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Slegers R, Wagner L, van Kuijk S, Hilkman D, Hofman P, van Hoof R, Jansen J, van Kranen-Mastenbroek V, Rijkers K, Tousseyn S, Colon A, Schijns O. Stereo-electroencephalography-guided radiofrequency thermocoagulation restricted to periventricular nodular heterotopias in patients with drug-resistant epilepsy: A single center experience. Seizure 2024; 121:105-113. [PMID: 39146706 DOI: 10.1016/j.seizure.2024.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 07/08/2024] [Accepted: 07/23/2024] [Indexed: 08/17/2024] Open
Abstract
INTRODUCTION Periventricular nodular heterotopias (PVNH) are developmental abnormalities with neurons abnormally clustered around the cerebral ventricles. Patients frequently present with focal drug-resistant epilepsy (DRE). However, the relationship between PVNH and the seizure onset zone (SOZ) is complex. Stereo-electroencephalography (SEEG) is an invasive diagnostic procedure for patients with DRE. In selected patients, the SEEG may be converted into a therapeutic procedure, lesioning the probable (SOZ) with pulsed radiofrequency thermocoagulation (RFTC). The aim of our study was to evaluate the efficacy and safety of SEEG-RFTC in a series of DRE patients with PVNH. METHODS Twenty-four patients with focal DRE related to PVNH and treated with SEEG-guided-RFTC restricted to nodules were prospectively collected between 2016 and 2023 and retrospectively analyzed after a follow-up of at least 12 months. RESULTS Seventeen patients (71 %) responded (ILAE class 1-4) after SEEG-guided RFTC of whom eleven (46 %) became seizure-free (class 1) at last follow up, nine (45 %) despite residual PVNH tissue on MRI. SEEG seizure onset was restricted to PVNH in eleven patients (class 1 in 45 %) and simultaneously in PVNH and other cortical areas in thirteen patients (class 1 in 46 %). Out of 31 SEEG-RFTC procedures in twenty-four patients, adverse events, related to RFTC, were recorded in eight (26 %), of which two patients (8 %) had predicted permanent visual complaints whilst the other five had transient complaints. SIGNIFICANCE This study demonstrates that a considerable percentage of patients, even with bilateral, multiple PVNH and involvement of adjacent cortical regions can be rendered seizure-free with SEEG-guided-RFTC restricted to the nodules. Furthermore, this study delivers evidence that the complete destruction of the entire nodule is not necessary to render a patient seizure free. This justifies the use of SEEG in patients with single, multiple or bilateral PVNHs to provide insight into the epileptogenic organization in and around these lesions.
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Affiliation(s)
- Rutger Slegers
- Department of Neurosurgery, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands; Academic Center for Epileptology, Kempenhaeghe and Maastricht UMC+, Maastricht Heeze, the Netherlands
| | - Louis Wagner
- Department of Neurosurgery, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands; Academic Center for Epileptology, Kempenhaeghe and Maastricht UMC+, Maastricht Heeze, the Netherlands.
| | - Sander van Kuijk
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht (UMC+), the Netherlands
| | - Danny Hilkman
- Academic Center for Epileptology, Kempenhaeghe and Maastricht UMC+, Maastricht Heeze, the Netherlands; Department of Clinical Neurophysiology, Maastricht University Medical Centre (MUMC+), the Netherlands
| | - Paul Hofman
- Mental Health and Neuroscience (MHeNS) Research Institute, University Maastricht (UM), Maastricht, the Netherlands; Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre (MUMC+), the Netherlands
| | - Raf van Hoof
- Academic Center for Epileptology, Kempenhaeghe and Maastricht UMC+, Maastricht Heeze, the Netherlands
| | - Jacobus Jansen
- Academic Center for Epileptology, Kempenhaeghe and Maastricht UMC+, Maastricht Heeze, the Netherlands; Mental Health and Neuroscience (MHeNS) Research Institute, University Maastricht (UM), Maastricht, the Netherlands; Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre (MUMC+), the Netherlands; Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Vivianne van Kranen-Mastenbroek
- Academic Center for Epileptology, Kempenhaeghe and Maastricht UMC+, Maastricht Heeze, the Netherlands; Department of Clinical Neurophysiology, Maastricht University Medical Centre (MUMC+), the Netherlands
| | - Kim Rijkers
- Department of Neurosurgery, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands; Academic Center for Epileptology, Kempenhaeghe and Maastricht UMC+, Maastricht Heeze, the Netherlands; Mental Health and Neuroscience (MHeNS) Research Institute, University Maastricht (UM), Maastricht, the Netherlands
| | - Simon Tousseyn
- Department of Neurosurgery, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands; Academic Center for Epileptology, Kempenhaeghe and Maastricht UMC+, Maastricht Heeze, the Netherlands; Mental Health and Neuroscience (MHeNS) Research Institute, University Maastricht (UM), Maastricht, the Netherlands
| | - Albert Colon
- Department of Neurosurgery, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands; Academic Center for Epileptology, Kempenhaeghe and Maastricht UMC+, Maastricht Heeze, the Netherlands; Centre de les Etudes et traitement de l' epilepsie, CETE, centre hospitalier universitaire Martinique, Fort-de-France, France
| | - Olaf Schijns
- Department of Neurosurgery, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands; Academic Center for Epileptology, Kempenhaeghe and Maastricht UMC+, Maastricht Heeze, the Netherlands; Mental Health and Neuroscience (MHeNS) Research Institute, University Maastricht (UM), Maastricht, the Netherlands
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Eriksson MH, Prentice F, Piper RJ, Wagstyl K, Adler S, Chari A, Booth J, Moeller F, Das K, Eltze C, Cooray G, Perez Caballero A, Menzies L, McTague A, Shavel-Jessop S, Tisdall MM, Cross JH, Martin Sanfilippo P, Baldeweg T. Long-term neuropsychological trajectories in children with epilepsy: does surgery halt decline? Brain 2024; 147:2791-2802. [PMID: 38643018 PMCID: PMC11292899 DOI: 10.1093/brain/awae121] [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: 11/11/2023] [Revised: 02/29/2024] [Accepted: 03/16/2024] [Indexed: 04/22/2024] Open
Abstract
Neuropsychological impairments are common in children with drug-resistant epilepsy. It has been proposed that epilepsy surgery might alleviate these impairments by providing seizure freedom; however, findings from prior studies have been inconsistent. We mapped long-term neuropsychological trajectories in children before and after undergoing epilepsy surgery, to measure the impact of disease course and surgery on functioning. We performed a retrospective cohort study of 882 children who had undergone epilepsy surgery at Great Ormond Street Hospital (1990-2018). We extracted patient information and neuropsychological functioning [obtained from IQ tests (domains: full-scale IQ, verbal IQ, performance IQ, working memory and processing speed) and tests of academic attainment (reading, spelling and numeracy)] and investigated changes in functioning using regression analyses. We identified 500 children (248 females) who had undergone epilepsy surgery [median age at surgery = 11.9 years, interquartile range = (7.8, 15.0)] and neuropsychological assessment. These children showed declines in all domains of neuropsychological functioning in the time leading up to surgery (all P-values ≤0.001; e.g. βFSIQ = -1.9, SEFSIQ = 0.3, PFSIQ < 0.001). Children lost on average one to four points per year, depending on the domain considered; 27%-43% declined by ≥10 points from their first to their last preoperative assessment. At the time of presurgical evaluation, most children (46%-60%) scored one or more standard deviations below the mean (<85) on the different neuropsychological domains; 37% of these met the threshold for intellectual disability (full-scale IQ < 70). On a group level, there was no change in performance from pre- to postoperative assessment on any of the domains (all P-values ≥0.128). However, children who became seizure free through surgery showed higher postoperative neuropsychological performance (e.g. rrb-FSIQ = 0.37, P < 0.001). These children continued to demonstrate improvements in neuropsychological functioning over the course of their long-term follow-up (e.g. βFSIQ = 0.9, SEFSIQ = 0.3, PFSIQ = 0.004). Children who had discontinued antiseizure medication treatment at 1-year follow-up showed an 8- to 13-point advantage in postoperative working memory, processing speed and numeracy, and greater improvements in verbal IQ, working memory, reading and spelling (all P-values ≤0.034) over the postoperative period compared with children who were seizure free and still receiving antiseizure medication. In conclusion, by providing seizure freedom and the opportunity for antiseizure medication cessation, epilepsy surgery might not only halt but reverse the downward trajectory that children with drug-resistant epilepsy display in neuropsychological functioning. To halt this decline as soon as possible or, potentially, to prevent it from occurring in the first place, children with focal epilepsy should be considered for epilepsy surgery as early as possible after diagnosis.
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Affiliation(s)
- Maria H Eriksson
- Developmental Neurosciences Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, WC1N 1EH, UK
- Department of Neuropsychology, Great Ormond Street Hospital for Children, London, WC1N 3JH, UK
- Department of Neurology, Great Ormond Street Hospital for Children, London, WC1N 3JH, UK
| | - Freya Prentice
- Developmental Neurosciences Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, WC1N 1EH, UK
- Department of Neuropsychology, Great Ormond Street Hospital for Children, London, WC1N 3JH, UK
| | - Rory J Piper
- Developmental Neurosciences Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, WC1N 1EH, UK
- Department of Neurosurgery, Great Ormond Street Hospital for Children, London, WC1N 3JH, UK
| | - Konrad Wagstyl
- Department of Imaging Neuroscience, UCL Queen Square Institute of Neurology, London, WC1N 3BG, UK
| | - Sophie Adler
- Developmental Neurosciences Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, WC1N 1EH, UK
| | - Aswin Chari
- Developmental Neurosciences Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, WC1N 1EH, UK
- Department of Neurosurgery, Great Ormond Street Hospital for Children, London, WC1N 3JH, UK
| | - John Booth
- Data Research, Innovation and Virtual Environments Unit, Great Ormond Street Hospital for Children, London, WC1N 3JH, UK
| | - Friederike Moeller
- Department of Neurophysiology, Great Ormond Street Hospital for Children, London, WC1N 3JH, UK
| | - Krishna Das
- Department of Neurology, Great Ormond Street Hospital for Children, London, WC1N 3JH, UK
- Department of Neurophysiology, Great Ormond Street Hospital for Children, London, WC1N 3JH, UK
| | - Christin Eltze
- Department of Neurophysiology, Great Ormond Street Hospital for Children, London, WC1N 3JH, UK
| | - Gerald Cooray
- Department of Neurophysiology, Great Ormond Street Hospital for Children, London, WC1N 3JH, UK
- Department of Clinical Neuroscience, Karolinska Institutet, Solna 171 77, Sweden
| | - Ana Perez Caballero
- North Thames Genomic Laboratory Hub, Great Ormond Street Hospital for Children, London, WC1N 3JH, UK
| | - Lara Menzies
- Department of Clinical Genetics, Great Ormond Street Hospital for Children, London, WC1N 3JH, UK
| | - Amy McTague
- Developmental Neurosciences Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, WC1N 1EH, UK
- Department of Clinical Genetics, Great Ormond Street Hospital for Children, London, WC1N 3JH, UK
| | - Sara Shavel-Jessop
- Developmental Neurosciences Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, WC1N 1EH, UK
- Department of Neuropsychology, Great Ormond Street Hospital for Children, London, WC1N 3JH, UK
| | - Martin M Tisdall
- Developmental Neurosciences Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, WC1N 1EH, UK
- Department of Neurosurgery, Great Ormond Street Hospital for Children, London, WC1N 3JH, UK
| | - J Helen Cross
- Developmental Neurosciences Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, WC1N 1EH, UK
- Department of Neurology, Great Ormond Street Hospital for Children, London, WC1N 3JH, UK
- Department of Neurosurgery, Great Ormond Street Hospital for Children, London, WC1N 3JH, UK
- Young Epilepsy, Lingfield, RH7 6PW, UK
| | - Patricia Martin Sanfilippo
- Developmental Neurosciences Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, WC1N 1EH, UK
- Department of Neuropsychology, Great Ormond Street Hospital for Children, London, WC1N 3JH, UK
| | - Torsten Baldeweg
- Developmental Neurosciences Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, WC1N 1EH, UK
- Department of Neuropsychology, Great Ormond Street Hospital for Children, London, WC1N 3JH, UK
- Department of Neurosurgery, Great Ormond Street Hospital for Children, London, WC1N 3JH, UK
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Zhu Q, Li S, Meng X, Xu Q, Zhang Z, Shao W, Zhang D. Spatio-Temporal Graph Hubness Propagation Model for Dynamic Brain Network Classification. IEEE TRANSACTIONS ON MEDICAL IMAGING 2024; 43:2381-2394. [PMID: 38319754 DOI: 10.1109/tmi.2024.3363014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
Dynamic brain network has the advantage over static brain network in characterizing the variation pattern of functional brain connectivity, and it has attracted increasing attention in brain disease diagnosis. However, most of the existing dynamic brain networks analysis methods rely on extracting features from independent brain networks divided by sliding windows, making them hard to reveal the high-order dynamic evolution laws of functional brain networks. Additionally, they cannot effectively extract the spatio-temporal topology features in dynamic brain networks. In this paper, we propose to use optimal transport (OT) theory to capture the topology evolution of the dynamic brain networks, and develop a multi-channel spatio-temporal graph convolutional network that collaboratively extracts the temporal and spatial features from the evolution networks. Specifically, we first adaptively evaluate the graph hubness of brain regions in the brain network of each time window, which comprehensively models information transmission among multiple brain regions. Second, the hubness propagation information across adjacent time windows is captured by optimal transport, describing high-order topology evolution of dynamic brain networks. Moreover, we develop a spatio-temporal graph convolutional network with attention mechanism to collaboratively extract the intrinsic temporal and spatial topology information from the above networks. Finally, the multi-layer perceptron is adopted for classifying the dynamic brain network. The extensive experiment on the collected epilepsy dataset and the public ADNI dataset show that our proposed method not only outperforms several state-of-the-art methods in brain disease diagnosis, but also reveals the key dynamic alterations of brain connectivities between patients and healthy controls.
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Hall GR, Hutchings F, Horsley J, Simpson CM, Wang Y, de Tisi J, Miserocchi A, McEvoy AW, Vos SB, Winston GP, Duncan JS, Taylor PN. Epileptogenic networks in extra temporal lobe epilepsy. Netw Neurosci 2023; 7:1351-1362. [PMID: 38144694 PMCID: PMC10631792 DOI: 10.1162/netn_a_00327] [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: 12/21/2022] [Accepted: 06/22/2023] [Indexed: 12/26/2023] Open
Abstract
Extra temporal lobe epilepsy (eTLE) may involve heterogenous widespread cerebral networks. We investigated the structural network of an eTLE cohort, at the postulated epileptogenic zone later surgically removed, as a network node: the resection zone (RZ). We hypothesized patients with an abnormal connection to/from the RZ to have proportionally increased abnormalities based on topological proximity to the RZ, in addition to poorer post-operative seizure outcome. Structural and diffusion MRI were collected for 22 eTLE patients pre- and post-surgery, and for 29 healthy controls. The structural connectivity of the RZ prior to surgery, measured via generalized fractional anisotropy (gFA), was compared with healthy controls. Abnormal connections were identified as those with substantially reduced gFA (z < -1.96). For patients with one or more abnormal connections to/from the RZ, connections with closer topological distance to the RZ had higher proportion of abnormalities. The minority of the seizure-free patients (3/11) had one or more abnormal connections, while most non-seizure-free patients (8/11) had abnormal connections to the RZ. Our data suggest that eTLE patients with one or more abnormal structural connections to/from the RZ had more proportional abnormal connections based on topological distance to the RZ and associated with reduced chance of seizure freedom post-surgery.
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Affiliation(s)
- Gerard R. Hall
- CNNP Lab, Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Frances Hutchings
- CNNP Lab, Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Jonathan Horsley
- CNNP Lab, Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Callum M. Simpson
- CNNP Lab, Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Yujiang Wang
- CNNP Lab, Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle upon Tyne, United Kingdom
- Department of Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Jane de Tisi
- Department of Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom
- UCL/UCLH NIHR University College London Hospitals Biomedical Research Centre, London, United Kingdom
| | - Anna Miserocchi
- Department of Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Andrew W. McEvoy
- Department of Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Sjoerd B. Vos
- Centre for Microscopy, Characterisation, and Analysis, University of Western Australia, Nedlands, Australia
| | - Gavin P. Winston
- Department of Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom
- Department of Medicine, Division of Neurology, Queen’s University, Kingston, Canada
| | - John S. Duncan
- Department of Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom
- UCL/UCLH NIHR University College London Hospitals Biomedical Research Centre, London, United Kingdom
| | - Peter N. Taylor
- CNNP Lab, Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle upon Tyne, United Kingdom
- Department of Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
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Cohen NT, Xie H, Gholipour T, Gaillard WD. A scoping review of the functional magnetic resonance imaging-based functional connectivity of focal cortical dysplasia-related epilepsy. Epilepsia 2023; 64:3130-3142. [PMID: 37731142 DOI: 10.1111/epi.17775] [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: 06/13/2023] [Revised: 09/17/2023] [Accepted: 09/18/2023] [Indexed: 09/22/2023]
Abstract
Focal cortical dysplasia (FCD) is the most frequent etiology of operable pharmacoresistant epilepsy in children. There is burgeoning evidence that FCD-related epilepsy is a disorder that involves distributed brain networks. Functional magnetic resonance imaging (fMRI) is a tool that allows one to infer neuronal activity and to noninvasively map whole-brain functional networks. Despite its relatively widespread availability at most epilepsy centers, the clinical application of fMRI remains mostly task-based in epilepsy. Another approach is to map and characterize cortical functional networks of individuals using resting state fMRI (rsfMRI). The focus of this scoping review is to summarize the evidence to date of investigations of the network basis of FCD-related epilepsy, and to highlight numerous potential future applications of rsfMRI in the exploration of diagnostic and therapeutic strategies for FCD-related epilepsy. There are numerous studies demonstrating a global disruption of cortical functional networks in FCD-related epilepsy. The underlying pathological subtypes of FCD influence overall functional network patterns. There is evidence that cortical functional network mapping may help to predict postsurgical seizure outcomes, highlighting the translational potential of these findings. Additionally, several studies emphasize the important effect of FCD interaction with cortical networks and the expression of epilepsy and its comorbidities.
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Affiliation(s)
- Nathan T Cohen
- Center for Neuroscience Research, Children's National Hospital, George Washington University School of Medicine, Washington, District of Columbia, USA
- Department of Neurology, Children's National Hospital, George Washington University School of Medicine, Washington, District of Columbia, USA
| | - Hua Xie
- Center for Neuroscience Research, Children's National Hospital, George Washington University School of Medicine, Washington, District of Columbia, USA
- Department of Neurology, Children's National Hospital, George Washington University School of Medicine, Washington, District of Columbia, USA
| | - Taha Gholipour
- Center for Neuroscience Research, Children's National Hospital, George Washington University School of Medicine, Washington, District of Columbia, USA
- Department of Neurology, George Washington University Epilepsy Center, Washington, District of Columbia, USA
| | - William D Gaillard
- Center for Neuroscience Research, Children's National Hospital, George Washington University School of Medicine, Washington, District of Columbia, USA
- Department of Neurology, Children's National Hospital, George Washington University School of Medicine, Washington, District of Columbia, USA
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Rao Y, Liu W, Zhu Y, Lin Q, Kuang C, Huang H, Jiao B, Ma L, Lin J. Altered functional brain network patterns in patients with migraine without aura after transcutaneous auricular vagus nerve stimulation. Sci Rep 2023; 13:9604. [PMID: 37311825 DOI: 10.1038/s41598-023-36437-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 06/03/2023] [Indexed: 06/15/2023] Open
Abstract
Transcutaneous auricular vagus nerve stimulation (taVNS) shows excellent effects on relieving clinical symptoms in migraine patients. Nevertheless, the neurological mechanisms of taVNS for migraineurs remain unclear. In recent years, voxel-wise degree centrality (DC) and functional connectivity (FC) methods were extensively utilized for exploring alterations in patterns of FC in the resting-state brain. In the present study, thirty-five migraine patients without aura and thirty-eight healthy controls (HCs) were recruited for magnetic resonance imaging scans. Firstly, this study used voxel-wise DC analysis to explore brain regions where abnormalities were present in migraine patients. Secondly, for elucidating neurological mechanisms underlying taVNS in migraine, seed-based resting-state functional connectivity analysis was employed to the taVNS treatment group. Finally, correlation analysis was performed to explore the relationship between alterations in neurological mechanisms and clinical symptoms. Our findings indicated that migraineurs have lower DC values in the inferior temporal gyrus (ITG) and paracentral lobule than in healthy controls (HCs). In addition, migraineurs have higher DC values in the cerebellar lobule VIII and the fusiform gyrus than HCs. Moreover, after taVNS treatment (post-taVNS), patients displayed increased FC between the ITG with the inferior parietal lobule (IPL), orbitofrontal gyrus, angular gyrus, and posterior cingulate gyrus than before taVNS treatment (pre-taVNS). Besides, the post-taVNS patients showed decreased FC between the cerebellar lobule VIII with the supplementary motor area and postcentral gyrus compared with the pre-taVNS patients. The changed FC of ITG-IPL was significantly related to changes in headache intensity. Our study suggested that migraine patients without aura have altered brain connectivity patterns in several hub regions involving multisensory integration, pain perception, and cognitive function. More importantly, taVNS modulated the default mode network and the vestibular cortical network related to the dysfunctions in migraineurs. This paper provides a new perspective on the potential neurological mechanisms and therapeutic targets of taVNS for treating migraine.
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Affiliation(s)
- Yuyang Rao
- Department of Psychology, School of Public Health and Management, Guangzhou University of Chinese Medicine, No.232, Huandong Road, University Town, Guangzhou, 510006, China
| | - Wenting Liu
- Department of Psychology, School of Public Health and Management, Guangzhou University of Chinese Medicine, No.232, Huandong Road, University Town, Guangzhou, 510006, China
| | - Yunpeng Zhu
- Department of Psychology, School of Public Health and Management, Guangzhou University of Chinese Medicine, No.232, Huandong Road, University Town, Guangzhou, 510006, China
| | - Qiwen Lin
- Department of Psychology, School of Public Health and Management, Guangzhou University of Chinese Medicine, No.232, Huandong Road, University Town, Guangzhou, 510006, China
| | - Changyi Kuang
- Department of Psychology, School of Public Health and Management, Guangzhou University of Chinese Medicine, No.232, Huandong Road, University Town, Guangzhou, 510006, China
| | - Huiyuan Huang
- Department of Psychology, School of Public Health and Management, Guangzhou University of Chinese Medicine, No.232, Huandong Road, University Town, Guangzhou, 510006, China
| | - Bingqing Jiao
- Department of Psychology, School of Public Health and Management, Guangzhou University of Chinese Medicine, No.232, Huandong Road, University Town, Guangzhou, 510006, China
| | - Lijun Ma
- Department of Psychology, School of Public Health and Management, Guangzhou University of Chinese Medicine, No.232, Huandong Road, University Town, Guangzhou, 510006, China.
| | - Jiabao Lin
- Department of Psychology, School of Public Health and Management, Guangzhou University of Chinese Medicine, No.232, Huandong Road, University Town, Guangzhou, 510006, China.
- Institut des Sciences Cognitives Marc Jeannerod, CNRS UMR 5229, Université Claude Bernard Lyon 1, Lyon, France.
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Sathe AV, Matias CM, Kogan M, Ailes I, Syed M, Kang K, Miao J, Talekar K, Faro S, Mohamed FB, Tracy J, Sharan A, Alizadeh M. Resting-State fMRI Can Detect Alterations in Seizure Onset and Spread Regions in Patients with Non-Lesional Epilepsy: A Pilot Study. FRONTIERS IN NEUROIMAGING 2023; 2:1109546. [PMID: 37206659 PMCID: PMC10194331 DOI: 10.3389/fnimg.2023.1109546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Introduction Epilepsy is defined as non-lesional (NLE) when a lesion cannot be localized via standard neuroimaging. NLE is known to have a poor response to surgery. Stereotactic electroencephalography (sEEG) can detect functional connectivity (FC) between zones of seizure onset (OZ) and early (ESZ) and late (LSZ) spread. We examined whether resting-state fMRI (rsfMRI) can detect FC alterations in NLE to see whether noninvasive imaging techniques can localize areas of seizure propagation to potentially target for intervention. Methods This is a retrospective study of 8 patients with refractory NLE who underwent sEEG electrode implantation and 10 controls. The OZ, ESZ, and LSZ were identified by generating regions around sEEG contacts that recorded seizure activity. Amplitude synchronization analysis was used to detect the correlation of the OZ to the ESZ. This was also done using the OZ and ESZ of each NLE patient for each control. Patients with NLE were compared to controls individually using Wilcoxon tests and as a group using Mann-Whitney tests. Amplitude of low-frequency fluctuations (ALFF), fractional ALFF (fALFF), regional homogeneity (ReHo), degree of centrality (DoC), and voxel-mirrored homotopic connectivity (VMHC) were calculated as the difference between NLE and controls and compared between the OZ and ESZ and to zero. A general linear model was used with age as a covariate with Bonferroni correction for multiple comparisons. Results Five out of 8 patients with NLE showed decreased correlations from the OZ to the ESZ. Group analysis showed patients with NLE had lower connectivity with the ESZ. Patients with NLE showed higher fALFF and ReHo in the OZ but not the ESZ, and higher DoC in the OZ and ESZ. Our results indicate that patients with NLE show high levels of activity but dysfunctional connections in seizure-related areas. Discussion rsfMRI analysis showed decreased connectivity directly between seizure-related areas, while FC metric analysis revealed increases in local and global connectivity in seizure-related areas. FC analysis of rsfMRI can detect functional disruption that may expose the pathophysiology underlying NLE.
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Affiliation(s)
- Anish V. Sathe
- Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA, USA
- Correspondence: Anish V. Sathe,
| | - Caio M. Matias
- Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA, USA
| | - Michael Kogan
- Department of Neurological Surgery, University of New Mexico, Albuquerque, NM, USA
| | - Isaiah Ailes
- Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA, USA
| | - Mashaal Syed
- Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA, USA
| | - KiChang Kang
- Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA, USA
| | - Jingya Miao
- Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA, USA
| | - Kiran Talekar
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Scott Faro
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Feroze B. Mohamed
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Joseph Tracy
- Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Ashwini Sharan
- Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA, USA
| | - Mahdi Alizadeh
- Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA, USA
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Shu Y, Liu X, Yu P, Li H, Duan W, Wei Z, Li K, Xie W, Zeng Y, Peng D. Inherent regional brain activity changes in male obstructive sleep apnea with mild cognitive impairment: A resting-state magnetic resonance study. Front Aging Neurosci 2022; 14:1022628. [DOI: 10.3389/fnagi.2022.1022628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 10/13/2022] [Indexed: 11/13/2022] Open
Abstract
Obstructive sleep apnea (OSA) is the most common sleep disorder worldwide. Previous studies have shown that OSA patients are often accompanied by cognitive function loss, and the underlying neurophysiological mechanism is still unclear. This study aimed to determine whether there are differences in regional homogeneity (Reho) and functional connectivity (FC) across the brain between OSA patients with MCI (OSA-MCI) and those without MCI (OSA-nMCI) and whether such differences can be used to distinguish the two groups. Resting state magnetic resonance data were collected from 48 OSA-MCI patients and 47 OSA-nMCI patients. The brain regions with significant differences in Reho and FC between the two groups were identified, and the Reho and FC features were combined with machine learning methods for classification. Compared with OSA-nMCI patients, OSA-MCI patients showed significantly lower Reho in bilateral lingual gyrus and left superior temporal gyrus. OSA-MCI patients also showed significantly lower FC between the bilateral lingual gyrus and bilateral cuneus, left superior temporal gyrus and left middle temporal gyrus, middle frontal gyrus, and bilateral posterior cingulate/calcarine/cerebellar anterior lobe. Based on Reho and FC features, logistic regression classification accuracy was 0.87; sensitivity, 0.70; specificity, 0.89; and area under the curve, 0.85. Correlation analysis showed that MoCA scale score in OSA patients was significant positive correlation sleep efficiency and negatively correlation with neck circumference. In conclusion, our results showed that the OSA-MCI group showed decreased Reho and FC in specific brain regions compared with the OSA-nMCI group, which may help to understand the underlying neuroimaging mechanism of OSA leading to cognitive dysfunction and may serve as a potential biomarker to distinguish whether OSA is accompanied by cognitive impairment.
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Teng Y, Yin T, Yang Y, Sun R, Tian Z, Ma P, He Z, Qu Y, Huang L, Chen Y, Zeng F. The Role of Medial Prefrontal Cortex in Acupuncture Treatment for Functional Dyspepsia. Front Neurosci 2022; 16:801899. [PMID: 35464313 PMCID: PMC9022633 DOI: 10.3389/fnins.2022.801899] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 02/25/2022] [Indexed: 11/18/2022] Open
Abstract
Acupuncture is an effective therapy for functional dyspepsia (FD). However, the efficacy of acupuncture in the treatment of FD varies among individuals in clinical practice. This study aimed to reveal the brain response patterns in acupuncture higher response/lower response FD patients. Firstly, we performed a within-group comparison of brain function activity before and after acupuncture treatment in 115 FD patients and analyzed the correlation between brain function activity changes and clinical improvements. Secondly, 115 subjects were divided into the acupuncture higher response group or the lower response group based on the median clinical improvement values. The changes in functional brain activity after acupuncture treatment were investigated in these two groups, respectively. Finally, the identified brain regions associated with the clinical improvements were set as regions of interest (ROI), and the ROI-to-voxel functional connectivity comparisons were also performed in both groups, respectively. The results demonstrated that the functional activities of the left cerebellum inferior, right middle temporal gyrus, and right medial prefrontal cortex (mPFC) were increased, and the left Heschl and right middle cingulate cortex were decreased in 115 FD patients after acupuncture treatment. The functional connectivity changes of mPFC were correlated with improving the Nepean Dyspepsia Symptom Index. The significant increase in mPFC functional activity was also found in acupuncture higher response FD patients but not in lower response FD patients. The functional connectivity between the mPFC and default mode network (DMN) was significantly diminished in the higher response group but not in the lower response group. In conclusion, this study suggested that modulating the functional activity of the mPFC and its connectivity to the DMN may be one of the important mechanisms of acupuncture for treating FD with a higher response.
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Affiliation(s)
- Yuke Teng
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Tao Yin
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yue Yang
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ruirui Sun
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zilei Tian
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Peihong Ma
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Zhaoxuan He
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yuzhu Qu
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Liuyang Huang
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yuan Chen
- International Education School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- *Correspondence: Yuan Chen,
| | - Fang Zeng
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Fang Zeng, ;
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