dc.type.austinJournal Article-
dc.type.austinResearch Support, Non-U.S. Gov't-
item.openairetypeJournal Article-
item.fulltextNo Fulltext- Florey Institute of Neuroscience and Mental Health- Florey Institute of Neuroscience and Mental Health- Research Centre-
Appears in Collections:Journal articles
Show simple item record

Page view(s)

checked on Mar 30, 2023

Google ScholarTM


Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.