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research
Causal hierarchy within the thalamo-cortical network in spike and wave discharges
Authors
A Labate
A Salek-Haddadi
+82 more
A Salek-Haddadi
AD Liston
AE Cavanna
AE Cavanna
Anna E. Vaudano
B Clemens
B Mazoyer
BA Vogt
D Craiu
DA Gusnard
DA Gusnard
David W. Carmichael
DM Tucker
E Niedermeyer
EH Yeterian
EM Marcus
F Amor
F Andermann
F Moeller
GK Kostopoulos
GR Leichnetz
GW Van Hoesen
H Jasper
H Laufs
H Laufs
H Laufs
H Meeren
Helmut Laufs
HK Meeren
J Gotman
J Guey
JD Schmahmann
John S. Duncan
JR Binder
JS Archer
JS Archer
K Friston
K Hamandi
K Hamandi
K Hamandi
K Krakow
Karl J. Friston
KE Stephan
Khalid Hamandi
KJ Friston
KJ Friston
KJ Friston
L Lemieux
Liset Menendez de la Prida
Louis Lemieux
LQ Uddin
M Boly
M Brázdil
M Petrides
M Steriade
Maxime Guye
MD Holmes
ME Faymonville
ME Raichle
MI Garrido
NC Andreasen
NM Van Gelder
O David
P Anderer
P Fransson
P Gloor
P Gloor
P Gloor
PK McGuire
PO Polack
PS Goldman-Rakic
R Hill
Rachel Thornton
Roman Rodionov
S Laureys
SC Johnson
SJ Kiebel
SJ Kiebel
Stefan J. Kiebel
WD Penny
X De Tiège
Y Aghakhani
Publication date
1 January 2009
Publisher
Doi
Cite
View
on
PubMed
Abstract
Background: Generalised spike wave (GSW) discharges are the electroencephalographic (EEG) hallmark of absence seizures, clinically characterised by a transitory interruption of ongoing activities and impaired consciousness, occurring during states of reduced awareness. Several theories have been proposed to explain the pathophysiology of GSW discharges and the role of thalamus and cortex as generators. In this work we extend the existing theories by hypothesizing a role for the precuneus, a brain region neglected in previous works on GSW generation but already known to be linked to consciousness and awareness. We analysed fMRI data using dynamic causal modelling (DCM) to investigate the effective connectivity between precuneus, thalamus and prefrontal cortex in patients with GSW discharges. Methodology and Principal Findings: We analysed fMRI data from seven patients affected by Idiopathic Generalized Epilepsy (IGE) with frequent GSW discharges and significant GSW-correlated haemodynamic signal changes in the thalamus, the prefrontal cortex and the precuneus. Using DCM we assessed their effective connectivity, i.e. which region drives another region. Three dynamic causal models were constructed: GSW was modelled as autonomous input to the thalamus (model A), ventromedial prefrontal cortex (model B), and precuneus (model C). Bayesian model comparison revealed Model C (GSW as autonomous input to precuneus), to be the best in 5 patients while model A prevailed in two cases. At the group level model C dominated and at the population-level the p value of model C was ∼1. Conclusion: Our results provide strong evidence that activity in the precuneus gates GSW discharges in the thalamo-(fronto) cortical network. This study is the first demonstration of a causal link between haemodynamic changes in the precuneus - an index of awareness - and the occurrence of pathological discharges in epilepsy. © 2009 Vaudano et al
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