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Xie K, Royer J, Larivière S, Rodriguez-Cruces R, Frässle S, Cabalo DG, Ngo A, DeKraker J, Auer H, Tavakol S, Weng Y, Abdallah C, Arafat T, Horwood L, Frauscher B, Caciagli L, Bernasconi A, Bernasconi N, Zhang Z, Concha L, Bernhardt BC. Atypical connectome topography and signal flow in temporal lobe epilepsy. Prog Neurobiol 2024; 236:102604. [PMID: 38604584 DOI: 10.1016/j.pneurobio.2024.102604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 12/18/2023] [Accepted: 04/07/2024] [Indexed: 04/13/2024]
Abstract
Temporal lobe epilepsy (TLE) is the most common pharmaco-resistant epilepsy in adults. While primarily associated with mesiotemporal pathology, recent evidence suggests that brain alterations in TLE extend beyond the paralimbic epicenter and impact macroscale function and cognitive functions, particularly memory. Using connectome-wide manifold learning and generative models of effective connectivity, we examined functional topography and directional signal flow patterns between large-scale neural circuits in TLE at rest. Studying a multisite cohort of 95 patients with TLE and 95 healthy controls, we observed atypical functional topographies in the former group, characterized by reduced differentiation between sensory and transmodal association cortices, with most marked effects in bilateral temporo-limbic and ventromedial prefrontal cortices. These findings were consistent across all study sites, present in left and right lateralized patients, and validated in a subgroup of patients with histopathological validation of mesiotemporal sclerosis and post-surgical seizure freedom. Moreover, they were replicated in an independent cohort of 30 TLE patients and 40 healthy controls. Further analyses demonstrated that reduced differentiation related to decreased functional signal flow into and out of temporolimbic cortical systems and other brain networks. Parallel analyses of structural and diffusion-weighted MRI data revealed that topographic alterations were independent of TLE-related cortical thinning but partially mediated by white matter microstructural changes that radiated away from paralimbic circuits. Finally, we found a strong association between the degree of functional alterations and behavioral markers of memory dysfunction. Our work illustrates the complex landscape of macroscale functional imbalances in TLE, which can serve as intermediate markers bridging microstructural changes and cognitive impairment.
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Affiliation(s)
- Ke Xie
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC H3A 2B4, Canada
| | - Jessica Royer
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC H3A 2B4, Canada; Analytical Neurophysiology Laboratory, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC H3A 2B4, Canada
| | - Sara Larivière
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC H3A 2B4, Canada
| | - Raul Rodriguez-Cruces
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC H3A 2B4, Canada
| | - Stefan Frässle
- Translational Neuromodeling Unit (TNU), Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Donna Gift Cabalo
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC H3A 2B4, Canada
| | - Alexander Ngo
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC H3A 2B4, Canada
| | - Jordan DeKraker
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC H3A 2B4, Canada
| | - Hans Auer
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC H3A 2B4, Canada
| | - Shahin Tavakol
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC H3A 2B4, Canada
| | - Yifei Weng
- Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Chifaou Abdallah
- Analytical Neurophysiology Laboratory, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC H3A 2B4, Canada
| | - Thaera Arafat
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC H3A 2B4, Canada
| | - Linda Horwood
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC H3A 2B4, Canada; Analytical Neurophysiology Laboratory, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC H3A 2B4, Canada
| | - Birgit Frauscher
- Analytical Neurophysiology Laboratory, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC H3A 2B4, Canada; Department of Neurology, Duke University School of Medicine and Department of Biomedical Engineering, Duke University Pratt School of Engineering, Durham, NC 27705, USA
| | - Lorenzo Caciagli
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Neurology, Inselspital, Sleep-Wake-Epilepsy-Center, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3 BG, United Kingdom
| | - Andrea Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC H3A 2B4, Canada
| | - Neda Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC H3A 2B4, Canada
| | - Zhiqiang Zhang
- Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Luis Concha
- Institute of Neurobiology, Universidad Nacional Autónoma de Mexico (UNAM), Queretaro, Mexico
| | - Boris C Bernhardt
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC H3A 2B4, Canada.
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2
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Chen J, Ngo A, Rodríguez-Cruces R, Royer J, Caligiuri ME, Gambardella A, Concha L, Keller SS, Cendes F, Yasuda CL, Alvim MKM, Bonilha L, Gleichgerrcht E, Focke NK, Kreilkamp B, Domin M, von Podewils F, Langner S, Rummel C, Wiest R, Martin P, Kotikalapudi R, Bender B, O’Brien TJ, Sinclair B, Vivash L, Kwan P, Desmond PM, Lui E, Duma GM, Bonanni P, Ballerini A, Vaudano AE, Meletti S, Tondelli M, Alhusaini S, Doherty CP, Cavalleri GL, Delanty N, Kälviäinen R, Jackson GD, Kowalczyk M, Mascalchi M, Semmelroch M, Thomas RH, Soltanian-Zadeh H, Davoodi-Bojd E, Zhang J, Lenge M, Guerrini R, Bartolini E, Hamandi K, Foley S, Rüber T, Bauer T, Weber B, Caldairou B, Depondt C, Absil J, Carr SJA, Abela E, Richardson MP, Devinsky O, Pardoe H, Severino M, Striano P, Tortora D, Kaestner E, Hatton SN, Arienzo D, Vos SB, Ryten M, Taylor PN, Duncan JS, Whelan CD, Galovic M, Winston GP, Thomopoulos SI, Thompson PM, Sisodiya SM, Labate A, McDonald CR, Caciagli L, Bernasconi N, Bernasconi A, Larivière S, Schrader D, Bernhardt BC. A WORLDWIDE ENIGMA STUDY ON EPILEPSY-RELATED GRAY AND WHITE MATTER COMPROMISE ACROSS THE ADULT LIFESPAN. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.03.02.583073. [PMID: 38496668 PMCID: PMC10942350 DOI: 10.1101/2024.03.02.583073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Objectives Temporal lobe epilepsy (TLE) is commonly associated with mesiotemporal pathology and widespread alterations of grey and white matter structures. Evidence supports a progressive condition although the temporal evolution of TLE is poorly defined. This ENIGMA-Epilepsy study utilized multimodal magnetic resonance imaging (MRI) data to investigate structural alterations in TLE patients across the adult lifespan. We charted both grey and white matter changes and explored the covariance of age-related alterations in both compartments. Methods We studied 769 TLE patients and 885 healthy controls across an age range of 17-73 years, from multiple international sites. To assess potentially non-linear lifespan changes in TLE, we harmonized data and combined median split assessments with cross-sectional sliding window analyses of grey and white matter age-related changes. Covariance analyses examined the coupling of grey and white matter lifespan curves. Results In TLE, age was associated with a robust grey matter thickness/volume decline across a broad cortico-subcortical territory, extending beyond the mesiotemporal disease epicentre. White matter changes were also widespread across multiple tracts with peak effects in temporo-limbic fibers. While changes spanned the adult time window, changes accelerated in cortical thickness, subcortical volume, and fractional anisotropy (all decreased), and mean diffusivity (increased) after age 55 years. Covariance analyses revealed strong limbic associations between white matter tracts and subcortical structures with cortical regions. Conclusions This study highlights the profound impact of TLE on lifespan changes in grey and white matter structures, with an acceleration of aging-related processes in later decades of life. Our findings motivate future longitudinal studies across the lifespan and emphasize the importance of prompt diagnosis as well as intervention in patients.
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Affiliation(s)
- Judy Chen
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Alexander Ngo
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Raúl Rodríguez-Cruces
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Jessica Royer
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | | | - Antonio Gambardella
- Neuroscience Research Center, University Magna Græcia, Catanzaro, CZ, Italy
- Institute of Neurology, University Magna Græcia, Catanzaro, CZ, Italy
| | - Luis Concha
- Institute of Neurobiology, Universidad Nacional Autónoma de México, Querétaro, México
| | - Simon S. Keller
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
- Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - Fernando Cendes
- Department of Neurology, University of Campinas-–UNICAMP, Campinas, São Paulo, Brazil
| | - Clarissa L. Yasuda
- Department of Neurology, University of Campinas-–UNICAMP, Campinas, São Paulo, Brazil
| | - Marina K. M. Alvim
- Department of Neurology, University of Campinas-–UNICAMP, Campinas, São Paulo, Brazil
| | | | | | - Niels K. Focke
- Department of Neurology, University of Medicine Göttingen, Göttingen, Germany
| | - Barbara Kreilkamp
- Department of Neurology, University of Medicine Göttingen, Göttingen, Germany
| | - Martin Domin
- Institute of Diagnostic Radiology and Neuroradiology, Functional Imaging Unit, University Medicine Greifswald, Greifswald, Germany
| | - Felix von Podewils
- Department of Neurology, University Medicine Greifswald, Epilepsy Center, Greifswald, Germany
| | - Soenke Langner
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Christian Rummel
- Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Bern, Switzerland
| | - Roland Wiest
- Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Bern, Switzerland
| | - Pascal Martin
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Raviteja Kotikalapudi
- Department of Neurology, University of Medicine Göttingen, Göttingen, Germany
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Benjamin Bender
- Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Germany
| | - Terence J. O’Brien
- Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia
- Departments of Medicine and Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Benjamin Sinclair
- Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia
- Departments of Medicine and Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Lucy Vivash
- Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia
- Departments of Medicine and Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Patrick Kwan
- Departments of Medicine and Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Patricia M. Desmond
- Departments of Medicine and Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Elaine Lui
- Departments of Medicine and Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Gian Marco Duma
- Scientific Institute IRCCS E.Medea, Epilepsy Unit, Conegliano (TV), Italy
| | - Paolo Bonanni
- Scientific Institute IRCCS E.Medea, Epilepsy Unit, Conegliano (TV), Italy
| | - Alice Ballerini
- Department of Biomedical, Metabolic and Neural Science, University of Modena and Reggio Emilia, Modena, Italy
| | - Anna Elisabetta Vaudano
- Neurology Unit, OCB Hospital, Azienda Ospedaliera-Universitaria, Modena, Italy
- Department of Biomedical, Metabolic and Neural Science, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefano Meletti
- Neurology Unit, OCB Hospital, Azienda Ospedaliera-Universitaria, Modena, Italy
- Department of Biomedical, Metabolic and Neural Science, University of Modena and Reggio Emilia, Modena, Italy
| | - Manuela Tondelli
- Department of Biomedical, Metabolic and Neural Science, University of Modena and Reggio Emilia, Modena, Italy
- Primary Care Department, Azienda Sanitaria Locale di Modena, Modena, Italy
| | - Saud Alhusaini
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Neurology, Alpert Medical School of Brown University, Providence, RI, USA
| | - Colin P. Doherty
- Department of Neurology, St James’ Hospital, Dublin, Ireland
- FutureNeuro SFI Research Centre, Dublin, Ireland
| | - Gianpiero L. Cavalleri
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
- FutureNeuro SFI Research Centre, Dublin, Ireland
| | - Norman Delanty
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
- FutureNeuro SFI Research Centre, Dublin, Ireland
| | - Reetta Kälviäinen
- Epilepsy Center, Neuro Center, Kuopio University Hospital, Member of the European Reference Network for Rare and Complex Epilepsies EpiCARE, Kuopio, Finland
- Faculty of Health Sciences, School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Graeme D. Jackson
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne VIC 3010, Australia
| | - Magdalena Kowalczyk
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne VIC 3010, Australia
| | - Mario Mascalchi
- Neuroradiology Research Program, Meyer Children Hospital of Florence, University of Florence, Florence, Italy
| | - Mira Semmelroch
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne VIC 3010, Australia
| | - Rhys H. Thomas
- Transitional and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Hamid Soltanian-Zadeh
- Contol and Intelligent Processing Center of Excellence (CIPCE), School of Electrical and Computer Engineering, University of Tehran, Tehran, Iran
- Departments of Research Administration and Radiology, Henry Ford Health System, Detroit, MI, USA
| | | | - Junsong Zhang
- Cognitive Science Department, Xiamen University, Xiamen, China
| | - Matteo Lenge
- Child Neurology Unit and Laboratories, Neuroscience Department, Meyer Children’s Hospital IRCCS, Florence, Italy
| | - Renzo Guerrini
- Child Neurology Unit and Laboratories, Neuroscience Department, Meyer Children’s Hospital IRCCS, Florence, Italy
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Italy
| | | | - Khalid Hamandi
- Cardiff University Brain Research Imaging Centre (CUBRIC), College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
- The Welsh Epilepsy Unit, Department of Neurology, University Hospital of Wales, Cardiff, UK
| | - Sonya Foley
- Cardiff University Brain Research Imaging Centre (CUBRIC), College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Theodor Rüber
- Department of Neuroradiology, University Hospital Bonn, Bonn, Germany
- Department of Epileptology, University Hospital Bonn, Bonn, Germany
| | - Tobias Bauer
- Department of Neuroradiology, University Hospital Bonn, Bonn, Germany
- Department of Epileptology, University Hospital Bonn, Bonn, Germany
| | - Bernd Weber
- Institute of Experimental Epileptology and Cognition Research, University Hospital Bonn, Bonn, Germany
| | - Benoit Caldairou
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Chantal Depondt
- Department of Neurology, Hôpital Erasme, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles, Brussels, Belgium
| | - Julie Absil
- Department of Radiology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Sarah J. A. Carr
- School of Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
| | - Eugenio Abela
- School of Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
| | - Mark P. Richardson
- School of Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
| | - Orrin Devinsky
- Department of Neurology, NYU Grossman School of Medicine, New York, NY, United States
| | - Heath Pardoe
- Department of Neurology, NYU Grossman School of Medicine, New York, NY, United States
| | | | - Pasquale Striano
- IRCCS Istituto Giannina Gaslini, Genova, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Domenico Tortora
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Erik Kaestner
- Department of Radiation Medicine and Applied Sciences; Department of Psychiatry, Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA, United States
| | - Sean N. Hatton
- Department of Neurosciences, Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA, United States
| | - Donatello Arienzo
- Department of Radiation Medicine and Applied Sciences; Department of Psychiatry, Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA, United States
| | - Sjoerd B. Vos
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- Chalfont Centre for Epilepsy, Bucks, UK
- Centre for Medical Image Computing, University College London, London, UK
| | - Mina Ryten
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- MRI Unit, Epilepsy Society, Chalfont St Peter, Bucks, UK
| | - Peter N. Taylor
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- CNNP Lab, ICOS group, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - John S. Duncan
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- Chalfont Centre for Epilepsy, Bucks, UK
| | - Christopher D. Whelan
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Marian Galovic
- Department of Neurology, Clinical Neuroscience Center, University Hospital and University of Zürich, Zürich, Switzerland
| | - Gavin P. Winston
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- Chalfont Centre for Epilepsy, Bucks, UK
- Department of Medicine, Division of Neurology, Queen’s University, Kingston, ON, Canada
| | - Sophia I. Thomopoulos
- Imaging Genetics Center, Mark & Mary Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Paul M. Thompson
- Imaging Genetics Center, Mark & Mary Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Sanjay M. Sisodiya
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- Chalfont Centre for Epilepsy, Bucks, UK
| | - Angelo Labate
- Neurophysiopathology and Movement Disorders Clinic, Regional Epilepsy Center, University of Messina, Italy
| | - Carrie R. McDonald
- Department of Radiation Medicine and Applied Sciences; Department of Psychiatry, Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA, United States
| | - Lorenzo Caciagli
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- MRI Unit, Epilepsy Society, Chalfont St Peter, Bucks, UK
| | - Neda Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Andrea Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Sara Larivière
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
- Center for Brain Circuit Therapeutics, Brigham and Women’s Hospital, Harvard University, Boston, MA, USA
| | - Dewi Schrader
- BC Children’s Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Boris C. Bernhardt
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
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3
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Casella C, Vecchiato K, Cromb D, Guo Y, Winkler AM, Hughes E, Dillon L, Green E, Colford K, Egloff A, Siddiqui A, Price A, Grande LC, Wood TC, Malik S, Teixeira RPAG, Carmichael DW, O'Muircheartaigh J. Widespread, depth-dependent cortical microstructure alterations in pediatric focal epilepsy. Epilepsia 2024; 65:739-752. [PMID: 38088235 DOI: 10.1111/epi.17861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 12/11/2023] [Accepted: 12/11/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVE Tissue abnormalities in focal epilepsy may extend beyond the presumed focus. The underlying pathophysiology of these broader changes is unclear, and it is not known whether they result from ongoing disease processes or treatment-related side effects, or whether they emerge earlier. Few studies have focused on the period of onset for most focal epilepsies, childhood. Fewer still have utilized quantitative magnetic resonance imaging (MRI), which may provide a more sensitive and interpretable measure of tissue microstructural change. Here, we aimed to determine common spatial modes of changes in cortical architecture in children with heterogeneous drug-resistant focal epilepsy and, secondarily, whether changes were related to disease severity. METHODS To assess cortical microstructure, quantitative T1 and T2 relaxometry (qT1 and qT2) was measured in 43 children with drug-resistant focal epilepsy (age range = 4-18 years) and 46 typically developing children (age range = 2-18 years). We assessed depth-dependent qT1 and qT2 values across the neocortex, as well as their gradient of change across cortical depths. We also determined whether global changes seen in group analyses were driven by focal pathologies in individual patients. Finally, as a proof-of-concept, we trained a classifier using qT1 and qT2 gradient maps from patients with radiologically defined abnormalities (MRI positive) and healthy controls, and tested whether this could classify patients without reported radiological abnormalities (MRI negative). RESULTS We uncovered depth-dependent qT1 and qT2 increases in widespread cortical areas in patients, likely representing microstructural alterations in myelin or gliosis. Changes did not correlate with disease severity measures, suggesting they may represent antecedent neurobiological alterations. Using a classifier trained with MRI-positive patients and controls, sensitivity was 71.4% at 89.4% specificity on held-out MRI-negative patients. SIGNIFICANCE These findings suggest the presence of a potential imaging endophenotype of focal epilepsy, detectable irrespective of radiologically identified abnormalities.
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Affiliation(s)
- Chiara Casella
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
- Department for Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Katy Vecchiato
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
- Department for Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Daniel Cromb
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Yourong Guo
- Department for Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Anderson M Winkler
- Department of Human Genetics, University of Texas Rio Grande Valley, Brownsville, Texas, USA
| | - Emer Hughes
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Louise Dillon
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Elaine Green
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Kathleen Colford
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Alexia Egloff
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Ata Siddiqui
- Department of Radiology, Guy's and Saint Thomas' Hospitals NHS Trust, London, UK
| | - Anthony Price
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Lucilio Cordero Grande
- Department of Biomedical Engineering, King's College London, London, UK
- Biomedical Image Technologies, Telecommunication Engineering School (ETSIT), Technical University of Madrid, Bioengineering, Biomaterials and Nanomedicine Networking Biomedical Research Centre, National Institute of Health Carlos III, Madrid, Spain
| | - Tobias C Wood
- Department of Neuroimaging, King's College London, London, UK
| | - Shaihan Malik
- Department of Biomedical Engineering, King's College London, London, UK
| | | | | | - Jonathan O'Muircheartaigh
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
- Department for Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- Medical Research Council (MRC) Centre for Neurodevelopmental Disorders, London, UK
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4
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Huang X, Du Y, Guo D, Xie F, Zhou C. Structural-functional coupling abnormalities in temporal lobe epilepsy. Front Neurosci 2023; 17:1272514. [PMID: 37928725 PMCID: PMC10620528 DOI: 10.3389/fnins.2023.1272514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 10/04/2023] [Indexed: 11/07/2023] Open
Abstract
Background Nowadays, researchers are using advanced multimodal neuroimaging techniques to construct the brain network connectome to elucidate the complex relationship among the networks of brain functions and structure. The objective of this study was to evaluate the coupling of structural connectivity (SC) and functional connectivity (FC) in the entire brain of healthy controls (HCs), and to investigate modifications in SC-FC coupling in individuals suffering from temporal lobe epilepsy (TLE). Methods We evaluated 65 patients with TLE matched for age and gender with 48 healthy controls. The SC-FC coupling between regions was determined, based on which whole-brain nodes were clustered. Differences in the coupling among the three groups of nodes were compared. To further validate the results obtained, the within-cluster coupling indices of the three groups were compared to determine the inter-group differences. Results Nodes were divided into five clusters. Cluster 1 was primarily located in the limbic system (n = 9/27), whereas cluster 5 was mainly within the visual network (n = 12/29). By comparing average cluster SC-FC coupling in each cluster of the three groups, we identified marked discrepancies within the three cohorts in Cluster 3 (p = 0.001), Cluster 4 (p < 0.001), and Cluster 5 (p < 0.001). Post-hoc analysis revealed that the SC-FC coupling strengths in LTLE and RTLE were significantly lower than that in HCs in Cluster 3 (PL = 0.001/PR = 0.003), Cluster 4 (PL = 0.001/PR < 0.001), and Cluster 5 (PL < 0.001/PR < 0.001). We also observed that the within-cluster SC-FC coupling in cluster 5 of left- and right TLE was significantly lower than in HCs (PL = 0.0001, PR = 0.0005). Conclusion The SC and FC are inconsistently coupled across the brain with spatial heterogeneity. In the fifth cluster with the highest degree of coupling in HCs, the average SC-FC coupling index of individuals with TLE was notably less than that of HCs, manifesting that brain regions with high coupling may be more delicate and prone to pathological disruption.
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Affiliation(s)
- Xiaoting Huang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Yangsa Du
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Danni Guo
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Fangfang Xie
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
| | - Chunyao Zhou
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
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5
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Xie K, Royer J, Larivière S, Rodriguez-Cruces R, Frässle S, Cabalo DG, Ngo A, DeKraker J, Auer H, Tavakol S, Weng Y, Abdallah C, Horwood L, Frauscher B, Caciagli L, Bernasconi A, Bernasconi N, Zhang Z, Concha L, Bernhardt BC. Atypical connectome topography and signal flow in temporal lobe epilepsy. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.05.23.541934. [PMID: 37292996 PMCID: PMC10245853 DOI: 10.1101/2023.05.23.541934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Temporal lobe epilepsy (TLE) is one of the most common pharmaco-resistant epilepsies in adults. While hippocampal pathology is the hallmark of this condition, emerging evidence indicates that brain alterations extend beyond the mesiotemporal epicenter and affect macroscale brain function and cognition. We studied macroscale functional reorganization in TLE, explored structural substrates, and examined cognitive associations. We investigated a multisite cohort of 95 patients with pharmaco-resistant TLE and 95 healthy controls using state-of-the-art multimodal 3T magnetic resonance imaging (MRI). We quantified macroscale functional topographic organization using connectome dimensionality reduction techniques and estimated directional functional flow using generative models of effective connectivity. We observed atypical functional topographies in patients with TLE relative to controls, manifesting as reduced functional differentiation between sensory/motor networks and transmodal systems such as the default mode network, with peak alterations in bilateral temporal and ventromedial prefrontal cortices. TLE-related topographic changes were consistent in all three included sites and reflected reductions in hierarchical flow patterns between cortical systems. Integration of parallel multimodal MRI data indicated that these findings were independent of TLE-related cortical grey matter atrophy, but mediated by microstructural alterations in the superficial white matter immediately beneath the cortex. The magnitude of functional perturbations was robustly associated with behavioral markers of memory function. Overall, this work provides converging evidence for macroscale functional imbalances, contributing microstructural alterations, and their associations with cognitive dysfunction in TLE.
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Affiliation(s)
- Ke Xie
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Jessica Royer
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
- Analytical Neurophysiology Laboratory, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Sara Larivière
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Raul Rodriguez-Cruces
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Stefan Frässle
- Translational Neuromodeling Unit (TNU), Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Donna Gift Cabalo
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Alexander Ngo
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Jordan DeKraker
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Hans Auer
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Shahin Tavakol
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Yifei Weng
- Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Chifaou Abdallah
- Analytical Neurophysiology Laboratory, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Linda Horwood
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
- Analytical Neurophysiology Laboratory, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Birgit Frauscher
- Analytical Neurophysiology Laboratory, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Lorenzo Caciagli
- Department of Biomedical Engineering, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
| | - Andrea Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Neda Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Zhiqiang Zhang
- Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Luis Concha
- Brain Connectivity Laboratory, Institute of Neurobiology, Universidad Nacional Autónoma de Mexico (UNAM), Mexico
| | - Boris C Bernhardt
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
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6
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Jiang Y, Li W, Qin Y, Zhang L, Tong X, Xiao F, Jiang S, Li Y, Gong Q, Zhou D, An D, Yao D, Luo C. In vivo characterization of magnetic resonance imaging-based T1w/T2w ratios reveals myelin-related changes in temporal lobe epilepsy. Hum Brain Mapp 2023; 44:2323-2335. [PMID: 36692056 PMCID: PMC10028664 DOI: 10.1002/hbm.26212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 12/12/2022] [Accepted: 01/09/2023] [Indexed: 01/25/2023] Open
Abstract
Temporal lobe epilepsy (TLE) is the most common type of intractable epilepsy in adults. Although brain myelination alterations have been observed in TLE, it remains unclear how the myelination network changes in TLE. This study developed a novel method in characterization of myelination structural covariance network (mSCN) by T1-weighted and T2-weighted magnetic resonance imaging (MRI). The mSCNs were estimated in 42 left TLE (LTLE), 42 right TLE (RTLE) patients, and 41 healthy controls (HCs). The topology of mSCN was analyzed by graph theory. Voxel-wise comparisons of myelination laterality were also examined among the three groups. Compared to HC, both patient groups showed decreased myelination in frontotemporal regions, amygdala, and thalamus; however, the LTLE showed lower myelination in left medial temporal regions than RTLE. Moreover, the LTLE exhibited decreased global efficiency compared with HC and more increased connections than RTLE. The laterality in putamen was differently altered between the two patient groups: higher laterality at posterior putamen in LTLE and higher laterality at anterior putamen in RTLE. The putamen may play a transfer station role in damage spreading induced by epileptic seizures from the hippocampus. This study provided a novel workflow by combination of T1-weighted and T2-weighted MRI to investigate in vivo the myelin-related microstructural feature in epileptic patients first time. Disconnections of mSCN implicate that TLE is a system disorder with widespread disruptions at regional and network levels.
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Affiliation(s)
- Yuchao Jiang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
- High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of life Science and technology, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
| | - Wei Li
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Yingjie Qin
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Le Zhang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Xin Tong
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Fenglai Xiao
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Sisi Jiang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
- High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of life Science and technology, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
| | - Yunfang Li
- Southern Medical District, Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China
| | - Qiyong Gong
- Huaxi MR Research Center, Department of Radiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Dong Zhou
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Dongmei An
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Dezhong Yao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
- Research Unit of NeuroInformation, Chinese Academy of Medical Sciences, Chengdu, People's Republic of China
- Department of Neurology, First Affiliated Hospital of Hainan Medical University, Haikou, People's Republic of China
| | - Cheng Luo
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
- High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of life Science and technology, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
- Research Unit of NeuroInformation, Chinese Academy of Medical Sciences, Chengdu, People's Republic of China
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7
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Li Z, Jiang C, Gao Q, Xiang W, Qi Z, Peng K, Lin J, Wang W, Deng B, Wang W. The relationship between the interictal epileptiform discharge source connectivity and cortical structural couplings in temporal lobe epilepsy. Front Neurol 2023; 14:1029732. [PMID: 36846133 PMCID: PMC9948620 DOI: 10.3389/fneur.2023.1029732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 01/09/2023] [Indexed: 02/05/2023] Open
Abstract
Objective The objective of this study was to explore the relation between interictal epileptiform discharge (IED) source connectivity and cortical structural couplings (SCs) in temporal lobe epilepsy (TLE). Methods High-resolution 3D-MRI and 32-sensor EEG data from 59 patients with TLE were collected. Principal component analysis was performed on the morphological data on MRI to obtain the cortical SCs. IEDs were labeled from EEG data and averaged. The standard low-resolution electromagnetic tomography analysis was performed to locate the source of the average IEDs. Phase-locked value was used to evaluate the IED source connectivity. Finally, correlation analysis was used to compare the IED source connectivity and the cortical SCs. Results The features of the cortical morphology in left and right TLE were similar across four cortical SCs, which could be mainly described as the default mode network, limbic regions, connections bilateral medial temporal, and connections through the ipsilateral insula. The IED source connectivity at the regions of interest was negatively correlated with the corresponding cortical SCs. Significance The cortical SCs were confirmed to be negatively related to IED source connectivity in patients with TLE as detected with MRI and EEG coregistered data. These findings suggest the important role of intervening IEDs in treating TLE.
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Affiliation(s)
- Zhensheng Li
- Department of Neurology, General Hospital of Southern Theater Command, Guangzhou, China
| | - Che Jiang
- Department of Neurosurgery, General Hospital of Southern Theater Command, Guangzhou, China
| | - Quwen Gao
- Department of Neurology, General Hospital of Southern Theater Command, Guangzhou, China
| | - Wei Xiang
- Department of Neurology, General Hospital of Southern Theater Command, Guangzhou, China
| | - Zijuan Qi
- Department of Neurology, General Hospital of Southern Theater Command, Guangzhou, China
| | - Kairun Peng
- Department of Neurology, General Hospital of Southern Theater Command, Guangzhou, China
| | - Jian Lin
- Department of Neurosurgery, General Hospital of Southern Theater Command, Guangzhou, China
| | - Wei Wang
- Department of Neurosurgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Bingmei Deng
- Department of Neurology, General Hospital of Southern Theater Command, Guangzhou, China,Bingmei Deng ✉
| | - Weimin Wang
- Department of Neurosurgery, General Hospital of Southern Theater Command, Guangzhou, China,*Correspondence: Weimin Wang ✉
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8
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Li R, Deng C, Wang X, Zou T, Biswal B, Guo D, Xiao B, Zhang X, Cheng JL, Liu D, Yang M, Chen H, Wu Q, Feng L. Interictal dynamic network transitions in mesial temporal lobe epilepsy. Epilepsia 2022; 63:2242-2255. [PMID: 35699346 DOI: 10.1111/epi.17325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/09/2022] [Accepted: 06/10/2022] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To reveal the possible routine of brain network dynamic alterations in patients with mesial temporal lobe epilepsy (mTLE) and to establish a predicted model of seizure recurrence during interictal periods. METHODS Seventy-nine unilateral mTLE patients with hippocampal sclerosis and 97 healthy controls from two centers were retrospectively enrolled. Dynamic brain configuration analyses were performed with resting-state functional magnetic resonance imaging (MRI) data to quantify the functional stability over time and the dynamic interactions between brain regions. Relationships between seizure frequency and ipsilateral hippocampal module allegiance were evaluated using a machine learning predictive model. RESULTS Compared to the healthy controls, patients with mTLE displayed an overall higher dynamic network, switching mainly in the epileptogenic regions (false discovery rate [FDR] corrected p-FDR < .05). Moreover, the dynamic network configuration in mTLE was characterized by decreased recruitment (intra-network communication), and increased integration (inter-network communication) among hippocampal systems and large-scale higher-order brain networks (p-FDR < .05). We further found that the dynamic interactions between the hippocampal system and the default-mode network (DMN) or control networks exhibited an opposite distribution pattern (p-FDR < .05). Strikingly, we showed that there was a robust association between predicted seizure frequency based on the ipsilateral hippocampal-DMN dynamics model and actual seizure frequency (p-perm < .001). SIGNIFICANCE These findings suggest that the interictal brain of mTLE is characterized by dynamical shifts toward unstable state. Our study provides novel insights into the brain dynamic network alterations and supports the potential use of DMN dynamic parameters as candidate neuroimaging markers in monitoring the seizure frequency clinically during interictal periods.
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Affiliation(s)
- Rong Li
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Chijun Deng
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Xuyang Wang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Ting Zou
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Bharat Biswal
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China.,Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, New Jersey, USA
| | - Danni Guo
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Bo Xiao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Xiaonan Zhang
- Department of Magnetic Resonance, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jing Liang Cheng
- Department of Magnetic Resonance, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ding Liu
- Department of Neurology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Mi Yang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Huafu Chen
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Qian Wu
- Department of Neurology, First Affiliated Hospital, Kunming Medical University, Kunming, China
| | - Li Feng
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
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9
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Park BY, Larivière S, Rodríguez-Cruces R, Royer J, Tavakol S, Wang Y, Caciagli L, Caligiuri ME, Gambardella A, Concha L, Keller SS, Cendes F, Alvim MKM, Yasuda C, Bonilha L, Gleichgerrcht E, Focke NK, Kreilkamp BAK, Domin M, von Podewils F, Langner S, Rummel C, Rebsamen M, Wiest R, Martin P, Kotikalapudi R, Bender B, O’Brien TJ, Law M, Sinclair B, Vivash L, Kwan P, Desmond PM, Malpas CB, Lui E, Alhusaini S, Doherty CP, Cavalleri GL, Delanty N, Kälviäinen R, Jackson GD, Kowalczyk M, Mascalchi M, Semmelroch M, Thomas RH, Soltanian-Zadeh H, Davoodi-Bojd E, Zhang J, Lenge M, Guerrini R, Bartolini E, Hamandi K, Foley S, Weber B, Depondt C, Absil J, Carr SJA, Abela E, Richardson MP, Devinsky O, Severino M, Striano P, Parodi C, Tortora D, Hatton SN, Vos SB, Duncan JS, Galovic M, Whelan CD, Bargalló N, Pariente J, Conde-Blanco E, Vaudano AE, Tondelli M, Meletti S, Kong X, Francks C, Fisher SE, Caldairou B, Ryten M, Labate A, Sisodiya SM, Thompson PM, McDonald CR, Bernasconi A, Bernasconi N, Bernhardt BC. Topographic divergence of atypical cortical asymmetry and atrophy patterns in temporal lobe epilepsy. Brain 2022; 145:1285-1298. [PMID: 35333312 PMCID: PMC9128824 DOI: 10.1093/brain/awab417] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/15/2021] [Accepted: 08/14/2021] [Indexed: 12/20/2022] Open
Abstract
Temporal lobe epilepsy, a common drug-resistant epilepsy in adults, is primarily a limbic network disorder associated with predominant unilateral hippocampal pathology. Structural MRI has provided an in vivo window into whole-brain grey matter structural alterations in temporal lobe epilepsy relative to controls, by either mapping (i) atypical inter-hemispheric asymmetry; or (ii) regional atrophy. However, similarities and differences of both atypical asymmetry and regional atrophy measures have not been systematically investigated. Here, we addressed this gap using the multisite ENIGMA-Epilepsy dataset comprising MRI brain morphological measures in 732 temporal lobe epilepsy patients and 1418 healthy controls. We compared spatial distributions of grey matter asymmetry and atrophy in temporal lobe epilepsy, contextualized their topographies relative to spatial gradients in cortical microstructure and functional connectivity calculated using 207 healthy controls obtained from Human Connectome Project and an independent dataset containing 23 temporal lobe epilepsy patients and 53 healthy controls and examined clinical associations using machine learning. We identified a marked divergence in the spatial distribution of atypical inter-hemispheric asymmetry and regional atrophy mapping. The former revealed a temporo-limbic disease signature while the latter showed diffuse and bilateral patterns. Our findings were robust across individual sites and patients. Cortical atrophy was significantly correlated with disease duration and age at seizure onset, while degrees of asymmetry did not show a significant relationship to these clinical variables. Our findings highlight that the mapping of atypical inter-hemispheric asymmetry and regional atrophy tap into two complementary aspects of temporal lobe epilepsy-related pathology, with the former revealing primary substrates in ipsilateral limbic circuits and the latter capturing bilateral disease effects. These findings refine our notion of the neuropathology of temporal lobe epilepsy and may inform future discovery and validation of complementary MRI biomarkers in temporal lobe epilepsy.
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Affiliation(s)
- Bo-yong Park
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
- Department of Data Science, Inha University, Incheon, Republic of Korea
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, Republic of Korea
| | - Sara Larivière
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Raul Rodríguez-Cruces
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Jessica Royer
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Shahin Tavakol
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Yezhou Wang
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Lorenzo Caciagli
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- MRI Unit, Epilepsy Society, Chalfont St Peter, Buckinghamshire, UK
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Antonio Gambardella
- Neuroscience Research Center, University Magna Græcia, Catanzaro, CZ, Italy
- Institute of Neurology, University Magna Græcia, Catanzaro, CZ, Italy
| | - Luis Concha
- Institute of Neurobiology, Universidad Nacional Autónoma de México, Querétaro, México
| | - Simon S Keller
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
- Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Fernando Cendes
- Department of Neurology, University of Campinas–UNICAMP, Campinas, São Paulo, Brazil
| | - Marina K M Alvim
- Department of Neurology, University of Campinas–UNICAMP, Campinas, São Paulo, Brazil
| | - Clarissa Yasuda
- Department of Neurology, University of Campinas–UNICAMP, Campinas, São Paulo, Brazil
| | | | | | - Niels K Focke
- Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
| | | | - Martin Domin
- Institute of Diagnostic Radiology and Neuroradiology, Functional Imaging Unit, University Medicine Greifswald, Greifswald, Germany
| | - Felix von Podewils
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Soenke Langner
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Christian Rummel
- Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Bern, Switzerland
| | - Michael Rebsamen
- Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Bern, Switzerland
| | - Roland Wiest
- Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Bern, Switzerland
| | - Pascal Martin
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Raviteja Kotikalapudi
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- Department of Radiology, Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Tübingen, Germany
| | - Benjamin Bender
- Department of Radiology, Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Tübingen, Germany
| | - Terence J O’Brien
- Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia
- Departments of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Meng Law
- Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia
| | - Benjamin Sinclair
- Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia
- Departments of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Lucy Vivash
- Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia
- Departments of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Patrick Kwan
- Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia
- Departments of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Patricia M Desmond
- Department of Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Charles B Malpas
- Departments of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Elaine Lui
- Department of Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Saud Alhusaini
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Neurology, Yale University School of Medicine, New Haven, CT, USA
| | - Colin P Doherty
- Department of Neurology, St James’ Hospital, Dublin, Ireland
- FutureNeuro SFI Research Centre, Dublin, Ireland
| | - Gianpiero L Cavalleri
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
- FutureNeuro SFI Research Centre, Dublin, Ireland
| | - Norman Delanty
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
- FutureNeuro SFI Research Centre, Dublin, Ireland
| | - Reetta Kälviäinen
- Epilepsy Center, Neuro Center, Kuopio University Hospital, Member of the European Reference Network for Rare and Complex Epilepsies EpiCARE, Kuopio, Finland
- Faculty of Health Sciences, School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Graeme D Jackson
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria, 3010, Australia
| | - Magdalena Kowalczyk
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria, 3010, Australia
| | - Mario Mascalchi
- Neuroradiology Research Program, Meyer Children Hospital of Florence, University of Florence, Florence, Italy
| | - Mira Semmelroch
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria, 3010, Australia
| | - Rhys H Thomas
- Transitional and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Hamid Soltanian-Zadeh
- Control and Intelligent Processing Center of Excellence (CIPCE), School of Electrical and Computer Engineering, University of Tehran, Tehran, Iran
- Departments of Research Administration and Radiology, Henry Ford Health System, Detroit, MI, USA
| | | | - Junsong Zhang
- Department of Artificial Intelligence, Xiamen University, Xiamen, China
| | - Matteo Lenge
- Child Neurology Unit and Laboratories, Neuroscience Department, Children’s Hospital A. Meyer-University of Florence, Florence, Italy
- Functional and Epilepsy Neurosurgery Unit, Neurosurgery Department, Children’s Hospital A. Meyer-University of Florence, Florence, Italy
| | - Renzo Guerrini
- Child Neurology Unit and Laboratories, Neuroscience Department, Children’s Hospital A. Meyer-University of Florence, Florence, Italy
| | - Emanuele Bartolini
- USL Centro Toscana, Neurology Unit, Nuovo Ospedale Santo Stefano, Prato, Italy
| | - Khalid Hamandi
- Cardiff University Brain Research Imaging Centre (CUBRIC), College of Biomedical Sciences, Cardiff University, Cardiff, UK
- The Welsh Epilepsy Unit, Department of Neurology, University Hospital of Wales, Cardiff, UK
| | - Sonya Foley
- Cardiff University Brain Research Imaging Centre (CUBRIC), College of Biomedical Sciences, Cardiff University, Cardiff, UK
| | - Bernd Weber
- Institute of Experimental Epileptology and Cognition Research, University Hospital Bonn, Bonn, Germany
| | - Chantal Depondt
- Department of Neurology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Julie Absil
- Department of Radiology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Sarah J A Carr
- Division of Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
| | - Eugenio Abela
- Division of Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
| | - Mark P Richardson
- Division of Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
| | - Orrin Devinsky
- Department of Neurology, NYU Grossman School of Medicine, New York, NY, USA
| | - Mariasavina Severino
- IRCCS Istituto Giannina Gaslini, Genova, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Pasquale Striano
- IRCCS Istituto Giannina Gaslini, Genova, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Costanza Parodi
- IRCCS Istituto Giannina Gaslini, Genova, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Domenico Tortora
- IRCCS Istituto Giannina Gaslini, Genova, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Sean N Hatton
- Department of Neurosciences, Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA, USA
| | - Sjoerd B Vos
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- MRI Unit, Epilepsy Society, Chalfont St Peter, Buckinghamshire, UK
- Centre for Medical Image Computing, University College London, London, UK
| | - John S Duncan
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- MRI Unit, Epilepsy Society, Chalfont St Peter, Buckinghamshire, UK
| | - Marian Galovic
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- MRI Unit, Epilepsy Society, Chalfont St Peter, Buckinghamshire, UK
- Department of Neurology, Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland
| | - Christopher D Whelan
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Núria Bargalló
- Magnetic Resonance Image Core Facility, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Radiology CDIC, Hospital Clinic Barcelona, Barcelona, Spain
| | - Jose Pariente
- Magnetic Resonance Image Core Facility, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | | | - Anna Elisabetta Vaudano
- Neurology Unit, Azienda Ospedaliero-Universitaria of Modena, OCB Hospital, Modena, Italy
- Department of Biomedical, Metabolic, and Neural Sciences, Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy
| | - Manuela Tondelli
- Neurology Unit, Azienda Ospedaliero-Universitaria of Modena, OCB Hospital, Modena, Italy
- Department of Biomedical, Metabolic, and Neural Sciences, Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefano Meletti
- Neurology Unit, Azienda Ospedaliero-Universitaria of Modena, OCB Hospital, Modena, Italy
- Department of Biomedical, Metabolic, and Neural Sciences, Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy
| | - Xiang‐Zhen Kong
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China
| | - Clyde Francks
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Simon E Fisher
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Benoit Caldairou
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Mina Ryten
- Department of Neurodegenerative Disease, Queen Square Institute of Neurology, University College London, London, UK
- NIHR Great Ormond Street Hospital Biomedical Research Centre, University College London, London, UK
- Department of Genetics and Genomic Medicine, Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Angelo Labate
- Neurology, BIOMORF Department, University of Messina, Messina, Italy
| | - Sanjay M Sisodiya
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- MRI Unit, Epilepsy Society, Chalfont St Peter, Buckinghamshire, UK
| | - Paul M Thompson
- Imaging Genetics Center, Mark & Mary Stevens Institute for Neuroimaging and Informatics, USC Keck School of Medicine, Los Angeles, CA, USA
| | - Carrie R McDonald
- Department of Psychiatry, Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA, USA
| | - Andrea Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Neda Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Boris C Bernhardt
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
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10
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Li W, Jiang Y, Qin Y, Li X, Lei D, Zhang H, Luo C, Gong Q, Zhou D, An D. Cortical remodeling before and after successful temporal lobe epilepsy surgery. Acta Neurol Scand 2022; 146:144-151. [PMID: 35506500 DOI: 10.1111/ane.13631] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/11/2022] [Accepted: 04/24/2022] [Indexed: 02/05/2023]
Abstract
OBJECTIVES To explore dynamic alterations of cortical thickness before and after successful anterior temporal lobectomy (ATL) in patients with unilateral mesial temporal lobe epilepsy (mTLE). MATERIALS AND METHODS High-resolution T1-weighted MRI was obtained in 28 mTLE patients who achieved seizure freedom for at least 24 months after ATL and 29 healthy controls. Patients were scanned at five timepoints, including before surgery, 3, 6, 12 and 24 months after surgery. Preoperative cortical thickness of mTLE patients were compared with healthy controls. Dynamic alterations of cortical thickness before and after surgery were compared among five scans using linear mixed models. RESULTS Patients with mTLE showed cortical thinning pre-surgically in ipsilateral entorhinal cortex, parahippocampal gyrus, inferior parietal cortex, lateral occipital cortex; contralateral pericalcarine cortex (PCC); and bilateral caudal middle frontal gyrus (cMFG), paracentral lobule, precentral gyrus (PCG), superior parietal cortex. Cortical thickening was observed in contralateral rostral anterior cingulate cortex (rACC). Patients showed postsurgical cortical thinning in ipsilateral temporal lobe, fusiform gyrus, caudal anterior cingulate cortex, lingual gyrus, and insula. Ipsilateral cMFG, PCC, and contralateral PCG showed significant cortical thickening after surgery. In addition, contralateral rACC showed cortical thickening at 3 months follow-up, however, with obvious cortical thinning at 24 months follow-up. CONCLUSIONS Mesial temporal lobe epilepsy patients showed widespread cortical thinning before and after anterior temporal lobectomy. Progressive cortical thinning mainly existed in neighboring regions of resection. Postoperative cortical thickening may indicate cortical remodeling after successful surgery.
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Affiliation(s)
- Wei Li
- Department of Neurology, West China Hospital Sichuan University Chengdu China
| | - Yuchao Jiang
- MOE Key Lab for Neuroinformation, Center for Information in Medicine, School of life Science and technology, The Clinical Hospital of Chengdu Brain Science Institute University of Electronic Science and Technology of China Chengdu China
| | - Yingjie Qin
- Department of Neurology, West China Hospital Sichuan University Chengdu China
| | - Xiuli Li
- Department of Radiology, Huaxi MR Research Center, West China Hospital Sichuan University Chengdu China
| | - Du Lei
- Department of Radiology, Huaxi MR Research Center, West China Hospital Sichuan University Chengdu China
| | - Heng Zhang
- Department of Neurosurgery, West China Hospital Sichuan University Chengdu China
| | - Cheng Luo
- MOE Key Lab for Neuroinformation, Center for Information in Medicine, School of life Science and technology, The Clinical Hospital of Chengdu Brain Science Institute University of Electronic Science and Technology of China Chengdu China
| | - Qiyong Gong
- Department of Radiology, Huaxi MR Research Center, West China Hospital Sichuan University Chengdu China
| | - Dong Zhou
- Department of Neurology, West China Hospital Sichuan University Chengdu China
| | - Dongmei An
- Department of Neurology, West China Hospital Sichuan University Chengdu China
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11
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Jo H, Kim J, Kim D, Hwang Y, Seo D, Hong S, Shon YM. Lateralizing Characteristics of Morphometric Changes to Hippocampus and Amygdala in Unilateral Temporal Lobe Epilepsy with Hippocampal Sclerosis. Medicina (B Aires) 2022; 58:medicina58040480. [PMID: 35454319 PMCID: PMC9029741 DOI: 10.3390/medicina58040480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 03/21/2022] [Accepted: 03/23/2022] [Indexed: 11/16/2022] Open
Abstract
Background andObjective: In the present study, a detailed investigation of substructural volume change in the hippocampus (HC) and amygdala (AMG) was performed and the association with clinical features in patients with mesial temporal lobe epilepsy with hippocampal sclerosis (TLE-HS) determined. Methods: The present study included 22 patients with left-sided TLE-HS (LTLE-HS) and 26 patients with right-sided TLE-HS (RTLE-HS). In addition, 28 healthy controls underwent high-resolution T2-weighted image (T2WI) and T1-weighted image (T1WI) MRI scanning. Subfield analysis of HC and AMG was performed using FreeSurfer version 6.0. Results: Patients with TLE-HS showed a decrease in the volume of substructures in both HC and AMG, and this change was observed on the contralateral side and the ipsilateral side with HS. The volume reduction pattern of substructures showed laterality-dependent characteristics. Patients with LTLE-HS had smaller volumes of the ipsilateral subiculum (SUB), contralateral SUB, and ipsilateral cortical nucleus of AMG than patients with RTLE-HS. Patients with RTLE-HS had reduced ipsilateral cornu ammonis (CA) 2/3 and contralateral cortico-amygdaloid transition area (CAT) volumes. The relationship between clinical variables and subregions was different based on the lateralization of the seizure focus. Focal to bilateral tonic-clonic seizures (FTBTCS) was associated with contralateral and ipsilateral side subregions only in LTLE-HS. The abdominal FAS was associated with the volume reduction of AMG subregions only in LTLE-HS, but the volume reduction was less than in patients without FAS. Conclusions: The results indicate that unilateral TLE-HS is a bilateral disease that shows different laterality-dependent characteristics based on the subfield analysis of HC and AMG. Subfield volumes of HC and AMG were associated with clinical variables, and the more damaged substructures depended on laterality in TLE-HS. These findings support the evidence that LTLE-HS and RTLE-HS are disparate epilepsy entities rather than simply identical syndromes harboring a mesial temporal lesion. In addition, the presence of FAS supports good localization value, and abdominal FAS has a high localization value, especially in patients with LTLE-HS.
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Affiliation(s)
- Hyunjin Jo
- Samsung Medical Center, Department of Neurology, Sungkyunkwan University School of Medicine, Seoul 06355, Korea; (H.J.); (J.K.); (D.S.); (S.H.)
| | - Jeongsik Kim
- Samsung Medical Center, Department of Neurology, Sungkyunkwan University School of Medicine, Seoul 06355, Korea; (H.J.); (J.K.); (D.S.); (S.H.)
| | - Dongyeop Kim
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul 03760, Korea;
| | - Yoonha Hwang
- Department of Neurology, The Catholic University of Korea Eunpyeong St. Mary’s Hospital, Seoul 07345, Korea;
| | - Daewon Seo
- Samsung Medical Center, Department of Neurology, Sungkyunkwan University School of Medicine, Seoul 06355, Korea; (H.J.); (J.K.); (D.S.); (S.H.)
| | - Seungbong Hong
- Samsung Medical Center, Department of Neurology, Sungkyunkwan University School of Medicine, Seoul 06355, Korea; (H.J.); (J.K.); (D.S.); (S.H.)
| | - Young-Min Shon
- Samsung Medical Center, Department of Neurology, Sungkyunkwan University School of Medicine, Seoul 06355, Korea; (H.J.); (J.K.); (D.S.); (S.H.)
- Department of Medical Device Management and Research, Samsung Advanced Institute for Health Sciences & Technology (SAHIST), Sunkyunkwan University, Seoul 06355, Korea
- Correspondence: ; Tel.: +82-2-3410-2701
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12
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Zhao Y, Zhang C, Yang H, Liu C, Yu T, Lu J, Chen N, Li K. Recovery of cortical atrophy in patients with temporal lobe epilepsy after successful anterior temporal lobectomy. Epilepsy Behav 2021; 123:108272. [PMID: 34500432 DOI: 10.1016/j.yebeh.2021.108272] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/09/2021] [Accepted: 08/14/2021] [Indexed: 11/30/2022]
Abstract
The aims of this study were to investigate whether the cortical atrophy caused by temporal lobe epilepsy (TLE) was reversible after successful anterior temporal lobectomy (ATL) and to further observe whether possible changes are related to age at surgery and cognitive changes. Twelve patients with unilateral mesial TLE who received ATL and remained seizure free in one year follow-up were included. They underwent two MRI scans few days before and oneyear after surgery. Thirty age- and sex-matched healthy participants were recruited as controls. Group comparisons were used to test the differences in cortical thickness (CTh) between the pre-/postsurgical patients and controls. Longitudinal test was used to directly show postsurgical changes of the patients. Besides, the correlations between regional cortical volume (CVo) changes and age at surgery or cognitive changes were also tested. Compared with controls, the patients with TLE showed dispersed cortical thinning especially in the bilateral frontal lobes before surgery and no significant cortical thinning except for cortices near the resected areas after surgery. The longitudinal analysis showed CTh increment in the ipsilateral precentral and postcentral gyrus, cuneus and widespread in the contralateral cortex. In the volumetric analysis, the CVo changes in the contralateral hemisphere were negatively correlated with age at surgery and positively correlated with MoCA score changes. This study suggests that the cortical atrophy caused by TLE could recover after successful ATL. The recovery ability is greater in younger subjects and is positively related to cognitive recovery. These findings could serve as new clues that patients with TLE can benefit from timely and successful ATL.
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Affiliation(s)
- Yongxiang Zhao
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100053, PR China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing 100053, PR China
| | - Chao Zhang
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100053, PR China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing 100053, PR China; Department of Radiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province 221006, PR China
| | - Hongyu Yang
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100053, PR China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing 100053, PR China; Department of Radiology, Luhe Hospital, Capital Medical University, Beijing 101100, PR China
| | - Chang Liu
- Department of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, PR China
| | - Tao Yu
- Department of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, PR China
| | - Jie Lu
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100053, PR China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing 100053, PR China
| | - Nan Chen
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100053, PR China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing 100053, PR China.
| | - Kuncheng Li
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100053, PR China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing 100053, PR China.
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13
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Fadaie F, Lee HM, Caldairou B, Gill RS, Sziklas V, Crane J, Bernhardt BC, Hong SJ, Bernasconi A, Bernasconi N. Atypical functional connectome hierarchy impacts cognition in temporal lobe epilepsy. Epilepsia 2021; 62:2589-2603. [PMID: 34490890 DOI: 10.1111/epi.17032] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/24/2021] [Accepted: 07/26/2021] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Drug-resistant temporal lobe epilepsy (TLE) is typically associated with hippocampal pathology. However, widespread network alterations are increasingly recognized and suggested to perturb cognitive function in multiple domains. Here we tested (1) whether TLE shows atypical cortical hierarchical organization, differentiating sensory and higher order systems; and (2) whether atypical hierarchy predicts cognitive impairment. METHODS We studied 72 well-characterized drug-resistant TLE patients and 41 healthy controls, statistically matched for age and sex, using multimodal magnetic resonance imaging analysis and cognitive testing. To model cortical hierarchical organization in vivo, we used a bidirectional stepwise functional connectivity analysis tapping into the differentiation between sensory/unimodal and paralimbic/transmodal cortices. Linear models compared patients to controls. Finally, we assessed associations of functional anomalies to cortical atrophy and microstructural anomalies, as well as clinical and cognitive parameters. RESULTS Compared to controls, TLE presented with bidirectional disruptions of sensory-paralimbic functional organization. Stepwise connectivity remained segregated within paralimbic and salience networks at the top of the hierarchy, and sensorimotor and dorsal attention at the bottom. Whereas paralimbic segregation was associated with atypical cortical myeloarchitecture and hippocampal atrophy, dysconnectivity of sensorimotor cortices reflected diffuse cortical thinning. The degree of abnormal hierarchical organization in sensory-petal streams covaried, with broad cognitive impairments spanning sensorimotor, attention, fluency, and visuoconstructional ability and memory, and was more marked in patients with longer disease duration and Engel I outcome. SIGNIFICANCE Our findings show atypical functional integration between paralimbic/transmodal and sensory/unimodal systems in TLE. Differential associations with paralimbic microstructure and sensorimotor atrophy suggest that system-level imbalance likely reflects complementary structural processes, but ultimately accounts for a broad spectrum of cognitive impairments. Hierarchical contextualization of cognitive deficits promises to open new avenues for personalized counseling in TLE.
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Affiliation(s)
- Fatemeh Fadaie
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Hyo M Lee
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Benoit Caldairou
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Ravnoor S Gill
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Viviane Sziklas
- Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Joelle Crane
- Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Boris C Bernhardt
- Medical Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Seok-Jun Hong
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Andrea Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Neda Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
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14
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Lu CQ, Gosden GP, Okromelidze L, Jain A, Gupta V, Grewal SS, Lin C, Tatum WO, Messina SA, Quiñones-Hinojosa A, Ju S, Middlebrooks EH. Brain structural differences in temporal lobe and frontal lobe epilepsy patients: A voxel-based morphometry and vertex-based surface analysis. Neuroradiol J 2021; 35:193-202. [PMID: 34313179 DOI: 10.1177/19714009211034839] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE Exploration of the effect of chronic recurrent seizures in focal epilepsy on brain volumes has produced many conflicting reports. To determine differences in brain structure in temporal lobe epilepsy (TLE) and extratemporal epilepsy (using frontal lobe epilepsy (FLE) a surrogate) further, we performed a retrospective analysis of a large cohort of patients with seizure-onset zone proven by intracranial monitoring. METHODS A total of 120 TLE patients, 86 FLE patients, and 54 healthy controls were enrolled in this study. An analysis of variance of voxel-based morphometry (VBM) was used to seek morphometric brain differences among TLE patients, FLE patients, and healthy controls. Additionally, a vertex-based surface analysis was utilized to analyze the hippocampus and thalamus. Significant side-specific differences in hippocampal gray matter volume were present between the left TLE (LTLE), right TLE RTLE (RTLE), and control groups (p<0.05, family-wise error (FWE) corrected). RESULTS Vertex analyses revealed significant volume reduction in inferior parts of the left hippocampus in the LTLE group and lateral parts of the right hippocampus in the RTLE group compared to controls (p<0.05, FWE corrected). Significant differences were also detected between the LTLE and control group in the bilateral medial and inferior thalamus (p<0.05, FWE corrected). FLE patients did not exhibit focal atrophy of gray matter across the brain. CONCLUSION Our results highlight the variation in morphometric lateralized changes in the brain between different epilepsy onset zones, providing critical insight into the natural history of people with drug-resistant focal epilepsies.
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Affiliation(s)
- Chun-Qiang Lu
- Department of Radiology, 6915Mayo Clinic, Mayo Clinic, USA.,Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School of Southeast University, P.R. China
| | - Grant P Gosden
- Department of Radiology, 6915Mayo Clinic, Mayo Clinic, USA
| | | | - Ayushi Jain
- Department of Radiology, 6915Mayo Clinic, Mayo Clinic, USA
| | - Vivek Gupta
- Department of Radiology, 6915Mayo Clinic, Mayo Clinic, USA
| | | | - Chen Lin
- Department of Radiology, 6915Mayo Clinic, Mayo Clinic, USA
| | | | | | | | - Shenghong Ju
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School of Southeast University, P.R. China
| | - Erik H Middlebrooks
- Department of Radiology, 6915Mayo Clinic, Mayo Clinic, USA.,Department of Neurosurgery, Mayo Clinic, USA
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15
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Gleichgerrcht E, Munsell BC, Alhusaini S, Alvim MKM, Bargalló N, Bender B, Bernasconi A, Bernasconi N, Bernhardt B, Blackmon K, Caligiuri ME, Cendes F, Concha L, Desmond PM, Devinsky O, Doherty CP, Domin M, Duncan JS, Focke NK, Gambardella A, Gong B, Guerrini R, Hatton SN, Kälviäinen R, Keller SS, Kochunov P, Kotikalapudi R, Kreilkamp BAK, Labate A, Langner S, Larivière S, Lenge M, Lui E, Martin P, Mascalchi M, Meletti S, O'Brien TJ, Pardoe HR, Pariente JC, Xian Rao J, Richardson MP, Rodríguez-Cruces R, Rüber T, Sinclair B, Soltanian-Zadeh H, Stein DJ, Striano P, Taylor PN, Thomas RH, Elisabetta Vaudano A, Vivash L, von Podewills F, Vos SB, Weber B, Yao Y, Lin Yasuda C, Zhang J, Thompson PM, Sisodiya SM, McDonald CR, Bonilha L. Artificial intelligence for classification of temporal lobe epilepsy with ROI-level MRI data: A worldwide ENIGMA-Epilepsy study. Neuroimage Clin 2021; 31:102765. [PMID: 34339947 PMCID: PMC8346685 DOI: 10.1016/j.nicl.2021.102765] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 07/15/2021] [Accepted: 07/17/2021] [Indexed: 01/22/2023]
Abstract
Artificial intelligence has recently gained popularity across different medical fields to aid in the detection of diseases based on pathology samples or medical imaging findings. Brain magnetic resonance imaging (MRI) is a key assessment tool for patients with temporal lobe epilepsy (TLE). The role of machine learning and artificial intelligence to increase detection of brain abnormalities in TLE remains inconclusive. We used support vector machine (SV) and deep learning (DL) models based on region of interest (ROI-based) structural (n = 336) and diffusion (n = 863) brain MRI data from patients with TLE with ("lesional") and without ("non-lesional") radiographic features suggestive of underlying hippocampal sclerosis from the multinational (multi-center) ENIGMA-Epilepsy consortium. Our data showed that models to identify TLE performed better or similar (68-75%) compared to models to lateralize the side of TLE (56-73%, except structural-based) based on diffusion data with the opposite pattern seen for structural data (67-75% to diagnose vs. 83% to lateralize). In other aspects, structural and diffusion-based models showed similar classification accuracies. Our classification models for patients with hippocampal sclerosis were more accurate (68-76%) than models that stratified non-lesional patients (53-62%). Overall, SV and DL models performed similarly with several instances in which SV mildly outperformed DL. We discuss the relative performance of these models with ROI-level data and the implications for future applications of machine learning and artificial intelligence in epilepsy care.
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Affiliation(s)
| | - Brent C Munsell
- Department of Psychiatry, University of North Carolina at Chapel Hill, NC, USA; Department of Computer Science, University of North Carolina at Chapel Hill, NC, USA
| | - Saud Alhusaini
- Neurology Department, Yale University School of Medicine, New Haven, CT, USA; Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Marina K M Alvim
- Department of Neurology and Neuroimaging Laboratory, University of Campinas - UNICAMP, Campinas, SP, Brazil
| | - Núria Bargalló
- Magnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain; Department of Radiology of Center of Image Diagnosis (CDIC), Hospital Clinic de Barcelona, Barcelona, Spain
| | - Benjamin Bender
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Tübingen, Germany
| | - Andrea Bernasconi
- Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Neda Bernasconi
- Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Boris Bernhardt
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Karen Blackmon
- Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, USA
| | - Maria Eugenia Caligiuri
- Neuroscience Research Center, Department of Medical and Surgical Sciences, University "Magna Græcia" of Catanzaro, Catanzaro, Italy
| | - Fernando Cendes
- Department of Neurology and Neuroimaging Laboratory, University of Campinas - UNICAMP, Campinas, SP, Brazil
| | - Luis Concha
- Instituto de Neurobiología, Universidad Nacional Autónoma de México, Querétaro, Mexico
| | - Patricia M Desmond
- Department of Radiology, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Orrin Devinsky
- Department of Neurology, Langone School of Medicine, New York University, New York, NY, USA
| | - Colin P Doherty
- Trinity College Dublin, School of Medicine, Dublin, Ireland; FutureNeuro SFI Research Centre for Rare and Chronic Neurological Diseases, Dublin, Ireland
| | - Martin Domin
- Functional Imaging Unit, Department of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - John S Duncan
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
| | - Niels K Focke
- University Medicine Göttingen, Clinical Neurophysiology, Göttingen, Germany
| | - Antonio Gambardella
- Neuroscience Research Center, Department of Medical and Surgical Sciences, University "Magna Græcia" of Catanzaro, Catanzaro, Italy; Institute of Neurology, University "Magna Græcia" of Catanzaro, Catanzaro, Italy
| | - Bo Gong
- Department of Radiology, BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Renzo Guerrini
- Neuroscience Department, University of Florence, Florence, Italy
| | - Sean N Hatton
- Center for Multimodal Imaging and Genetics, University of California, San Diego, La Jolla, CA, USA
| | - Reetta Kälviäinen
- Kuopio University Hospital, Member of EpiCARE ERN, Kuopio, Finland; Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland
| | - Simon S Keller
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK; The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Peter Kochunov
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Raviteja Kotikalapudi
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Tübingen, Germany; Department of Clinical Neurophysiology, University Hospital Göttingen, Goettingen, Germany; Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University Hospital Tübingen, Tübingen, Germany
| | - Barbara A K Kreilkamp
- University Medicine Göttingen, Clinical Neurophysiology, Göttingen, Germany; Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - Angelo Labate
- Neuroscience Research Center, Department of Medical and Surgical Sciences, University "Magna Græcia" of Catanzaro, Catanzaro, Italy; Institute of Neurology, University "Magna Græcia" of Catanzaro, Catanzaro, Italy
| | - Soenke Langner
- Institute for Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany; Institute for Diagnostic and Interventional Radiology, Pediatric and Neuroradiology, University Medical Centre Rostock, Rostock, Germany
| | - Sara Larivière
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Matteo Lenge
- Pediatric Neurology, Neurogenetics and Neurobiology Unit and Laboratories, Children's Hospital A. Meyer-University of Florence, Florence, Italy; Functional and Epilepsy Neurosurgery Unit, Neurosurgery Department, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | - Elaine Lui
- Department of Radiology, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Pascal Martin
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University Hospital Tübingen, Tübingen, Germany
| | - Mario Mascalchi
- 'Mario Serio' Department of Clinical and Experimental Medica Sciences, University of Florence, Florence, Italy
| | - Stefano Meletti
- Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Neurology Unit, OCB Hospital, AOU Modena, Modena, Italy
| | - Terence J O'Brien
- Department of Neuroscience, Monash University, Melbourne, VIC, Australia; The Department of Medicine (The Royal Melbourne Hospital), The University of Melbourne, Parkville, VIC, Australia; Department of Neurology, Alfred Health, Melbourne, VIC, Australia
| | - Heath R Pardoe
- Department of Neurology, Langone School of Medicine, New York University, New York, NY, USA
| | - Jose C Pariente
- Magnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Jun Xian Rao
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | | | - Raúl Rodríguez-Cruces
- Instituto de Neurobiología, Universidad Nacional Autónoma de México, Querétaro, Mexico; Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Theodor Rüber
- Department of Epileptology, University Hospital Bonn, Bonn, Germany
| | - Ben Sinclair
- Department of Neuroscience, Monash University, Melbourne, VIC, Australia; The Department of Medicine (The Royal Melbourne Hospital), The University of Melbourne, Parkville, VIC, Australia; Department of Neurology, Alfred Health, Melbourne, VIC, Australia
| | - Hamid Soltanian-Zadeh
- Radiology and Research Administration, Henry Ford Health System, Detroit, MI, USA; School of Electrical and Computer Engineering, College of Engineering, University of Tehran, Tehran, Iran
| | - Dan J Stein
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Pasquale Striano
- IRCCS Istituto 'G. Gaslini', Genova, Italy; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Peter N Taylor
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy; School of Computing, Newcastle University, Newcastle Upon Tyne, UK
| | - Rhys H Thomas
- Institute of Translational and Clinical Research, Newcastle University, Newcastle Upon Tyne, UK
| | - Anna Elisabetta Vaudano
- Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Neurology Unit, OCB Hospital, AOU Modena, Modena, Italy
| | - Lucy Vivash
- Department of Neuroscience, Monash University, Melbourne, VIC, Australia; The Department of Medicine (The Royal Melbourne Hospital), The University of Melbourne, Parkville, VIC, Australia; Department of Neurology, Alfred Health, Melbourne, VIC, Australia
| | - Felix von Podewills
- Department of Neurology, Epilepsy Center, University Medicine Greifswald, Greifswald, Germany
| | - Sjoerd B Vos
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK; Neuroradiological Academic Unit, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Bernd Weber
- Institute of Experimental Epileptology and Cognition Research, University of Bonn, Bonn, Germany
| | - Yi Yao
- Institute of Experimental Epileptology and Cognition Research, University of Bonn, Bonn, Germany
| | - Clarissa Lin Yasuda
- Department of Neurology and Neuroimaging Laboratory, University of Campinas - UNICAMP, Campinas, SP, Brazil
| | - Junsong Zhang
- Cognitive Science Department, School of Informatics, Xiamen University, Xiamen, China
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Sanjay M Sisodiya
- UCL Queen Square Institute of Neurology, London, UK; Chalfont Centre for Epilepsy, Bucks, UK
| | - Carrie R McDonald
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Leonardo Bonilha
- Department of Neurology, Medical University of South Carolina, Charleston, SC, USA
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16
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Moghaddam HS, Aarabi MH, Mehvari-Habibabadi J, Sharifpour R, Mohajer B, Mohammadi-Mobarakeh N, Hashemi-Fesharaki SS, Elisevich K, Nazem-Zadeh MR. Distinct patterns of hippocampal subfield volume loss in left and right mesial temporal lobe epilepsy. Neurol Sci 2020; 42:1411-1421. [PMID: 32783160 DOI: 10.1007/s10072-020-04653-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 08/06/2020] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To investigate the pattern and severity of hippocampal subfield volume loss in patients with left and right mesial temporal lobe epilepsy (mTLE) using quantitative MRI volumetric analysis. METHODS A total of 21 left and 14 right mTLE subjects, as well as 15 healthy controls, were enrolled in this cross-sectional study. A publically available magnetic resonance imaging (MRI) brain volumetry system (volBrain) was used for volumetric analysis of hippocampal subfields. The T1-weighted images were processed with a HIPS pipeline. RESULTS A distinct pattern of hippocampal subfield atrophy was found between left and right mTLE patients when compared with controls. Patients with left mTLE exhibited ipsilateral hippocampal atrophy and segmental volume depletion of the Cornu Ammonis (CA) 2/CA3, CA4/dentate gyrus (DG), and strata radiatum-lacunosum-moleculare (SR-SL-SM). Those with right mTLE exhibited similar ipsilateral hippocampal atrophy but with additional segmental CA1 volume depletion. More extensive bilateral subfield volume loss was apparent with right mTLE patients. CONCLUSION We demonstrate that left and right mTLE patients show a dissimilar pattern of hippocampal subfield atrophy, suggesting the pathophysiology of epileptogenesis in left and right mTLE to be different.
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Affiliation(s)
| | | | | | - Roya Sharifpour
- Medical Physics and Biomedical Engineering Department, Tehran University of Medical Sciences (TUMS), Tehran, Iran.,Research Center for Molecular and Cellular Imaging, Research Center for Science and Technology in Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Bahram Mohajer
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Neda Mohammadi-Mobarakeh
- Medical Physics and Biomedical Engineering Department, Tehran University of Medical Sciences (TUMS), Tehran, Iran.,Research Center for Molecular and Cellular Imaging, Research Center for Science and Technology in Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | | | - Kost Elisevich
- Department of Clinical Neurosciences, Spectrum Health, College of Human Medicine, Michigan State University, Grand Rapids, MI, 49503, USA
| | - Mohammad-Reza Nazem-Zadeh
- Medical Physics and Biomedical Engineering Department, Tehran University of Medical Sciences (TUMS), Tehran, Iran. .,Research Center for Molecular and Cellular Imaging, Research Center for Science and Technology in Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
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17
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Weng Y, Larivière S, Caciagli L, Vos de Wael R, Rodríguez-Cruces R, Royer J, Xu Q, Bernasconi N, Bernasconi A, Thomas Yeo BT, Lu G, Zhang Z, Bernhardt BC. Macroscale and microcircuit dissociation of focal and generalized human epilepsies. Commun Biol 2020; 3:244. [PMID: 32424317 PMCID: PMC7234993 DOI: 10.1038/s42003-020-0958-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 04/15/2020] [Indexed: 01/01/2023] Open
Abstract
Thalamo-cortical pathology plays key roles in both generalized and focal epilepsies, but there is little work directly comparing these syndromes at the level of whole-brain mechanisms. Using multimodal imaging, connectomics, and computational simulations, we examined thalamo-cortical and cortico-cortical signatures and underlying microcircuits in 96 genetic generalized (GE) and 107 temporal lobe epilepsy (TLE) patients, along with 65 healthy controls. Structural and functional network profiling highlighted extensive atrophy, microstructural disruptions and decreased thalamo-cortical connectivity in TLE, while GE showed only subtle structural anomalies paralleled by enhanced thalamo-cortical connectivity. Connectome-informed biophysical simulations indicated modest increases in subcortical drive contributing to cortical dynamics in GE, while TLE presented with reduced subcortical drive and imbalanced excitation-inhibition within limbic and somatomotor microcircuits. Multiple sensitivity analyses supported robustness. Our multiscale analyses differentiate human focal and generalized epilepsy at the systems-level, showing paradoxically more severe microcircuit and macroscale imbalances in the former.
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Affiliation(s)
- Yifei Weng
- Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, 3801 University Street, Montreal, QC, H3A2B4, Canada
| | - Sara Larivière
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, 3801 University Street, Montreal, QC, H3A2B4, Canada
| | - Lorenzo Caciagli
- University College London Queen Square Institute of Neurology, London, United Kingdom
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA
| | - Reinder Vos de Wael
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, 3801 University Street, Montreal, QC, H3A2B4, Canada
| | - Raúl Rodríguez-Cruces
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, 3801 University Street, Montreal, QC, H3A2B4, Canada
| | - Jessica Royer
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, 3801 University Street, Montreal, QC, H3A2B4, Canada
| | - Qiang Xu
- Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Neda Bernasconi
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, 3801 University Street, Montreal, QC, H3A2B4, Canada
| | - Andrea Bernasconi
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, 3801 University Street, Montreal, QC, H3A2B4, Canada
| | - B T Thomas Yeo
- Department of Electrical and Computer Engineering, Centre for Sleep and Cognition, Clinical Imaging Research Centre and N.1 Institute for Health, National University of Singapore, Singapore, Singapore
| | - Guangming Lu
- Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Zhiqiang Zhang
- Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
| | - Boris C Bernhardt
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, 3801 University Street, Montreal, QC, H3A2B4, Canada.
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18
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Foit NA, Bernasconi A, Bernasconi N. Functional Networks in Epilepsy Presurgical Evaluation. Neurosurg Clin N Am 2020; 31:395-405. [PMID: 32475488 DOI: 10.1016/j.nec.2020.03.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Continuing advancements in neuroimaging methodology allow for increasingly detailed in vivo characterization of structural and functional brain networks, leading to the recognition of epilepsy as a disorder of large-scale networks. In surgical candidates, analysis of functional networks has proved invaluable for the identification of eloquent brain areas, such as hemispherical language dominance. More recently, connectome-based biomarkers have demonstrated potential to further inform clinical decision making in drug-refractory epilepsy. This article summarizes current evidence on epilepsy as a network disorder, emphasizing potential benefits of network analysis techniques for preoperative assessments and resection planning.
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Affiliation(s)
- Niels Alexander Foit
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, 3801 Rue Université, Montreal, Quebec H3A 2B4, Canada
| | - Andrea Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, 3801 Rue Université, Montreal, Quebec H3A 2B4, Canada
| | - Neda Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, 3801 Rue Université, Montreal, Quebec H3A 2B4, Canada.
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19
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Rodríguez-Cruces R, Bernhardt BC, Concha L. Multidimensional associations between cognition and connectome organization in temporal lobe epilepsy. Neuroimage 2020; 213:116706. [PMID: 32151761 DOI: 10.1016/j.neuroimage.2020.116706] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 01/14/2020] [Accepted: 03/03/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Temporal lobe epilepsy (TLE) is known to affect large-scale structural networks and cognitive function in multiple domains. The study of complex relations between structural network organization and cognition requires comprehensive analytical methods and a shift towards multivariate techniques. Here, we sought to identify multidimensional associations between cognitive performance and structural network topology in TLE. METHODS We studied 34 drug-resistant adult TLE patients and 24 age- and sex-matched healthy controls. Participants underwent a comprehensive neurocognitive battery and multimodal MRI, allowing for large-scale connectomics, and morphological evaluation of subcortical and neocortical regions. Using canonical correlation analysis, we identified a multivariate mode that links cognitive performance to a brain structural network. Our approach was complemented by bootstrap-based hierarchical clustering to derive cognitive subtypes and associated patterns of macroscale connectome anomalies. RESULTS Both methodologies provided converging evidence for a close coupling between cognitive impairments across multiple domains and large-scale structural network compromise. Cognitive classes presented with an increasing gradient of abnormalities (increasing cortical and subcortical atrophy and less efficient white matter connectome organization in patients with increasing degrees of cognitive impairments). Notably, network topology characterized cognitive performance better than morphometric measures did. CONCLUSIONS Our multivariate approach emphasized a close coupling of cognitive dysfunction and large-scale network anomalies in TLE. Our findings contribute to understand the complexity of structural connectivity regulating the heterogeneous cognitive deficits found in epilepsy.
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Affiliation(s)
- Raúl Rodríguez-Cruces
- Universidad Nacional Autónoma de México, Instituto de Neurobiología, Querétaro, Querétaro, Mexico; MICA Laboratory, Montreal Neurological Institute and Hospital, Montreal, Canada.
| | - Boris C Bernhardt
- MICA Laboratory, Montreal Neurological Institute and Hospital, Montreal, Canada.
| | - Luis Concha
- Universidad Nacional Autónoma de México, Instituto de Neurobiología, Querétaro, Querétaro, Mexico.
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20
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Microstructural imaging in temporal lobe epilepsy: Diffusion imaging changes relate to reduced neurite density. NEUROIMAGE-CLINICAL 2020; 26:102231. [PMID: 32146320 PMCID: PMC7063236 DOI: 10.1016/j.nicl.2020.102231] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 02/27/2020] [Accepted: 02/27/2020] [Indexed: 01/06/2023]
Abstract
PURPOSE Previous imaging studies in patients with refractory temporal lobe epilepsy (TLE) have examined the spatial distribution of changes in imaging parameters such as diffusion tensor imaging (DTI) metrics and cortical thickness. Multi-compartment models offer greater specificity with parameters more directly related to known changes in TLE such as altered neuronal density and myelination. We studied the spatial distribution of conventional and novel metrics including neurite density derived from NODDI (Neurite Orientation Dispersion and Density Imaging) and myelin water fraction (MWF) derived from mcDESPOT (Multi-Compartment Driven Equilibrium Single Pulse Observation of T1/T2)] to infer the underlying neurobiology of changes in conventional metrics. METHODS 20 patients with TLE and 20 matched controls underwent magnetic resonance imaging including a volumetric T1-weighted sequence, multi-shell diffusion from which DTI and NODDI metrics were derived and a protocol suitable for mcDESPOT fitting. Models of the grey matter-white matter and grey matter-CSF surfaces were automatically generated from the T1-weighted MRI. Conventional diffusion and novel metrics of neurite density and MWF were sampled from intracortical grey matter and subcortical white matter surfaces and cortical thickness was measured. RESULTS In intracortical grey matter, diffusivity was increased in the ipsilateral temporal and frontopolar cortices with more restricted areas of reduced neurite density. Diffusivity increases were largely related to reductions in neurite density, and to a lesser extent CSF partial volume effects, but not MWF. In subcortical white matter, widespread bilateral reductions in fractional anisotropy and increases in radial diffusivity were seen. These were primarily related to reduced neurite density, with an additional relationship to reduced MWF in the temporal pole and anterolateral temporal neocortex. Changes were greater with increasing epilepsy duration. Bilaterally reduced cortical thickness in the mesial temporal lobe and centroparietal cortices was unrelated to neurite density and MWF. CONCLUSIONS Diffusivity changes in grey and white matter are primarily related to reduced neurite density with an additional relationship to reduced MWF in the temporal pole. Neurite density may represent a more sensitive and specific biomarker of progressive neuronal damage in refractory TLE that deserves further study.
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21
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Whelan CD, Altmann A, Botía JA, Jahanshad N, Hibar DP, Absil J, Alhusaini S, Alvim MKM, Auvinen P, Bartolini E, Bergo FPG, Bernardes T, Blackmon K, Braga B, Caligiuri ME, Calvo A, Carr SJ, Chen J, Chen S, Cherubini A, David P, Domin M, Foley S, França W, Haaker G, Isaev D, Keller SS, Kotikalapudi R, Kowalczyk MA, Kuzniecky R, Langner S, Lenge M, Leyden KM, Liu M, Loi RQ, Martin P, Mascalchi M, Morita ME, Pariente JC, Rodríguez-Cruces R, Rummel C, Saavalainen T, Semmelroch MK, Severino M, Thomas RH, Tondelli M, Tortora D, Vaudano AE, Vivash L, von Podewils F, Wagner J, Weber B, Yao Y, Yasuda CL, Zhang G, Bargalló N, Bender B, Bernasconi N, Bernasconi A, Bernhardt BC, Blümcke I, Carlson C, Cavalleri GL, Cendes F, Concha L, Delanty N, Depondt C, Devinsky O, Doherty CP, Focke NK, Gambardella A, Guerrini R, Hamandi K, Jackson GD, Kälviäinen R, Kochunov P, Kwan P, Labate A, McDonald CR, Meletti S, O'Brien TJ, Ourselin S, Richardson MP, Striano P, Thesen T, Wiest R, Zhang J, Vezzani A, Ryten M, Thompson PM, Sisodiya SM. Structural brain abnormalities in the common epilepsies assessed in a worldwide ENIGMA study. Brain 2019; 141:391-408. [PMID: 29365066 PMCID: PMC5837616 DOI: 10.1093/brain/awx341] [Citation(s) in RCA: 285] [Impact Index Per Article: 57.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 10/24/2017] [Indexed: 12/02/2022] Open
Abstract
Progressive functional decline in the epilepsies is largely unexplained. We formed the ENIGMA-Epilepsy consortium to understand factors that influence brain measures in epilepsy, pooling data from 24 research centres in 14 countries across Europe, North and South America, Asia, and Australia. Structural brain measures were extracted from MRI brain scans across 2149 individuals with epilepsy, divided into four epilepsy subgroups including idiopathic generalized epilepsies (n =367), mesial temporal lobe epilepsies with hippocampal sclerosis (MTLE; left, n = 415; right, n = 339), and all other epilepsies in aggregate (n = 1026), and compared to 1727 matched healthy controls. We ranked brain structures in order of greatest differences between patients and controls, by meta-analysing effect sizes across 16 subcortical and 68 cortical brain regions. We also tested effects of duration of disease, age at onset, and age-by-diagnosis interactions on structural measures. We observed widespread patterns of altered subcortical volume and reduced cortical grey matter thickness. Compared to controls, all epilepsy groups showed lower volume in the right thalamus (Cohen’s d = −0.24 to −0.73; P < 1.49 × 10−4), and lower thickness in the precentral gyri bilaterally (d = −0.34 to −0.52; P < 4.31 × 10−6). Both MTLE subgroups showed profound volume reduction in the ipsilateral hippocampus (d = −1.73 to −1.91, P < 1.4 × 10−19), and lower thickness in extrahippocampal cortical regions, including the precentral and paracentral gyri, compared to controls (d = −0.36 to −0.52; P < 1.49 × 10−4). Thickness differences of the ipsilateral temporopolar, parahippocampal, entorhinal, and fusiform gyri, contralateral pars triangularis, and bilateral precuneus, superior frontal and caudal middle frontal gyri were observed in left, but not right, MTLE (d = −0.29 to −0.54; P < 1.49 × 10−4). Contrastingly, thickness differences of the ipsilateral pars opercularis, and contralateral transverse temporal gyrus, were observed in right, but not left, MTLE (d = −0.27 to −0.51; P < 1.49 × 10−4). Lower subcortical volume and cortical thickness associated with a longer duration of epilepsy in the all-epilepsies, all-other-epilepsies, and right MTLE groups (beta, b < −0.0018; P < 1.49 × 10−4). In the largest neuroimaging study of epilepsy to date, we provide information on the common epilepsies that could not be realistically acquired in any other way. Our study provides a robust ranking of brain measures that can be further targeted for study in genetic and neuropathological studies. This worldwide initiative identifies patterns of shared grey matter reduction across epilepsy syndromes, and distinctive abnormalities between epilepsy syndromes, which inform our understanding of epilepsy as a network disorder, and indicate that certain epilepsy syndromes involve more widespread structural compromise than previously assumed.
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Affiliation(s)
- Christopher D Whelan
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, California, USA.,Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Andre Altmann
- Translational Imaging Group, Centre for Medical Image Computing, University College London, London, UK
| | - Juan A Botía
- Reta Lila Weston Institute and Department of Molecular Neuroscience, UCL Institute of Neurology, London WC1N 3BG, UK
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, California, USA
| | - Derrek P Hibar
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, California, USA
| | - Julie Absil
- Department of Radiology, Hôpital Erasme, Universite Libre de Bruxelles, Brussels 1070, Belgium
| | - Saud Alhusaini
- Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland.,Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Marina K M Alvim
- Department of Neurology, University of Campinas, Campinas, Brazil
| | - Pia Auvinen
- Epilepsy Center, Department of Neurology, Kuopio University, Kuopio, Finland.,Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland
| | - Emanuele Bartolini
- Pediatric Neurology Unit, Children's Hospital A. Meyer-University of Florence, Italy.,IRCCS Stella Maris Foundation, Pisa, Italy
| | - Felipe P G Bergo
- Department of Neurology, University of Campinas, Campinas, Brazil
| | - Tauana Bernardes
- Department of Neurology, University of Campinas, Campinas, Brazil
| | - Karen Blackmon
- Comprehensive Epilepsy Center, Department of Neurology, New York University School of Medicine, New York, USA.,Department of Physiology, Neuroscience and Behavioral Science, St. George's University, Grenada, West Indies
| | - Barbara Braga
- Department of Neurology, University of Campinas, Campinas, Brazil
| | - Maria Eugenia Caligiuri
- Institute of Molecular Bioimaging and Physiology of the National Research Council (IBFM-CNR), Catanzaro, Italy
| | - Anna Calvo
- Magnetic Resonance Image Core Facility, IDIBAPS, Barcelona, Spain
| | - Sarah J Carr
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Jian Chen
- Department of Computer Science and Engineering, The Ohio State University, USA
| | - Shuai Chen
- Cognitive Science Department, Xiamen University, Xiamen, China.,Fujian Key Laboratory of the Brain-like Intelligent Systems, China
| | - Andrea Cherubini
- Institute of Molecular Bioimaging and Physiology of the National Research Council (IBFM-CNR), Catanzaro, Italy
| | - Philippe David
- Department of Radiology, Hôpital Erasme, Universite Libre de Bruxelles, Brussels 1070, Belgium
| | - Martin Domin
- Functional Imaging Unit, Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Sonya Foley
- Cardiff University Brain Research Imaging Centre, School of Psychology, Wales, UK
| | - Wendy França
- Department of Neurology, University of Campinas, Campinas, Brazil
| | - Gerrit Haaker
- Department of Neurosurgery, University Hospital, Freiburg, Germany.,Department of Neuropathology, University Hospital Erlangen, Germany
| | - Dmitry Isaev
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, California, USA
| | - Simon S Keller
- Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, UK
| | - Raviteja Kotikalapudi
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,Department of Diagnostic and Interventional Neuroradiology, University of Tübingen, Tübingen, Germany
| | - Magdalena A Kowalczyk
- The Florey Institute of Neuroscience and Mental Health, Austin Campus, Melbourne, VIC, Australia
| | - Ruben Kuzniecky
- Comprehensive Epilepsy Center, Department of Neurology, New York University School of Medicine, New York, USA
| | - Soenke Langner
- Functional Imaging Unit, Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Matteo Lenge
- Pediatric Neurology Unit, Children's Hospital A. Meyer-University of Florence, Italy
| | - Kelly M Leyden
- Multimodal Imaging Laboratory, University of California San Diego, San Diego, California, USA.,Department of Psychiatry, University of California San Diego, San Diego, California, USA
| | - Min Liu
- Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute and Hospital, Mcgill University, Montreal, Quebec, Canada
| | - Richard Q Loi
- Multimodal Imaging Laboratory, University of California San Diego, San Diego, California, USA.,Department of Psychiatry, University of California San Diego, San Diego, California, USA
| | - Pascal Martin
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Mario Mascalchi
- Neuroradiology Unit, Children's Hospital A. Meyer, Florence, Italy.,"Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Italy
| | - Marcia E Morita
- Department of Neurology, University of Campinas, Campinas, Brazil
| | - Jose C Pariente
- Magnetic Resonance Image Core Facility, IDIBAPS, Barcelona, Spain
| | - Raul Rodríguez-Cruces
- Instituto de Neurobiología, Universidad Nacional Autónoma de México. Querétaro, Querétaro, México
| | - Christian Rummel
- Support Center for Advanced Neuroimaging (SCAN), University Institute for Diagnostic and Interventional Neuroradiology, Inselspital, University of Bern, Bern, Switzerland
| | - Taavi Saavalainen
- Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland.,Central Finland Central Hospital, Medical Imaging Unit, Jyväskylä, Finland
| | - Mira K Semmelroch
- The Florey Institute of Neuroscience and Mental Health, Austin Campus, Melbourne, VIC, Australia
| | - Mariasavina Severino
- Neuroradiology Unit, Department of Head and Neck and Neurosciences, Istituto Giannina Gaslini, Genova, Italy
| | - Rhys H Thomas
- Institute of Psychological Medicine and Clinical Neurosciences, Hadyn Ellis Building, Maindy Road, Cardiff, UK.,Department of Neurology, University Hospital of Wales, Cardiff, UK
| | - Manuela Tondelli
- Department of Biomedical, Metabolic, and Neural Science, University of Modena and Reggio Emilia, NOCSE Hospital, Modena, Italy
| | - Domenico Tortora
- Neuroradiology Unit, Department of Head and Neck and Neurosciences, Istituto Giannina Gaslini, Genova, Italy
| | - Anna Elisabetta Vaudano
- Department of Biomedical, Metabolic, and Neural Science, University of Modena and Reggio Emilia, NOCSE Hospital, Modena, Italy
| | - Lucy Vivash
- Melbourne Brain Centre, Department of Medicine, University of Melbourne, Parkville, VIC, 3052, Australia.,Department of Neurology, Royal Melbourne Hospital, Parkville, 3050, Australia
| | - Felix von Podewils
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Jan Wagner
- Department of Epileptology, University Hospital Bonn, Bonn, Germany.,Department of Neurology, Philips University of Marburg, Marburg Germany
| | - Bernd Weber
- Department of Epileptology, University Hospital Bonn, Bonn, Germany.,Department of Neurocognition / Imaging, Life&Brain Research Centre, Bonn, Germany
| | - Yi Yao
- The Affiliated Chenggong Hospital of Xiamen University, Xiamen, China
| | | | - Guohao Zhang
- Department of Computer Science and Electrical Engineering, University of Maryland, Baltimore County, USA
| | - Nuria Bargalló
- Magnetic Resonance Image Core Facility, IDIBAPS, Barcelona, Spain.,Centre de Diagnostic Per la Imatge (CDIC), Hospital Clinic, Barcelona, Spain
| | - Benjamin Bender
- Department of Diagnostic and Interventional Neuroradiology, University of Tübingen, Tübingen, Germany
| | - Neda Bernasconi
- Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute and Hospital, Mcgill University, Montreal, Quebec, Canada
| | - Andrea Bernasconi
- Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute and Hospital, Mcgill University, Montreal, Quebec, Canada
| | - Boris C Bernhardt
- Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute and Hospital, Mcgill University, Montreal, Quebec, Canada.,Multimodal Imaging and Connectome Analysis Lab, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Ingmar Blümcke
- Department of Neuropathology, University Hospital Erlangen, Germany
| | - Chad Carlson
- Comprehensive Epilepsy Center, Department of Neurology, New York University School of Medicine, New York, USA.,Medical College of Wisconsin, Department of Neurology, Milwaukee, WI, USA
| | - Gianpiero L Cavalleri
- Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland.,FutureNeuro Research Centre, RCSI, Dublin, Ireland
| | - Fernando Cendes
- Department of Neurology, University of Campinas, Campinas, Brazil
| | - Luis Concha
- Instituto de Neurobiología, Universidad Nacional Autónoma de México. Querétaro, Querétaro, México
| | - Norman Delanty
- Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland.,FutureNeuro Research Centre, RCSI, Dublin, Ireland.,Division of Neurology, Beaumont Hospital, Dublin 9, Ireland
| | - Chantal Depondt
- Department of Neurology, Hôpital Erasme, Universite Libre de Bruxelles, Brussels 1070, Belgium
| | - Orrin Devinsky
- Comprehensive Epilepsy Center, Department of Neurology, New York University School of Medicine, New York, USA
| | - Colin P Doherty
- FutureNeuro Research Centre, RCSI, Dublin, Ireland.,Neurology Department, St. James's Hospital, Dublin 8, Ireland
| | - Niels K Focke
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,Department of Clinical Neurophysiology, University Medicine Göttingen, Göttingen, Germany
| | - Antonio Gambardella
- Institute of Molecular Bioimaging and Physiology of the National Research Council (IBFM-CNR), Catanzaro, Italy.,Institute of Neurology, University "Magna Græcia", Catanzaro, Italy
| | - Renzo Guerrini
- Pediatric Neurology Unit, Children's Hospital A. Meyer-University of Florence, Italy.,IRCCS Stella Maris Foundation, Pisa, Italy
| | - Khalid Hamandi
- Institute of Psychological Medicine and Clinical Neurosciences, Hadyn Ellis Building, Maindy Road, Cardiff, UK.,Department of Neurology, University Hospital of Wales, Cardiff, UK
| | - Graeme D Jackson
- The Florey Institute of Neuroscience and Mental Health, Austin Campus, Melbourne, VIC, Australia.,Florey Department of Neuroscience and Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Reetta Kälviäinen
- Epilepsy Center, Department of Neurology, Kuopio University, Kuopio, Finland.,Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland
| | - Peter Kochunov
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Maryland, USA
| | - Patrick Kwan
- Department of Neurology, Royal Melbourne Hospital, Parkville, 3050, Australia
| | - Angelo Labate
- Institute of Molecular Bioimaging and Physiology of the National Research Council (IBFM-CNR), Catanzaro, Italy.,Institute of Neurology, University "Magna Græcia", Catanzaro, Italy
| | - Carrie R McDonald
- Multimodal Imaging Laboratory, University of California San Diego, San Diego, California, USA.,Department of Psychiatry, University of California San Diego, San Diego, California, USA
| | - Stefano Meletti
- Department of Biomedical, Metabolic, and Neural Science, University of Modena and Reggio Emilia, NOCSE Hospital, Modena, Italy
| | - Terence J O'Brien
- Department of Neurology, Royal Melbourne Hospital, Parkville, 3050, Australia.,Department of Medicine, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Sebastien Ourselin
- Translational Imaging Group, Centre for Medical Image Computing, University College London, London, UK
| | - Mark P Richardson
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.,Department of Neurology, King's College Hospital, London, UK
| | - Pasquale Striano
- Pediatric Neurology and Muscular Diseases Unit, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genova, Italy
| | - Thomas Thesen
- Comprehensive Epilepsy Center, Department of Neurology, New York University School of Medicine, New York, USA.,Department of Physiology, Neuroscience and Behavioral Science, St. George's University, Grenada, West Indies
| | - Roland Wiest
- Support Center for Advanced Neuroimaging (SCAN), University Institute for Diagnostic and Interventional Neuroradiology, Inselspital, University of Bern, Bern, Switzerland
| | - Junsong Zhang
- Cognitive Science Department, Xiamen University, Xiamen, China.,Fujian Key Laboratory of the Brain-like Intelligent Systems, China
| | - Annamaria Vezzani
- Dept of Neuroscience, Mario Negri Institute for Pharmacological Research, Via G. La Masa 19, 20156 Milano, Italy
| | - Mina Ryten
- Reta Lila Weston Institute and Department of Molecular Neuroscience, UCL Institute of Neurology, London WC1N 3BG, UK.,Department of Medical and Molecular Genetics, King's College London, London SE1 9RT, UK
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, California, USA
| | - Sanjay M Sisodiya
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK.,Chalfont Centre for Epilepsy, Bucks, UK
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22
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Bernhardt BC, Fadaie F, Liu M, Caldairou B, Gu S, Jefferies E, Smallwood J, Bassett DS, Bernasconi A, Bernasconi N. Temporal lobe epilepsy: Hippocampal pathology modulates connectome topology and controllability. Neurology 2019; 92:e2209-e2220. [PMID: 31004070 DOI: 10.1212/wnl.0000000000007447] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 01/08/2019] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE To assess whether hippocampal sclerosis (HS) severity is mirrored at the level of large-scale networks. METHODS We studied preoperative high-resolution anatomical and diffusion-weighted MRI of 44 temporal lobe epilepsy (TLE) patients with histopathologic diagnosis of HS (n = 25; TLE-HS) and isolated gliosis (n = 19; TLE-G) and 25 healthy controls. Hippocampal measurements included surface-based subfield mapping of atrophy and T2 hyperintensity indexing cell loss and gliosis, respectively. Whole-brain connectomes were generated via diffusion tractography and examined using graph theory along with a novel network control theory paradigm that simulates functional dynamics from structural network data. RESULTS Compared to controls, we observed markedly increased path length and decreased clustering in TLE-HS compared to controls, indicating lower global and local network efficiency, while TLE-G showed only subtle alterations. Similarly, network controllability was lower in TLE-HS only, suggesting limited range of functional dynamics. Hippocampal imaging markers were positively associated with macroscale network alterations, particularly in ipsilateral CA1-3. Systematic assessment across several networks revealed maximal changes in the hippocampal circuity. Findings were consistent when correcting for cortical thickness, suggesting independence from gray matter atrophy. CONCLUSIONS Severe HS is associated with marked remodeling of connectome topology and structurally governed functional dynamics in TLE, as opposed to isolated gliosis, which has negligible effects. Cell loss, particularly in CA1-3, may exert a cascading effect on brain-wide connectomes, underlining coupled disease processes across multiple scales.
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Affiliation(s)
- Boris C Bernhardt
- From the Neuroimaging of Epilepsy Laboratory (B.C.B., F.F., M.L., B.C., A.B., N.B.) and Multimodal Imaging and Connectome Analysis Laboratory (B.C.B.), McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Canada; Department of Bioengineering and Electrical and Systems Engineering (S.G., D.S.B.), University of Pennsylvania, Philadelphia; and York Neuroimaging Center (E.J., J.S.), University of York, UK
| | - Fatemeh Fadaie
- From the Neuroimaging of Epilepsy Laboratory (B.C.B., F.F., M.L., B.C., A.B., N.B.) and Multimodal Imaging and Connectome Analysis Laboratory (B.C.B.), McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Canada; Department of Bioengineering and Electrical and Systems Engineering (S.G., D.S.B.), University of Pennsylvania, Philadelphia; and York Neuroimaging Center (E.J., J.S.), University of York, UK
| | - Min Liu
- From the Neuroimaging of Epilepsy Laboratory (B.C.B., F.F., M.L., B.C., A.B., N.B.) and Multimodal Imaging and Connectome Analysis Laboratory (B.C.B.), McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Canada; Department of Bioengineering and Electrical and Systems Engineering (S.G., D.S.B.), University of Pennsylvania, Philadelphia; and York Neuroimaging Center (E.J., J.S.), University of York, UK
| | - Benoit Caldairou
- From the Neuroimaging of Epilepsy Laboratory (B.C.B., F.F., M.L., B.C., A.B., N.B.) and Multimodal Imaging and Connectome Analysis Laboratory (B.C.B.), McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Canada; Department of Bioengineering and Electrical and Systems Engineering (S.G., D.S.B.), University of Pennsylvania, Philadelphia; and York Neuroimaging Center (E.J., J.S.), University of York, UK
| | - Shi Gu
- From the Neuroimaging of Epilepsy Laboratory (B.C.B., F.F., M.L., B.C., A.B., N.B.) and Multimodal Imaging and Connectome Analysis Laboratory (B.C.B.), McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Canada; Department of Bioengineering and Electrical and Systems Engineering (S.G., D.S.B.), University of Pennsylvania, Philadelphia; and York Neuroimaging Center (E.J., J.S.), University of York, UK
| | - Elizabeth Jefferies
- From the Neuroimaging of Epilepsy Laboratory (B.C.B., F.F., M.L., B.C., A.B., N.B.) and Multimodal Imaging and Connectome Analysis Laboratory (B.C.B.), McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Canada; Department of Bioengineering and Electrical and Systems Engineering (S.G., D.S.B.), University of Pennsylvania, Philadelphia; and York Neuroimaging Center (E.J., J.S.), University of York, UK
| | - Jonathan Smallwood
- From the Neuroimaging of Epilepsy Laboratory (B.C.B., F.F., M.L., B.C., A.B., N.B.) and Multimodal Imaging and Connectome Analysis Laboratory (B.C.B.), McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Canada; Department of Bioengineering and Electrical and Systems Engineering (S.G., D.S.B.), University of Pennsylvania, Philadelphia; and York Neuroimaging Center (E.J., J.S.), University of York, UK
| | - Danielle S Bassett
- From the Neuroimaging of Epilepsy Laboratory (B.C.B., F.F., M.L., B.C., A.B., N.B.) and Multimodal Imaging and Connectome Analysis Laboratory (B.C.B.), McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Canada; Department of Bioengineering and Electrical and Systems Engineering (S.G., D.S.B.), University of Pennsylvania, Philadelphia; and York Neuroimaging Center (E.J., J.S.), University of York, UK
| | - Andrea Bernasconi
- From the Neuroimaging of Epilepsy Laboratory (B.C.B., F.F., M.L., B.C., A.B., N.B.) and Multimodal Imaging and Connectome Analysis Laboratory (B.C.B.), McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Canada; Department of Bioengineering and Electrical and Systems Engineering (S.G., D.S.B.), University of Pennsylvania, Philadelphia; and York Neuroimaging Center (E.J., J.S.), University of York, UK
| | - Neda Bernasconi
- From the Neuroimaging of Epilepsy Laboratory (B.C.B., F.F., M.L., B.C., A.B., N.B.) and Multimodal Imaging and Connectome Analysis Laboratory (B.C.B.), McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Canada; Department of Bioengineering and Electrical and Systems Engineering (S.G., D.S.B.), University of Pennsylvania, Philadelphia; and York Neuroimaging Center (E.J., J.S.), University of York, UK.
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23
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Kreilkamp BAK, Weber B, Elkommos SB, Richardson MP, Keller SS. Hippocampal subfield segmentation in temporal lobe epilepsy: Relation to outcomes. Acta Neurol Scand 2018; 137:598-608. [PMID: 29572865 PMCID: PMC5969077 DOI: 10.1111/ane.12926] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2018] [Indexed: 12/24/2022]
Abstract
Objective To investigate the clinical and surgical outcome correlates of preoperative hippocampal subfield volumes in patients with refractory temporal lobe epilepsy (TLE) using a new magnetic resonance imaging (MRI) multisequence segmentation technique. Methods We recruited 106 patients with TLE and hippocampal sclerosis (HS) who underwent conventional T1‐weighted and T2 short TI inversion recovery MRI. An automated hippocampal segmentation algorithm was used to identify twelve subfields in each hippocampus. A total of 76 patients underwent amygdalohippocampectomy and postoperative seizure outcome assessment using the standardized ILAE classification. Semiquantitative hippocampal internal architecture (HIA) ratings were correlated with hippocampal subfield volumes. Results Patients with left TLE had smaller volumes of the contralateral presubiculum and hippocampus‐amygdala transition area compared to those with right TLE. Patients with right TLE had reduced contralateral hippocampal tail volumes and improved outcomes. In all patients, there were no significant relationships between hippocampal subfield volumes and clinical variables such as duration and age at onset of epilepsy. There were no significant differences in any hippocampal subfield volumes between patients who were rendered seizure free and those with persistent postoperative seizure symptoms. Ipsilateral but not contralateral HIA ratings were significantly correlated with gross hippocampal and subfield volumes. Conclusions Our results suggest that ipsilateral hippocampal subfield volumes are not related to the chronicity/severity of TLE. We did not find any hippocampal subfield volume or HIA rating differences in patients with optimal and unfavorable outcomes. In patients with TLE and HS, sophisticated analysis of hippocampal architecture on MRI may have limited value for prediction of postoperative outcome.
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Affiliation(s)
- B. A. K. Kreilkamp
- Department of Molecular and Clinical Pharmacology; Institute of Translational Medicine; University of Liverpool; Liverpool UK
- Department of Neuroradiology; The Walton Centre NHS Foundation Trust; Liverpool UK
| | - B. Weber
- Department of Epileptology; University of Bonn; Bonn Germany
- Center for Economics and Neuroscience; University of Bonn; Bonn Germany
- Department of NeuroCognition/Imaging; Life& Brain Research Center; Bonn Germany
| | - S. B. Elkommos
- Department of Molecular and Clinical Sciences; St George's, University of London; London UK
| | - M. P. Richardson
- Department of Basic and Clinical Neuroscience; Institute of Psychiatry, Psychology & Neuroscience; King's College London; London UK
- Engineering and Physical Sciences Research Council Centre for Predictive Modelling in Healthcare; University of Exeter; Exeter UK
| | - S. S. Keller
- Department of Molecular and Clinical Pharmacology; Institute of Translational Medicine; University of Liverpool; Liverpool UK
- Department of Neuroradiology; The Walton Centre NHS Foundation Trust; Liverpool UK
- Department of Basic and Clinical Neuroscience; Institute of Psychiatry, Psychology & Neuroscience; King's College London; London UK
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24
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Obaid S, Tucholka A, Ghaziri J, Jodoin PM, Morency F, Descoteaux M, Bouthillier A, Nguyen DK. Cortical thickness analysis in operculo-insular epilepsy. NEUROIMAGE-CLINICAL 2018; 19:727-733. [PMID: 30003025 PMCID: PMC6040575 DOI: 10.1016/j.nicl.2018.05.033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 05/23/2018] [Accepted: 05/25/2018] [Indexed: 01/06/2023]
Abstract
Background In temporal lobe epilepsy (TLE), advanced neuroimaging techniques reveal anomalies extending beyond the temporal lobe such as thinning of fronto-central cortices. Operculo-insular epilepsy (OIE) is an under-recognized and poorly characterized condition with the potential of mimicking TLE. In this work, we investigated insular and extra-insular cortical thickness (CT) changes in OIE. Methods All participants (14 patients with refractory OIE, 9 age- and sex-matched patients with refractory TLE and 26 healthy controls) underwent a T1-weighted acquisition on a 3 T MRI. Anatomical images were processed with Advanced Normalization Tools. Between-group analysis of CT was performed using a two-sided t-test (threshold of p < 0.05 after correction for multiple comparisons; cut-off threshold of 250 voxels) between (i) patients with OIE vs TLE, and (ii) patients with OIE vs healthy controls. Results Significant widespread thinning was observed in OIE patients as compared with healthy controls mainly in the ipsilateral insula, peri-rolandic region, orbito-frontal area, mesiotemporal structures and lateral temporal neocortex. Contralateral cortical shrinkage followed a similar albeit milder and less diffuse pattern.The CT of OIE patients was equal or reduced relative to the TLE group for every cortical region analyzed. Thinning was observed diffusely in OIE patients, predominantly inboth insulae and the ipsilateral occipito-temporal area. Conclusion Our results reveal structural anomalies extending beyond the operculo-insular area in OIE.
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Affiliation(s)
- Sami Obaid
- Département de Neurosciences, Université de Montréal, Montréal, Québec, Canada; Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada; Service de Neurochirurgie, Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Alan Tucholka
- Barcelona Beta Brain Research Center, Foundation Pasqual Maragall, Barcelona, Spain
| | - Jimmy Ghaziri
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada; Département de psychologie, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Pierre-Marc Jodoin
- Sherbrooke Connectivity Imaging Lab (SCIL), Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Félix Morency
- Sherbrooke Connectivity Imaging Lab (SCIL), Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Maxime Descoteaux
- Sherbrooke Connectivity Imaging Lab (SCIL), Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Alain Bouthillier
- Service de Neurochirurgie, Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Dang K Nguyen
- Département de Neurosciences, Université de Montréal, Montréal, Québec, Canada; Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada; Service de Neurologie, Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada.
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25
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Bernhardt BC, Fadaie F, Vos de Wael R, Hong SJ, Liu M, Guiot MC, Rudko DA, Bernasconi A, Bernasconi N. Preferential susceptibility of limbic cortices to microstructural damage in temporal lobe epilepsy: A quantitative T1 mapping study. Neuroimage 2017; 182:294-303. [PMID: 28583883 DOI: 10.1016/j.neuroimage.2017.06.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 05/31/2017] [Accepted: 06/01/2017] [Indexed: 12/30/2022] Open
Abstract
The majority of MRI studies in temporal lobe epilepsy (TLE) have utilized morphometry to map widespread cortical alterations. Morphological markers, such as cortical thickness or grey matter density, reflect combinations of biological events largely driven by overall cortical geometry rather than intracortical tissue properties. Because of its sensitivity to intracortical myelin, quantitative measurement of longitudinal relaxation time (qT1) provides and an in vivo proxy for cortical microstructure. Here, we mapped the regional distribution of qT1 in a consecutive cohort of 24 TLE patients and 20 healthy controls. Compared to controls, patients presented with a strictly ipsilateral distribution of qT1 increases in temporopolar, parahippocampal and orbitofrontal cortices. Supervised statistical learning applied to qT1 maps could lateralize the seizure focus in 92% of patients. Intracortical profiling of qT1 along streamlines perpendicular to the cortical mantle revealed marked effects in upper levels that tapered off at the white matter interface. Findings remained robust after correction for cortical thickness and interface blurring, suggesting independence from previously reported morphological anomalies in this disorder. Mapping of qT1 along hippocampal subfield surfaces revealed marked increases in anterior portions of the ipsilateral CA1-3 and DG that were also robust against correction for atrophy. Notably, in operated patients, qualitative histopathological analysis of myelin stains in resected hippocampal specimens confirmed disrupted internal architecture and fiber organization. Both hippocampal and neocortical qT1 anomalies were more severe in patients with early disease onset. Finally, analysis of resting-state connectivity from regions of qT1 increases revealed altered intrinsic functional network embedding in patients, particularly to prefrontal networks. Analysis of qT1 suggests a preferential susceptibility of ipsilateral limbic cortices to microstructural damage, possibly related to disrupted myeloarchitecture. These alterations may reflect atypical neurodevelopment and affect the integrity of fronto-limbic functional networks.
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Affiliation(s)
- Boris C Bernhardt
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada; Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Fatemeh Fadaie
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Reinder Vos de Wael
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Seok-Jun Hong
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Min Liu
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Marie C Guiot
- Department of Pathology, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - David A Rudko
- Department of Neurology and Biomedical Engineering, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Andrea Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Neda Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada.
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26
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Bernhardt BC, Bernasconi A, Liu M, Hong SJ, Caldairou B, Goubran M, Guiot MC, Hall J, Bernasconi N. The spectrum of structural and functional imaging abnormalities in temporal lobe epilepsy. Ann Neurol 2016; 80:142-53. [PMID: 27228409 DOI: 10.1002/ana.24691] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Revised: 05/24/2016] [Accepted: 05/24/2016] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Although most temporal lobe epilepsy (TLE) patients show marked hippocampal sclerosis (HS) upon pathological examination, 40% present with no significant cell loss but gliotic changes only. To evaluate effects of hippocampal pathology on brain structure and functional networks, we aimed at dissociating multimodal magnetic resonance imaging (MRI) characteristics in patients with HS (TLE-HS) and those with gliosis only (TLE-G). METHODS In 20 TLE-HS, 19 TLE-G, and 25 healthy controls, we carried out a novel MRI-based hippocampal subfield surface analysis that integrated volume, T2 signal intensity, and diffusion markers with seed-based hippocampal functional connectivity. RESULTS Compared to controls, TLE-HS presented with marked ipsilateral atrophy, T2 hyperintensity, and mean diffusivity increases across all subfields, whereas TLE-G presented with dentate gyrus hypertrophy, focal increases in T2 intensity and mean diffusivity. Multivariate assessment confirmed a more marked ipsilateral load of anomalies across all subfields in TLE-HS, whereas anomalies in TLE-G were restricted to the subiculum. A between-cohort dissociation was independently suggested by resting-state functional connectivity analysis, revealing marked hippocampal decoupling from anterior and posterior default mode hubs in TLE-HS, whereas TLE-G did not differ from controls. Back-projection connectivity analysis from cortical targets revealed consistently decreased network embedding across all subfields in TLE-HS, while changes in TLE-G were limited to the subiculum. Hippocampal disconnectivity strongly correlated to T2 hyperintensity and marginally to atrophy. INTERPRETATION Multimodal MRI reveals diverging structural and functional connectivity profiles across the TLE spectrum. Pathology-specific modulations of large-scale functional brain networks lend novel evidence for a close interplay of structural and functional disruptions in focal epilepsy. Ann Neurol 2016;80:142-153.
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Affiliation(s)
- Boris C Bernhardt
- From the Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada.,Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Andrea Bernasconi
- From the Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada.,Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Min Liu
- From the Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada.,Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Seok-Jun Hong
- From the Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada.,Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Benoit Caldairou
- From the Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada.,Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Maged Goubran
- From the Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada.,Department of Radiology, Stanford School of Medicine, Stanford University, CA
| | - Marie C Guiot
- Department of Pathology, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Jeff Hall
- Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Neda Bernasconi
- From the Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada.,Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
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