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Transient cortico‐cortical disconnection during psychogenic nonepileptic seizures (PNES)
Author(s) -
Madec Tanguy,
Lagarde Stanislas,
McGonigal Aileen,
Arthuis Marie,
Benar ChristianGeorges,
Bartolomei Fabrice
Publication year - 2020
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/epi.16623
Subject(s) - ictal , psychogenic disease , insula , insular cortex , neuroscience , psychology , epilepsy , orbitofrontal cortex , cortex (anatomy) , posterior parietal cortex , amygdala , disconnection , stereoelectroencephalography , prefrontal cortex , electroencephalography , medicine , psychiatry , cognition , political science , law
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.