Dipole Source Localization of Periodic Sharp Wave Complexes in Creutzfeldt-Jakob Disease

J Korean Neurol Assoc > Volume 24(5); 2006 > Article

Journal of the Korean Neurological Association 2006;24(5): 421-427.

크로이츠펠트 야콥병에서 주기적 예파 복합체의 양극자 국지화 분석

정기영, 한석근 서대원 나덕렬 정진상 김성태a 이일근b

성균관대학교 의과대학 신경과학교실, 영상의학교실a, 건국대학교 의과대학 신경과학교실b

Dipole Source Localization of Periodic Sharp Wave Complexes in Creutzfeldt-Jakob Disease

Ki-Young Jung

Departments of Neurology, Radiologya, Sungkyunkwan University School of Medicine, Seoul; Department of Neurology, Kunkuk University, College of Medicineb, Seoul, Korea

Abstract

Background: Patients with Creutzfeldt-Jakob disease (CJD) show periodic sharp wave complexes (PSWCs) on electroencephalography (EEG) during the course of their illness. However, the source location of PSWCs and the pathophysiological mechanism remains unclear.
Methods: Ten patients with sporadic CJD who showed typical PSWCs on EEG underwent brain magnetic resonance imaging (MRI) and positron emission tomography (PET, n=8) or single-photon emission computed tomography (SPECT, n=2) scans. A 30-second epoch from the EEG was selected for analysis. The recording was separated blindly using independent component analysis. The separate independent components were subjected to dipole source localization using a single dipole model. The source locations were compared with neuroimaging findings in each patient.
Results: Two to three independent components responsible for the PSWCs seen in CJD were identified. The EEG recording reconstructed from the selected independent components accounted for about 70% of the variance in the original recording. All but one patient had dipole sources localized in both cortical and subcortical areas. One patient had only subcortical dipole sources in both caudate nuclei. The cortical locations included the cingulate, insula, frontal, temporal, and occipital areas. The subcortical sources were located in the striate, thalamic, and subthalamic nuclei. All the dipole sources were localized within lesions seen as neuroimaging abnormalities.
Conclusions: These results suggest that a subcortical mechanism, in addition to cortical structures, is involved in producing the generalized periodic discharges in CJD.KeyWords:Creutzfeldt-Jakob disease, Periodic discharges, Pathophysiology, EEG dipole source localization