Psychogenic nonepileptic seizures (PNES) are paroxysmal clinical events that are often misdiagnosed as epileptic seizures, but which are not associated with electrographic discharge. Brain connectivity changes occurring during PNES are not known. We studied functional connectivity (Fc) in two patients with drug‐resistant epilepsy, explored by stereotactic electroencephalography (EEG), in whom we recorded both epileptic seizures (ES) and PNES. Functional connectivity using pair‐wise nonlinear correlation was computed between signals from seven brain areas: amygdala, hippocampus, lateral temporal cortex, anterior insula, orbitofrontal cortex, prefrontal cortex, and lateral parietal cortex. We assessed changes in global Fc during PNES in comparison with a background period. During PNES, a global decrease of Fc occurred between the different brain regions studied, compared with the interictal period. In both patients, decreased Fc was prominent in connections involving the anterior insula and parietal cortex. In conclusion, some PNES are associated with ictal functional disconnection between brain areas, particularly involving the parietal cortices and the anterior insula.

中文翻译：

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心因性非癫痫性癫痫发作 (PNES) 期间的暂时性皮质-皮质断开

心因性非癫痫发作 (PNES) 是阵发性临床事件，常被误诊为癫痫发作，但与电图放电无关。PNES 期间发生的大脑连接变化尚不清楚。我们研究了两名耐药性癫痫患者的功能连接 (Fc)，通过立体定向脑电图 (EEG) 进行探索，我们记录了癫痫发作 (ES) 和 PNES。使用成对非线性相关性计算来自七个大脑区域的信号之间的功能连接：杏仁核、海马、外侧颞叶皮层、前脑岛、眶额皮层、前额叶皮层和外侧顶叶皮层。与背景期相比，我们评估了 PNES 期间全局 Fc 的变化。在 PNES 期间，与发作间期相比，所研究的不同大脑区域之间 Fc 整体下降。在这两名患者中，Fc 降低在涉及前岛叶和顶叶皮层的连接中很突出。总之，一些 PNES 与大脑区域之间的发作期功能断开有关，特别是涉及顶叶皮质和前脑岛。