{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T09:58:54Z","timestamp":1786960734597,"version":"build-2736575974"},"reference-count":94,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2022,10,6]],"date-time":"2022-10-06T00:00:00Z","timestamp":1665014400000},"content-version":"vor","delay-in-days":35,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Periodic discharges are a rare peculiar electroencephalogram pattern, occasionally associated with motor or other clinical manifestations, usually observed in critically ill patients. Their underlying pathophysiology remains poorly understood. Epileptic spasms in clusters and periodic discharges with motor manifestations share similar electroencephalogram pattern and some aetiologies of unfavourable prognosis such as subacute sclerosing panencephalitis or herpes encephalitis. Arterial spin labelling magnetic resonance imaging identifies localizing ictal and inter-ictal changes in neurovascular coupling, therefore assumed able to reveal concerned cerebral structures. Here, we retrospectively analysed ictal and inter-ictal arterial spin labelling magnetic resonance imaging in patients aged 6\u2005months to 15\u2005years (median 3\u2005years 4\u2005months) with periodic discharges including epileptic spasms, and compared these findings with those of patients with drug-resistant focal epilepsy who never presented periodic discharges nor epileptic spasms as well as to those of age-matched healthy controls. Ictal electroencephalogram was recorded either simultaneously with arterial spin labelling magnetic resonance imaging or during the close time lapse of patients\u2019 periodic discharges, whereas inter-ictal examinations were performed during the patients\u2019 active epilepsy but without seizures during the arterial spin labelling magnetic resonance imaging. Ictal arterial spin labelling magnetic resonance imaging was acquired in five patients with periodic discharges [subacute sclerosing panencephalitis (1), stroke-like events (3), West syndrome with cortical malformation (1), two of them also had inter-ictal arterial spin labelling magnetic resonance imaging]. Inter-ictal group included patients with drug-resistant epileptic spasms of various aetiologies (14) and structural drug-resistant focal epilepsy (8). Cortex, striatum and thalamus were segmented and divided in six functional subregions: prefrontal, motor (rostral, caudal), parietal, occipital and temporal. Rest cerebral blood flow values, absolute and relative to whole brain, were compared with those of age-matched controls for each subregion. Main findings were diffuse striatal as well as cortical motor cerebral blood flow increase during ictal examinations in generalized periodic discharges with motor manifestations (subacute sclerosing panencephalitis) and focal cerebral blood flow increase in corresponding cortical-striatal-thalamic subdivisions in lateralized periodic discharges with or without motor manifestations (stroke-like events and asymmetrical epileptic spasms) with straight topographical correlation with the electroencephalogram focus. For inter-ictal examinations, patients with epileptic spasms disclosed cerebral blood flow changes in corresponding cortical-striatal-thalamic subdivisions (absolute-cerebral blood flow decrease and relative-cerebral blood flow increase), more frequently when compared with the group of drug-resistant focal epilepsies, and not related to Vigabatrin treatment. Our results suggest that corresponding cortical-striatal-thalamic circuits are involved in periodic discharges with and without motor manifestations, including epileptic spasms, opening new insights in their pathophysiology and new therapeutical perspectives. Based on these findings, we propose a model for the generation of periodic discharges and of epileptic spasms combining existing pathophysiological models of cortical-striatal-thalamic network dynamics.<\/jats:p>","DOI":"10.1093\/braincomms\/fcac250","type":"journal-article","created":{"date-parts":[[2022,10,6]],"date-time":"2022-10-06T20:15:29Z","timestamp":1665087329000},"source":"Crossref","is-referenced-by-count":11,"title":["Periodic electroencephalographic discharges and epileptic spasms involve cortico-striatal-thalamic loops on Arterial Spin Labeling Magnetic Resonance Imaging"],"prefix":"10.1093","volume":"4","author":[{"given":"Monika","family":"Eisermann","sequence":"first","affiliation":[{"name":"Clinical Neurophysiology, H\u00f4pital Necker Enfants Malades , AP-HP, Paris Universit\u00e9, Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludovic","family":"Fillon","sequence":"additional","affiliation":[{"name":"Pediatric Radiology Department , AP-HP, H\u00f4pital Necker Enfants Malades, Universit\u00e9 de Paris, F-75015, Paris , France"},{"name":"Universit\u00e9 de Paris , Institut Imagine INSERM U1163, F-75015 , France"},{"name":"INSERM U1299 Trajectoires d\u00e9veloppementales & psychiatrie , Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Saitovitch","sequence":"additional","affiliation":[{"name":"Pediatric Radiology Department , AP-HP, H\u00f4pital Necker Enfants Malades, Universit\u00e9 de Paris, F-75015, Paris , France"},{"name":"Universit\u00e9 de Paris , Institut Imagine INSERM U1163, F-75015 , France"},{"name":"INSERM U1299 Trajectoires d\u00e9veloppementales & psychiatrie , Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Boisgontier","sequence":"additional","affiliation":[{"name":"Pediatric Radiology Department , AP-HP, H\u00f4pital Necker Enfants Malades, Universit\u00e9 de Paris, F-75015, Paris , France"},{"name":"Universit\u00e9 de Paris , Institut Imagine INSERM U1163, F-75015 , France"},{"name":"INSERM U1299 Trajectoires d\u00e9veloppementales & psychiatrie , Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Vin\u00e7on-Leite","sequence":"additional","affiliation":[{"name":"Pediatric Radiology Department , AP-HP, H\u00f4pital Necker Enfants Malades, Universit\u00e9 de Paris, F-75015, Paris , France"},{"name":"Universit\u00e9 de Paris , Institut Imagine INSERM U1163, F-75015 , France"},{"name":"INSERM U1299 Trajectoires d\u00e9veloppementales & psychiatrie , Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volodia","family":"Dangouloff-Ros","sequence":"additional","affiliation":[{"name":"Pediatric Radiology Department , AP-HP, H\u00f4pital Necker Enfants Malades, Universit\u00e9 de Paris, F-75015, Paris , France"},{"name":"Universit\u00e9 de Paris , Institut Imagine INSERM U1163, F-75015 , France"},{"name":"INSERM U1299 Trajectoires d\u00e9veloppementales & psychiatrie , Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4076-9642","authenticated-orcid":false,"given":"Thomas","family":"Blauwblomme","sequence":"additional","affiliation":[{"name":"Pediatric Neurosurgery, H\u00f4pital Necker, APHP, Paris France, Universit\u00e9 de Paris , Paris, France, INSERM U1163, IHU Imagine, Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Bourgeois","sequence":"additional","affiliation":[{"name":"Pediatric Neurosurgery, H\u00f4pital Necker, APHP, Paris France, Universit\u00e9 de Paris , Paris, France, INSERM U1163, IHU Imagine, Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Th\u00e9r\u00e8se","family":"Dangles","sequence":"additional","affiliation":[{"name":"Clinical Neurophysiology, H\u00f4pital Necker Enfants Malades , AP-HP, Paris Universit\u00e9, Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delphine","family":"Coste-Zeitoun","sequence":"additional","affiliation":[{"name":"Clinical Neurophysiology, H\u00f4pital Necker Enfants Malades , AP-HP, Paris Universit\u00e9, Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Vignolo-Diard","sequence":"additional","affiliation":[{"name":"Clinical Neurophysiology, H\u00f4pital Necker Enfants Malades , AP-HP, Paris Universit\u00e9, Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00e9lodie","family":"Aubart","sequence":"additional","affiliation":[{"name":"Pediatric Neurology Department, H\u00f4pital Necker Enfants Malades , AP-HP, INSERM U1163, Paris Universit\u00e9, Institut Imagine, Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manoelle","family":"Kossorotoff","sequence":"additional","affiliation":[{"name":"Pediatric Neurology Department, Necker Enfants Malades Hospital , AP-HP, Paris Universit\u00e9, Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Hully","sequence":"additional","affiliation":[{"name":"Pediatric Neurology Department, Necker Enfants Malades Hospital , AP-HP, Paris Universit\u00e9, Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Losito","sequence":"additional","affiliation":[{"name":"Clinical Neurophysiology, H\u00f4pital Necker Enfants Malades , AP-HP, Paris Universit\u00e9, Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Chemaly","sequence":"additional","affiliation":[{"name":"Reference Center for Rare Epilepsies, Department of Pediatric Neurology, Member of EPICARE Network , Institute Imagine INSERM 1163, Universit\u00e9 de Paris, Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Zilbovicius","sequence":"additional","affiliation":[{"name":"Pediatric Radiology Department , AP-HP, H\u00f4pital Necker Enfants Malades, Universit\u00e9 de Paris, F-75015, Paris , France"},{"name":"Universit\u00e9 de Paris , Institut Imagine INSERM U1163, F-75015 , France"},{"name":"INSERM U1299 Trajectoires d\u00e9veloppementales & psychiatrie , Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Desguerre","sequence":"additional","affiliation":[{"name":"Pediatric Neurology Department, H\u00f4pital Necker Enfants Malades , AP-HP, INSERM U1163, Paris Universit\u00e9, Institut Imagine, Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rima","family":"Nabbout","sequence":"additional","affiliation":[{"name":"Reference Center for Rare Epilepsies, Department of Pediatric Neurology, Member of EPICARE Network , Institute Imagine INSERM 1163, Universit\u00e9 de Paris, Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Boddaert","sequence":"additional","affiliation":[{"name":"Pediatric Radiology Department , AP-HP, H\u00f4pital Necker Enfants Malades, Universit\u00e9 de Paris, F-75015, Paris , France"},{"name":"Universit\u00e9 de Paris , Institut Imagine INSERM U1163, F-75015 , France"},{"name":"INSERM U1299 Trajectoires d\u00e9veloppementales & psychiatrie , Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Kaminska","sequence":"additional","affiliation":[{"name":"Clinical Neurophysiology, H\u00f4pital Necker Enfants Malades , AP-HP, Paris Universit\u00e9, Paris , 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