Все это верно и для эпилепсии, безусловно.
Сейчас появились доступные для клинициста инструменты, позволяющие исследовать структурные связи мозга: DTI (диффузионно-тензорная МРТ), функциональные связи: fMRI и продвинутые методы количественного анализа скальповой ЭЭГ.
Здесь хотел бы упомянуть некоторые программные работы, относящиеся к коннетике при эпилепсии:
Connectomics and epilepsy
by Engel et al
открытый источник: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4064674/
Вводы говорят сами за себя:
Epilepsy is ultimately a disorder of neuronal connections. The development of epilepsy (epileptogenesis), and the generation of spontaneous seizures (ictogenesis), are emergent properties of aberrant functional and structural connections between individual neurons to produce hypersynchrony, and large brain areas to permit propagation and the manifestation of clinical signs and symptoms. Elucidation of the networks responsible for epileptogenesis and ictogenesis at the whole brain and local circuit levels is now possible using techniques of MRI, electrophysiology, and chemical imaging. The new field of connectomics offers an unprecedented opportunity to delineate the structural and functional anatomy of diverse epilepsy conditions. Localizing the abnormalities responsible for epileptogenesis and ictogenesis, as well as behavioral comorbidities, in specific epilepsy syndromes, as well as in individual patients, will inform more effective surgical interventions, as well as future research into fundamental mechanisms, leading to novel therapies.
Connectomics and graph theory analyses: Novel insights into network abnormalities in epilepsy
by Gleichgerrcht et al
We discuss how connectomics may bring together pathophysiologic hypotheses from conceptual and basic models of epilepsy and in vivo biomarkers for clinical translational research. By providing neural network information unique to each individual, the field of connectomics may help to elucidate variability in clinical outcomes and open opportunities for personalized medicine approaches to epilepsy. Connectomics involves complex and rich data from each subject, thus collaborative efforts to enable the systematic and rigorous evaluation of this form of “big data” are paramount to leverage the full potential of this new approach.
Functional and structural brain networks in epilepsy: What have we learned?
by Diessen et al
Summary
Brain functioning is increasingly seen as a complex interplay of dynamic neural systems that rely on the integrity of structural and functional networks. Recent studies that have investigated functional and structural networks in epilepsy have revealed specific disruptions in connectivity and network topology and, consequently, have led to a shift from “focus” to “networks” in modern epilepsy research. Disruptions in these networks may be associated with cognitive and behavioral impairments often seen in patients with chronic epilepsy. In this review, we aim to provide an overview that would introduce the clinical neurologist and epileptologist to this new theoretical paradigm. We focus on the application of a theory, called “network analysis,” to characterize resting-state functional and structural networks and discuss current and future clinical applications of network analysis in patients with epilepsy.
А вот, например, типичная относительно свежая работы по коннектике эпилепсии, с продвинутым анализом ЭЭГ состояния покоя:
EEG Resting State Functional Connectivity Analysis in Children with Benign Epilepsy with Centrotemporal Spikes
by Adebimpe et al
открытый доступ: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4815534/
выводы:
In this study, we investigated abnormal patterns of resting-state EEG FC in BECTS patients using graph metrics in various frequency bands. Our results suggest that the functionality of brain networks in BECTS patients is altered, particularly in the α and β bands. Compared to healthy subjects, BECTS patients were characterized by widespread higher and lower phase synchronization values in the α and β bands, respectively.
In the θ and α bands, significantly lower global clustering coefficient and higher network degree and efficiency were observed in patients. In contrast, compared to controls, patients displayed significant lower global metrics in the β band. In the δ band, no significant differences in global graph metrics were observed between patients and controls.
Количество таких работ увеличивается экспоненциально, и было бы разумно, я считаю, на базе лаборатории приступить к подобного рода исследованиям, благо весь инструментарий на сегодня уже есть и доступен.
Помимо академического аспекта, такой анализ может иметь и очень большое практическое значение: например, можно оперативно контролировать динамику применения того или иного АЭПа, меняя схему лечения при необходимости, или объективно подтверждая нормализацию динамики работы мозга.
Например, если после назначения препарата, динамика изменения профиля функциональных связей не направлена к норме, или даже стала носить более аномальный характер, то очевидно, дальнейшие опыты с данным лекарством следует уже прекращать и начать вырабатывать другую схему лечения. На этом можно значительно сэкономить время и деньги пациента. Сделать подбор эффективной схемы терапии более зрячей.
Или вообще можно пытаться нормализовать выявленные релевантные отклонения степеней функциональных связей от нормальный методами нейроБОС.
С уважением,
Алексей
