癲癇是僅次於腦中風常見的神經疾病，約有0.5 至1%的人口罹患有癲癇發作的問 題。癲癇手術發展已經超過一百年，現今的手術方法仍以切除發作病灶腦皮質區為最有 效的方式。但是不同於前面提到的腦部病灶，癲癇發作的腦皮質區大部分無法以目前的 腦部影像技術將其定位來。神經外科切除部位選擇的依據，則需要神經內科醫師檢視顱 內腦電圖的發作癲癇腦波去定義癲癇發作區，另外須花費相當長的時間去找出腦功能 區。雖然科技的發展讓手術前評估變得更可信賴，但是手術中的腦圖譜描繪仍無可替 代。本計畫所提出之多通道顱內腦圖譜儀整體系統操作分為兩個主要的部分，第一個為 利用採用閉迴路偵測與抑制法，即透過感應電極持續監測腦波，若發生癲癇發作，則啟 動電刺激器迴受訊號以抑制之。第二部分為透過開發圖形介面提供使用人員更快速、更 便利的操作環境以監控即時腦波變化並且控制刺激器的參數(輸出電流值、刺激訊號頻 率)以針對不同的腦波特性找出最佳的刺激位置以及刺激參數。透過軟、硬體的開發整 合出一適用於癲癇術中所使用的多通道顱內腦圖譜儀。另外將運用常見之臨床神經生理 測驗，結合腦皮質電刺激可無傷害性暫時改變區域功能的腦圖譜描繪方式，建立配合腦 皮質刺激器測驗腦功能的研究方式。 Epilepsy, the common neurological disorder, affects 0.5 to 1% of populations. Although approximate 70% of patients with chronic epilepsies have adequate control of seizures by medication, the curative therapy for epilepsy is epilepsy surgery. To complete remove of epileptogenic zone is the only way to achieve seizure freedom. Even current imaging technique help epileptologists and neuroradiologists to identify cryptogenic brain lesion preoperatively. The identification of epileptogenic zone is still relied on the findings of intracranial records. In-charge clinician will read through the chronic extra-operative intracranial recording in which includes seizure-onset intracranial electroencephalography (iEEG) activities and responded brain EEG activities to cortical stimulation. In the grand project, the research team will develop a cortical stimulation system. The ideation of the device development is to improve the user-friendliness of brain mapping. With the developing device, there are several goals will be achieved. The first is to validate the feasibility of “touch-screen control current delivering subsystem”. Therefore, the safe and useful brain stimulation parameters including stimulation frequency/duration and stimulation train can be identified. The second is to integrate conventional neuropsychiatric tests with the cortical stimulation system to develop a convenient tool for brain function mapping.
