島葉癲癇的研究進展_Journal of Epilepsy

Authors：

張洪偉 , 張童 , 金瑞峰 , 高在芬 ,  劉勇

山東大學附屬兒童醫院（濟南市兒童醫院）　癲癇中心（濟南 250022）;

Corresponding?author：

劉勇, Email: etyyliuyong@163.com

Keywords：

島葉癲癇; 立體定向腦電圖; 癥狀學; 治療

DOI：

10.7507/2096-0247.202210002

Video：

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隨著立體定向腦電圖（Stereoelectroencephalography，SEEG）技術的廣泛使用，島葉癲癇逐漸被認識，其癥狀學也逐漸被描述清楚。在島葉癲癇的研究中，主觀癥狀（如上腹部感覺、聽覺和軀體感覺等）對于識別島葉癲癇至關重要，客觀的運動成分也比較突出。島葉癲癇癥狀學的多樣性與其特殊的皮層構筑特點、廣泛的功能連接和致癇網絡有關。由于島葉特殊的位置關系，切除手術有一定的風險，SEEG引導下立體定向腦電圖引導下射頻熱凝毀（Radio frequency thermocoagulation，RF-TC）、激光間質熱療法（MRI-guided laser interstitial thermal therapy，LITT）具有接近于切除性手術的有效性，同時具有更高的安全性。這種精準、微創的治療方法有可能會部分取代傳統的切除性外科手術，使更多的癲癇患者獲益，但目前來說該技術仍然只是一種嘗試。

Citation： 張洪偉, 張童, 金瑞峰, 高在芬, 劉勇. 島葉癲癇的研究進展. Journal of Epilepsy, 2023, 9(1): 43-47. doi: 10.7507/2096-0247.202210002 Copy

1.	Isnard J, Guénot M, Sindou M, et al. Clinical manifestations of insular lobe seizures: a stereo-electroencephalographic study. Epilepsia, 2004, 45(9): 1079-1090.
2.	Varnavas GG, Grand W. The insular cortex: morphological and vascular anatomic characteristics. Neurosurgery, 1999, 44(1): 127-138.
3.	Mesulam MM, Mufson EJ. Insula of the old world monkey. I. Architectonics in the insulo-orbito-temporal component of the paralimbic brain. J Comp Neurol, 1982, 212(1): 1-22.
4.	Benarroch EE. Insular cortex: Functional complexity and clinical correlations. Neurology, 2019, 93(21): 932-938.
5.	Gogolla N. The insular cortex. Curr Biol, 2017, 27(12): R580-R586.
6.	Morel A, Gallay MN, Baechler A, et al. The human insula: architectonic organization and postmortem MRI registration. Neuroscience, 2013, 236: 117-135.
7.	Fan L, Li H, Zhuo J, et al. The human brainnetome atlas: a new brain atlas based on connectional architecture. Cereb Cortex, 2016, 26(8): 3508-3526.
8.	Ghaziri J, Tucholka A, Girard G, et al. The Corticocortical structural connectivity of the human insula. Cereb Cortex, 2017, 27(2): 1216-1228.
9.	Ghaziri J, Tucholka A, Girard G, et al. Subcortical structural connectivity of insular subregions. Sci Rep, 2018, 8(1): 8596.
10.	Jobst BC, Gonzalez-Martinez J, Isnard J, et al. The insula and its epilepsies. Epilepsy Curr, 2019, 19(1): 11-21.
11.	Uddin LQ, Nomi JS, Hébert-Seropian B, et al. Structure and function of the human insula. J Clin Neurophysiol, 2017, 34(4): 300-306.
12.	Shelley BP, Trimble MR. The insular lobe of Reil——its anatamico-functional, behavioural and neuropsychiatric attributes in humans——a review. World J Biol Psychiatry, 2004, 5(4): 176-200.
13.	Nieuwenhuys R. The insular cortex: a review. Prog Brain Res, 2012, 195: 123-163.
14.	Kurth F, Zilles K, Fox PT, et al. A link between the systems: functional differentiation and integration within the human insula revealed by meta-analysis. Brain Struct Funct, 2010, 214(5-6): 519-534.
15.	Isnard J, Guénot M, Ostrowsky K, et al. The role of the insular cortex in temporal lobe epilepsy. Ann Neurol, 2000, 48(4): 614-623.
16.	Wang X, Hu W, McGonigal A, et al. Electroclinical features of insulo-opercular epilepsy: an SEEG and PET study. Ann Clin Transl Neurol, 2019, 6(7): 1165-1177.
17.	Peltola ME, Trébuchon A, Lagarde S, et al. Anatomoelectroclinical features of SEEG-confirmed pure insular-onset epilepsy. Epilepsy Behav, 2020, 105: 106964.
18.	Singh R, Principe A, Tadel F, et al. Mapping the insula with stereo-electroencephalography: the emergence of semiology in insula lobe seizures. Ann Neurol, 2020, 88(3): 477-488.
19.	Wang H, McGonigal A, Zhang K, et al. Semiologic subgroups of insulo-opercular seizures based on connectional architecture atlas. Epilepsia, 2020, 61(5): 984-994.
20.	Ryvlin P, Nguyen DK. Insular seizures and epilepsies: ictal semiology and minimal invasive surgery. Curr Opin Neurol, 2021, 34(2): 153-165.
21.	Dylgjeri S, Taussig D, Chipaux M, et al. Insular and insulo-opercular epilepsy in childhood: an SEEG study. Seizure, 2014, 23(4): 300-308.
22.	Proserpio P, Cossu M, Francione S, et al. Insular-opercular seizures manifesting with sleep-related paroxysmal motor behaviors: a stereo-EEG study. Epilepsia, 2011, 52(10): 1781-1791.
23.	Levy A, Yen Tran TP, Boucher O, et al. Operculo-insular epilepsy: scalp and intracranial electroencephalographic findings. J Clin Neurophysiol, 2017, 34(5): 438-447.
24.	Hagiwara K, Jung J, Bouet R, et al. How can we explain the frontal presentation of insular lobe epilepsy? The impact of non-linear analysis of insular seizures. Clin Neurophysiol, 2017, 128(5): 780-791.
25.	Wang H, David O, Zhou W, et al. Distinctive epileptogenic networks for parietal operculum seizures. Epilepsy Behav, 2019, 91: 59-67.
26.	[Bouthillier A, Weil AG, Martineau L, et al. Operculoinsular cortectomy for refractory epilepsy. Part 1: is it effective? . J Neurosurg , 2019, Sep 20: 1-10.
27.	Ikegaya N, Iwasaki M, Kaneko Y, et al. Cognitive and developmental outcomes after pediatric insular epilepsy surgery for focal cortical dysplasia. J Neurosurg Pediatr, 2020, 26(5): 543-551.
28.	Kerezoudis P, Singh R, Goyal A, et al. Insular epilepsy surgery: lessons learned from institutional review and patient-level meta-analysis. J Neurosurg, 2021: 1-13.
29.	中國醫師協會神經外科分會功能神經外科學組, 中國抗癲癇協會, 國家神經外科手術機器人應用示范項目專家指導委員會. 立體定向腦電圖引導射頻熱凝毀損治療藥物難治性癲癇的中國專家共識. 中華醫學雜志, 2021, 101(29): 2276-2282.
30.	鄧劼, 方鐵, 解自行, 等. 立體腦電圖引導的射頻熱凝術治療兒童藥物難治性癲癇的療效(附71例報告). 中華神經外科雜志, 2020, 36(4): 342-347.
31.	Mullatti N, Landre E, Mellerio C, et al. Stereotactic thermocoagulation for insular epilepsy: lessons from successes and failures. Epilepsia, 2019, 60(8): 1565-1579.
32.	戴陽, 王逸鶴, 安陽, 等. 立體定向腦電圖引導下立體交叉射頻熱凝毀損治療藥物難治性島葉癲癇的安全性及有效性觀察. 中華醫學雜志, 2021, 101(41): 3386-3392.
33.	胡文瀚, 莫嘉杰, 劉暢, 等. 磁共振引導激光間質熱療治療藥物難治性癲癇的手術策略及療效. 中華神經外科雜志, 2021, 37(8): 764-770.
34.	Hawasli AH, Bandt SK, Hogan RE, et al. Laser ablation as treatment strategy for medically refractory dominant insular epilepsy: therapeutic and functional considerations. Stereotact Funct Neurosurg, 2014, 92(6): 397-404.
35.	Perry MS, Donahue DJ, Malik SI, et al. Magnetic resonance imaging-guided laser interstitial thermal therapy as treatment for intractable insular epilepsy in children. J Neurosurg Pediatr, 2017, 20(6): 575-582.

1. Isnard J, Guénot M, Sindou M, et al. Clinical manifestations of insular lobe seizures: a stereo-electroencephalographic study. Epilepsia, 2004, 45(9): 1079-1090.
2. Varnavas GG, Grand W. The insular cortex: morphological and vascular anatomic characteristics. Neurosurgery, 1999, 44(1): 127-138.
3. Mesulam MM, Mufson EJ. Insula of the old world monkey. I. Architectonics in the insulo-orbito-temporal component of the paralimbic brain. J Comp Neurol, 1982, 212(1): 1-22.
4. Benarroch EE. Insular cortex: Functional complexity and clinical correlations. Neurology, 2019, 93(21): 932-938.
5. Gogolla N. The insular cortex. Curr Biol, 2017, 27(12): R580-R586.
6. Morel A, Gallay MN, Baechler A, et al. The human insula: architectonic organization and postmortem MRI registration. Neuroscience, 2013, 236: 117-135.
7. Fan L, Li H, Zhuo J, et al. The human brainnetome atlas: a new brain atlas based on connectional architecture. Cereb Cortex, 2016, 26(8): 3508-3526.
8. Ghaziri J, Tucholka A, Girard G, et al. The Corticocortical structural connectivity of the human insula. Cereb Cortex, 2017, 27(2): 1216-1228.
9. Ghaziri J, Tucholka A, Girard G, et al. Subcortical structural connectivity of insular subregions. Sci Rep, 2018, 8(1): 8596.
10. Jobst BC, Gonzalez-Martinez J, Isnard J, et al. The insula and its epilepsies. Epilepsy Curr, 2019, 19(1): 11-21.
11. Uddin LQ, Nomi JS, Hébert-Seropian B, et al. Structure and function of the human insula. J Clin Neurophysiol, 2017, 34(4): 300-306.
12. Shelley BP, Trimble MR. The insular lobe of Reil——its anatamico-functional, behavioural and neuropsychiatric attributes in humans——a review. World J Biol Psychiatry, 2004, 5(4): 176-200.
13. Nieuwenhuys R. The insular cortex: a review. Prog Brain Res, 2012, 195: 123-163.
14. Kurth F, Zilles K, Fox PT, et al. A link between the systems: functional differentiation and integration within the human insula revealed by meta-analysis. Brain Struct Funct, 2010, 214(5-6): 519-534.
15. Isnard J, Guénot M, Ostrowsky K, et al. The role of the insular cortex in temporal lobe epilepsy. Ann Neurol, 2000, 48(4): 614-623.
16. Wang X, Hu W, McGonigal A, et al. Electroclinical features of insulo-opercular epilepsy: an SEEG and PET study. Ann Clin Transl Neurol, 2019, 6(7): 1165-1177.
17. Peltola ME, Trébuchon A, Lagarde S, et al. Anatomoelectroclinical features of SEEG-confirmed pure insular-onset epilepsy. Epilepsy Behav, 2020, 105: 106964.
18. Singh R, Principe A, Tadel F, et al. Mapping the insula with stereo-electroencephalography: the emergence of semiology in insula lobe seizures. Ann Neurol, 2020, 88(3): 477-488.
19. Wang H, McGonigal A, Zhang K, et al. Semiologic subgroups of insulo-opercular seizures based on connectional architecture atlas. Epilepsia, 2020, 61(5): 984-994.
20. Ryvlin P, Nguyen DK. Insular seizures and epilepsies: ictal semiology and minimal invasive surgery. Curr Opin Neurol, 2021, 34(2): 153-165.
21. Dylgjeri S, Taussig D, Chipaux M, et al. Insular and insulo-opercular epilepsy in childhood: an SEEG study. Seizure, 2014, 23(4): 300-308.
22. Proserpio P, Cossu M, Francione S, et al. Insular-opercular seizures manifesting with sleep-related paroxysmal motor behaviors: a stereo-EEG study. Epilepsia, 2011, 52(10): 1781-1791.
23. Levy A, Yen Tran TP, Boucher O, et al. Operculo-insular epilepsy: scalp and intracranial electroencephalographic findings. J Clin Neurophysiol, 2017, 34(5): 438-447.
24. Hagiwara K, Jung J, Bouet R, et al. How can we explain the frontal presentation of insular lobe epilepsy? The impact of non-linear analysis of insular seizures. Clin Neurophysiol, 2017, 128(5): 780-791.
25. Wang H, David O, Zhou W, et al. Distinctive epileptogenic networks for parietal operculum seizures. Epilepsy Behav, 2019, 91: 59-67.
26. [Bouthillier A, Weil AG, Martineau L, et al. Operculoinsular cortectomy for refractory epilepsy. Part 1: is it effective? . J Neurosurg , 2019, Sep 20: 1-10.
27. Ikegaya N, Iwasaki M, Kaneko Y, et al. Cognitive and developmental outcomes after pediatric insular epilepsy surgery for focal cortical dysplasia. J Neurosurg Pediatr, 2020, 26(5): 543-551.
28. Kerezoudis P, Singh R, Goyal A, et al. Insular epilepsy surgery: lessons learned from institutional review and patient-level meta-analysis. J Neurosurg, 2021: 1-13.
29. 中國醫師協會神經外科分會功能神經外科學組, 中國抗癲癇協會, 國家神經外科手術機器人應用示范項目專家指導委員會. 立體定向腦電圖引導射頻熱凝毀損治療藥物難治性癲癇的中國專家共識. 中華醫學雜志, 2021, 101(29): 2276-2282.
30. 鄧劼, 方鐵, 解自行, 等. 立體腦電圖引導的射頻熱凝術治療兒童藥物難治性癲癇的療效(附71例報告). 中華神經外科雜志, 2020, 36(4): 342-347.
31. Mullatti N, Landre E, Mellerio C, et al. Stereotactic thermocoagulation for insular epilepsy: lessons from successes and failures. Epilepsia, 2019, 60(8): 1565-1579.
32. 戴陽, 王逸鶴, 安陽, 等. 立體定向腦電圖引導下立體交叉射頻熱凝毀損治療藥物難治性島葉癲癇的安全性及有效性觀察. 中華醫學雜志, 2021, 101(41): 3386-3392.
33. 胡文瀚, 莫嘉杰, 劉暢, 等. 磁共振引導激光間質熱療治療藥物難治性癲癇的手術策略及療效. 中華神經外科雜志, 2021, 37(8): 764-770.
34. Hawasli AH, Bandt SK, Hogan RE, et al. Laser ablation as treatment strategy for medically refractory dominant insular epilepsy: therapeutic and functional considerations. Stereotact Funct Neurosurg, 2014, 92(6): 397-404.
35. Perry MS, Donahue DJ, Malik SI, et al. Magnetic resonance imaging-guided laser interstitial thermal therapy as treatment for intractable insular epilepsy in children. J Neurosurg Pediatr, 2017, 20(6): 575-582.

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