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Feng X, Piper RJ, Prentice F, Clayden JD, Baldeweg T. Functional brain connectivity in children with focal epilepsy: A systematic review of functional MRI studies. Seizure 2024; 117:164-173. [PMID: 38432080 DOI: 10.1016/j.seizure.2024.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 03/05/2024] Open
Abstract
Epilepsy is increasingly recognised as a brain network disorder and many studies have investigated functional connectivity (FC) in children with epilepsy using functional MRI (fMRI). This systematic review of fMRI studies, published up to November 2023, investigated profiles of FC changes and their clinical relevance in children with focal epilepsy compared to healthy controls. A literature search in PubMed and Web of Science yielded 62 articles. We categorised the results into three groups: 1) differences in correlation-based FC between patients and controls; 2) differences in other FC measures between patients and controls; and 3) associations between FC and disease variables (for example, age of onset), cognitive and seizure outcomes. Studies revealed either increased or decreased FC across multiple brain regions in children with focal epilepsy. However, findings lacked consistency: conflicting FC alterations (decreased and increased FC) co-existed within or between brain regions across all focal epilepsy groups. The studies demonstrated overall that 1) interhemispheric connections often displayed abnormal connectivity and 2) connectivity within and between canonical functional networks was decreased, particularly for the default mode network. Focal epilepsy disrupted FC in children both locally (e.g., seizure-onset zones, or within-brain subnetworks) and globally (e.g., whole-brain network architecture). The wide variety of FC study methodologies limits clinical application of the results. Future research should employ longitudinal designs to understand the evolution of brain networks during the disease course and explore the potential of FC biomarkers for predicting cognitive and postsurgical seizure outcomes.
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Affiliation(s)
- Xiyu Feng
- Developmental Neurosciences Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, 30 Guilford, London WC1N 1EH, United Kingdom
| | - Rory J Piper
- Developmental Neurosciences Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, 30 Guilford, London WC1N 1EH, United Kingdom; Department of Neurosurgery, Great Ormond Street Hospital, London, United Kingdom
| | - Freya Prentice
- Developmental Neurosciences Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, 30 Guilford, London WC1N 1EH, United Kingdom
| | - Jonathan D Clayden
- Developmental Neurosciences Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, 30 Guilford, London WC1N 1EH, United Kingdom
| | - Torsten Baldeweg
- Developmental Neurosciences Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, 30 Guilford, London WC1N 1EH, United Kingdom.
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Boot EM, Omes QPM, Maaijwee N, Schaapsmeerders P, Arntz RM, Rutten-Jacobs LCA, Kessels RPC, de Leeuw FE, Tuladhar AM. Functional brain connectivity in young adults with post-stroke epilepsy. Brain Commun 2023; 5:fcad277. [PMID: 37953839 PMCID: PMC10639092 DOI: 10.1093/braincomms/fcad277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/07/2023] [Accepted: 10/17/2023] [Indexed: 11/14/2023] Open
Abstract
Approximately 1 in 10 young stroke patients (18-50 years) will develop post-stroke epilepsy, which is associated with cognitive impairment. While previous studies have shown altered brain connectivity in patients with epilepsy, little is however known about the changes in functional brain connectivity in young stroke patients with post-stroke epilepsy and their relationship with cognitive impairment. Therefore, we aimed to investigate whether young ischaemic stroke patients have altered functional networks and whether this alteration is related to cognitive impairment. We included 164 participants with a first-ever cerebral infarction at young age (18-50 years), along with 77 age- and sex-matched controls, from the Follow-Up of Transient Ischemic Attack and Stroke patients and Unelucidated Risk Factor Evaluation study. All participants underwent neuropsychological testing and resting-state functional MRI to generate functional connectivity networks. At follow-up (10.5 years after the index event), 23 participants developed post-stroke epilepsy. Graph theoretical analysis revealed functional network reorganization in participants with post-stroke epilepsy, in whom a weaker (i.e. network strength), less-integrated (i.e. global efficiency) and less-segregated (i.e. clustering coefficient and local efficiency) functional network was observed compared with the participants without post-stroke epilepsy group and the controls (P < 0.05). Regional analysis showed a trend towards decreased clustering coefficient, local efficiency and nodal efficiency in contralesional brain regions, including the caudal anterior cingulate cortex, posterior cingulate cortex, precuneus, superior frontal gyrus and insula in participants with post-stroke epilepsy compared with those without post-stroke epilepsy. Furthermore, participants with post-stroke epilepsy more often had impairment in the processing speed domain than the group without post-stroke epilepsy, in whom the network properties of the precuneus were positively associated with processing speed performance. Our findings suggest that post-stroke epilepsy is associated with functional reorganization of the brain network after stroke that is characterized by a weaker, less-integrated and less-segregated brain network in young ischaemic stroke patients compared with patients without post-stroke epilepsy. The contralesional brain regions, which are mostly considered as hub regions, might be particularly involved in the altered functional network and may contribute to cognitive impairment in post-stroke epilepsy patients. Overall, our findings provide additional evidence for a potential role of disrupted functional network as underlying pathophysiological mechanism for cognitive impairment in patients with post-stroke epilepsy.
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Affiliation(s)
- Esther M Boot
- Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Radboud University Medical Centre, Nijmegen 6525GA, The Netherlands
| | - Quinty P M Omes
- Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Radboud University Medical Centre, Nijmegen 6525GA, The Netherlands
| | - Noortje Maaijwee
- Department of Neurology and Neurorehabilitation, Luzerner Kantonsspital Neurocentre, Luzern 16, Switzerland
| | | | - Renate M Arntz
- Department of Neurology, Medisch Spectrum Twente, Enschede 7500 KA, The Netherlands
| | | | - Roy P C Kessels
- Donders Institute for Brain, Cognition and Behaviour, Department of Psychology, Radboud University, Nijmegen 6525 GD, The Netherlands
- Department of Medical Psychology and Radboudumc Alzheimer Centre, Radboud University Medical Centre, Nijmegen 6525 GA, The Netherlands
- Vincent van Gogh Institute for Psychiatry, Venray 5803 AC, The Netherlands
| | - Frank-Erik de Leeuw
- Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Radboud University Medical Centre, Nijmegen 6525GA, The Netherlands
| | - Anil M Tuladhar
- Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Radboud University Medical Centre, Nijmegen 6525GA, The Netherlands
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Madole JW, Buchanan CR, Rhemtulla M, Ritchie SJ, Bastin ME, Deary IJ, Cox SR, Tucker-Drob EM. Strong intercorrelations among global graph-theoretic indices of structural connectivity in the human brain. Neuroimage 2023; 275:120160. [PMID: 37169117 DOI: 10.1016/j.neuroimage.2023.120160] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 04/06/2023] [Accepted: 05/08/2023] [Indexed: 05/13/2023] Open
Abstract
Graph-theoretic metrics derived from neuroimaging data have been heralded as powerful tools for uncovering neural mechanisms of psychological traits, psychiatric disorders, and neurodegenerative diseases. In N = 8,185 human structural connectomes from UK Biobank, we examined the extent to which 11 commonly-used global graph-theoretic metrics index distinct versus overlapping information with respect to interindividual differences in brain organization. Using unthresholded, FA-weighted networks we found that all metrics other than Participation Coefficient were highly intercorrelated, both with each other (mean |r| = 0.788) and with a topologically-naïve summary index of brain structure (mean edge weight; mean |r| = 0.873). In a series of sensitivity analyses, we found that overlap between metrics is influenced by the sparseness of the network and the magnitude of variation in edge weights. Simulation analyses representing a range of population network structures indicated that individual differences in global graph metrics may be intrinsically difficult to separate from mean edge weight. In particular, Closeness, Characteristic Path Length, Global Efficiency, Clustering Coefficient, and Small Worldness were nearly perfectly collinear with one another (mean |r| = 0.939) and with mean edge weight (mean |r| = 0.952) across all observed and simulated conditions. Global graph-theoretic measures are valuable for their ability to distill a high-dimensional system of neural connections into summary indices of brain organization, but they may be of more limited utility when the goal is to index separable components of interindividual variation in specific properties of the human structural connectome.
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Affiliation(s)
- James W Madole
- Department of Psychology, University of Texas at Austin, Austin, TX, USA; VA Puget Sound Health Care System, Seattle Division, Seattle, WA, USA.
| | - Colin R Buchanan
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK; Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration, Edinburgh, UK
| | - Mijke Rhemtulla
- Department of Psychology, University of California, Davis, CA, USA
| | - Stuart J Ritchie
- Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
| | - Mark E Bastin
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK; Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration, Edinburgh, UK; Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Ian J Deary
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Simon R Cox
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK; Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration, Edinburgh, UK
| | - Elliot M Tucker-Drob
- Department of Psychology, University of Texas at Austin, Austin, TX, USA; Population Research Center and Center on Aging and Population Sciences, University of Texas at Austin, Austin, TX, USA
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Kim MK, Suh SI, Kim JH. Cerebello-thalamofrontal dysconnectivity in paroxysmal kinesigenic dyskinesia: A resting-state fMRI study. Parkinsonism Relat Disord 2022; 99:1-7. [PMID: 35537274 DOI: 10.1016/j.parkreldis.2022.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 04/06/2022] [Accepted: 04/29/2022] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The pathophysiology of paroxysmal kinesigenic dyskinesia (PKD) remains elusive to date; however, several lines of evidence from neuroimaging studies suggest involvement of the basal ganglia-thalamocortical network in PKD. We combined fractional amplitude of low-frequency fluctuation (fALFF) and seed-based functional connectivity (FC) analyses in order to comprehensively investigate intrinsic brain activity alterations and their relationships with disease severity in patients with idiopathic PKD. METHODS Resting-state functional MRI data were obtained and processed in 34 PKD patients and 34 matched controls. fALFF and seed-based FC maps were computed and compared between patients and controls. Linear regression analysis was further performed between regional fALFF values or FC strengths and clinical parameters in patients. RESULTS PKD patients had a significant increase in fALFF in bilateral thalamus and cerebellum compared with controls. FC analysis seeding at the thalamic clusters revealed significant FC increases in motor cortex and supplementary motor area in PKD patients relative to controls. Longer disease duration was associated with increasing FC strength between the thalamus and motor cortex. CONCLUSION We have provided evidence for abnormal intrinsic activity in the cerebello-thalamic circuit and increased thalamofrontal FC in PKD patients, implicating interictal cerebello-thalamofrontal dysconnectivity in the pathophysiology of PKD. Given the increasing FC strength in proportion to disease duration, the thalamofrontal hyperconnectivity might reflect either a consequence of recurrent dyskinesias on the brain or an innate pathology causing dyskinesias in PKD.
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Affiliation(s)
- Min Kyung Kim
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Sang-Il Suh
- Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Ji Hyun Kim
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea.
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Paulo DL, Wills KE, Johnson GW, Gonzalez HFJ, Rolston JD, Naftel RP, Reddy SB, Morgan VL, Kang H, Williams Roberson S, Narasimhan S, Englot DJ. SEEG Functional Connectivity Measures to Identify Epileptogenic Zones: Stability, Medication Influence, and Recording Condition. Neurology 2022; 98:e2060-e2072. [PMID: 35338075 PMCID: PMC9162047 DOI: 10.1212/wnl.0000000000200386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 02/01/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Functional connectivity (FC) measures can be used to differentiate epileptogenic zones (EZs) from non-EZs in patients with medically refractory epilepsy. Little work has been done to evaluate the stability of stereo-EEG (SEEG) FC measures over time and their relationship with antiseizure medication (ASM) use, a critical confounder in epilepsy FC studies. We aimed to answer the following questions: Are SEEG FC measures stable over time? Are they influenced by ASMs? Are they affected by patient data collection state? METHODS In 32 patients with medically refractory focal epilepsy, we collected a single 2-minute prospective SEEG resting-state (awake, eyes closed) data set and consecutive 2-minute retrospective pseudo-rest (awake, eyes open) data sets for days 1-7 postimplantation. ASM dosages were recorded for days 1-7 postimplantation and drug load score (DLS) per day was calculated to standardize and compare across patients. FC was evaluated using directed and nondirected measures. Standard clinical interpretation of ictal SEEG was used to classify brain regions as EZs and non-EZs. RESULTS Over 7 days, presumed EZs consistently had higher FC than non-EZs when using between imaginary coherence (ImCoh) and partial directed coherence (PDC) inward strength, without accounting for DLS. These measures were demonstrated to be stable over a short-term period of 3 consecutive days with the same DLS. Between ImCoh FC differences between EZs and non-EZs were reduced with DLS decreases, whereas other measures were not affected by DLS. FC differences between EZs and non-EZs were seen during both resting-state and pseudo-rest conditions; ImCoh values were strongly correlated between the 2 conditions, whereas PDC values were not. DISCUSSION Inward and nondirected SEEG FC is higher in presumed EZs vs non-EZs and measures are stable over time. However, certain measures may be affected by ASM dose, as between ImCoh differences between EZs and non-EZs are less pronounced with lower doses, and other measures such as PDC are poorly correlated across recording conditions. These findings allow novel insight into how SEEG FC measures may aid surgical localization and how they are influenced by ASMs and other factors.
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Affiliation(s)
- Danika L Paulo
- From the Departments of Neurological Surgery (D.L.P., K.E.W., R.P.N., V.L.M., S.N., D.J.E.), Radiology and Radiological Sciences (V.L.M., D.J.E.), Biostatistics (V.L.M., S.W.R., D.J.E.), and Neurology (H.K.), Vanderbilt University Medical Center; Vanderbilt University Institute of Imaging Science (K.E.W., G.W.J., H.F.J.G., V.L.M., S.N., D.J.E.); Vanderbilt Institute for Surgery and Engineering (K.E.W., G.W.J., H.F.J.G., V.L.M., S.N., D.J.E.); Department of Biomedical Engineering (G.W.J., H.F.J.G., V.L.M., S.W.R., S.N., D.J.E.), Vanderbilt University, Nashville, TN; Departments of Neurosurgery and Biomedical Engineering (J.D.R.), University of Utah, Salt Lake City; and Department of Pediatrics (S.B.R.), Vanderbilt Children's Hospital, Nashville, TN
| | - Kristin E Wills
- From the Departments of Neurological Surgery (D.L.P., K.E.W., R.P.N., V.L.M., S.N., D.J.E.), Radiology and Radiological Sciences (V.L.M., D.J.E.), Biostatistics (V.L.M., S.W.R., D.J.E.), and Neurology (H.K.), Vanderbilt University Medical Center; Vanderbilt University Institute of Imaging Science (K.E.W., G.W.J., H.F.J.G., V.L.M., S.N., D.J.E.); Vanderbilt Institute for Surgery and Engineering (K.E.W., G.W.J., H.F.J.G., V.L.M., S.N., D.J.E.); Department of Biomedical Engineering (G.W.J., H.F.J.G., V.L.M., S.W.R., S.N., D.J.E.), Vanderbilt University, Nashville, TN; Departments of Neurosurgery and Biomedical Engineering (J.D.R.), University of Utah, Salt Lake City; and Department of Pediatrics (S.B.R.), Vanderbilt Children's Hospital, Nashville, TN
| | - Graham W Johnson
- From the Departments of Neurological Surgery (D.L.P., K.E.W., R.P.N., V.L.M., S.N., D.J.E.), Radiology and Radiological Sciences (V.L.M., D.J.E.), Biostatistics (V.L.M., S.W.R., D.J.E.), and Neurology (H.K.), Vanderbilt University Medical Center; Vanderbilt University Institute of Imaging Science (K.E.W., G.W.J., H.F.J.G., V.L.M., S.N., D.J.E.); Vanderbilt Institute for Surgery and Engineering (K.E.W., G.W.J., H.F.J.G., V.L.M., S.N., D.J.E.); Department of Biomedical Engineering (G.W.J., H.F.J.G., V.L.M., S.W.R., S.N., D.J.E.), Vanderbilt University, Nashville, TN; Departments of Neurosurgery and Biomedical Engineering (J.D.R.), University of Utah, Salt Lake City; and Department of Pediatrics (S.B.R.), Vanderbilt Children's Hospital, Nashville, TN
| | - Hernan F J Gonzalez
- From the Departments of Neurological Surgery (D.L.P., K.E.W., R.P.N., V.L.M., S.N., D.J.E.), Radiology and Radiological Sciences (V.L.M., D.J.E.), Biostatistics (V.L.M., S.W.R., D.J.E.), and Neurology (H.K.), Vanderbilt University Medical Center; Vanderbilt University Institute of Imaging Science (K.E.W., G.W.J., H.F.J.G., V.L.M., S.N., D.J.E.); Vanderbilt Institute for Surgery and Engineering (K.E.W., G.W.J., H.F.J.G., V.L.M., S.N., D.J.E.); Department of Biomedical Engineering (G.W.J., H.F.J.G., V.L.M., S.W.R., S.N., D.J.E.), Vanderbilt University, Nashville, TN; Departments of Neurosurgery and Biomedical Engineering (J.D.R.), University of Utah, Salt Lake City; and Department of Pediatrics (S.B.R.), Vanderbilt Children's Hospital, Nashville, TN
| | - John D Rolston
- From the Departments of Neurological Surgery (D.L.P., K.E.W., R.P.N., V.L.M., S.N., D.J.E.), Radiology and Radiological Sciences (V.L.M., D.J.E.), Biostatistics (V.L.M., S.W.R., D.J.E.), and Neurology (H.K.), Vanderbilt University Medical Center; Vanderbilt University Institute of Imaging Science (K.E.W., G.W.J., H.F.J.G., V.L.M., S.N., D.J.E.); Vanderbilt Institute for Surgery and Engineering (K.E.W., G.W.J., H.F.J.G., V.L.M., S.N., D.J.E.); Department of Biomedical Engineering (G.W.J., H.F.J.G., V.L.M., S.W.R., S.N., D.J.E.), Vanderbilt University, Nashville, TN; Departments of Neurosurgery and Biomedical Engineering (J.D.R.), University of Utah, Salt Lake City; and Department of Pediatrics (S.B.R.), Vanderbilt Children's Hospital, Nashville, TN
| | - Robert P Naftel
- From the Departments of Neurological Surgery (D.L.P., K.E.W., R.P.N., V.L.M., S.N., D.J.E.), Radiology and Radiological Sciences (V.L.M., D.J.E.), Biostatistics (V.L.M., S.W.R., D.J.E.), and Neurology (H.K.), Vanderbilt University Medical Center; Vanderbilt University Institute of Imaging Science (K.E.W., G.W.J., H.F.J.G., V.L.M., S.N., D.J.E.); Vanderbilt Institute for Surgery and Engineering (K.E.W., G.W.J., H.F.J.G., V.L.M., S.N., D.J.E.); Department of Biomedical Engineering (G.W.J., H.F.J.G., V.L.M., S.W.R., S.N., D.J.E.), Vanderbilt University, Nashville, TN; Departments of Neurosurgery and Biomedical Engineering (J.D.R.), University of Utah, Salt Lake City; and Department of Pediatrics (S.B.R.), Vanderbilt Children's Hospital, Nashville, TN
| | - Shilpa B Reddy
- From the Departments of Neurological Surgery (D.L.P., K.E.W., R.P.N., V.L.M., S.N., D.J.E.), Radiology and Radiological Sciences (V.L.M., D.J.E.), Biostatistics (V.L.M., S.W.R., D.J.E.), and Neurology (H.K.), Vanderbilt University Medical Center; Vanderbilt University Institute of Imaging Science (K.E.W., G.W.J., H.F.J.G., V.L.M., S.N., D.J.E.); Vanderbilt Institute for Surgery and Engineering (K.E.W., G.W.J., H.F.J.G., V.L.M., S.N., D.J.E.); Department of Biomedical Engineering (G.W.J., H.F.J.G., V.L.M., S.W.R., S.N., D.J.E.), Vanderbilt University, Nashville, TN; Departments of Neurosurgery and Biomedical Engineering (J.D.R.), University of Utah, Salt Lake City; and Department of Pediatrics (S.B.R.), Vanderbilt Children's Hospital, Nashville, TN
| | - Victoria L Morgan
- From the Departments of Neurological Surgery (D.L.P., K.E.W., R.P.N., V.L.M., S.N., D.J.E.), Radiology and Radiological Sciences (V.L.M., D.J.E.), Biostatistics (V.L.M., S.W.R., D.J.E.), and Neurology (H.K.), Vanderbilt University Medical Center; Vanderbilt University Institute of Imaging Science (K.E.W., G.W.J., H.F.J.G., V.L.M., S.N., D.J.E.); Vanderbilt Institute for Surgery and Engineering (K.E.W., G.W.J., H.F.J.G., V.L.M., S.N., D.J.E.); Department of Biomedical Engineering (G.W.J., H.F.J.G., V.L.M., S.W.R., S.N., D.J.E.), Vanderbilt University, Nashville, TN; Departments of Neurosurgery and Biomedical Engineering (J.D.R.), University of Utah, Salt Lake City; and Department of Pediatrics (S.B.R.), Vanderbilt Children's Hospital, Nashville, TN
| | - Hakmook Kang
- From the Departments of Neurological Surgery (D.L.P., K.E.W., R.P.N., V.L.M., S.N., D.J.E.), Radiology and Radiological Sciences (V.L.M., D.J.E.), Biostatistics (V.L.M., S.W.R., D.J.E.), and Neurology (H.K.), Vanderbilt University Medical Center; Vanderbilt University Institute of Imaging Science (K.E.W., G.W.J., H.F.J.G., V.L.M., S.N., D.J.E.); Vanderbilt Institute for Surgery and Engineering (K.E.W., G.W.J., H.F.J.G., V.L.M., S.N., D.J.E.); Department of Biomedical Engineering (G.W.J., H.F.J.G., V.L.M., S.W.R., S.N., D.J.E.), Vanderbilt University, Nashville, TN; Departments of Neurosurgery and Biomedical Engineering (J.D.R.), University of Utah, Salt Lake City; and Department of Pediatrics (S.B.R.), Vanderbilt Children's Hospital, Nashville, TN
| | - Shawniqua Williams Roberson
- From the Departments of Neurological Surgery (D.L.P., K.E.W., R.P.N., V.L.M., S.N., D.J.E.), Radiology and Radiological Sciences (V.L.M., D.J.E.), Biostatistics (V.L.M., S.W.R., D.J.E.), and Neurology (H.K.), Vanderbilt University Medical Center; Vanderbilt University Institute of Imaging Science (K.E.W., G.W.J., H.F.J.G., V.L.M., S.N., D.J.E.); Vanderbilt Institute for Surgery and Engineering (K.E.W., G.W.J., H.F.J.G., V.L.M., S.N., D.J.E.); Department of Biomedical Engineering (G.W.J., H.F.J.G., V.L.M., S.W.R., S.N., D.J.E.), Vanderbilt University, Nashville, TN; Departments of Neurosurgery and Biomedical Engineering (J.D.R.), University of Utah, Salt Lake City; and Department of Pediatrics (S.B.R.), Vanderbilt Children's Hospital, Nashville, TN
| | - Saramati Narasimhan
- From the Departments of Neurological Surgery (D.L.P., K.E.W., R.P.N., V.L.M., S.N., D.J.E.), Radiology and Radiological Sciences (V.L.M., D.J.E.), Biostatistics (V.L.M., S.W.R., D.J.E.), and Neurology (H.K.), Vanderbilt University Medical Center; Vanderbilt University Institute of Imaging Science (K.E.W., G.W.J., H.F.J.G., V.L.M., S.N., D.J.E.); Vanderbilt Institute for Surgery and Engineering (K.E.W., G.W.J., H.F.J.G., V.L.M., S.N., D.J.E.); Department of Biomedical Engineering (G.W.J., H.F.J.G., V.L.M., S.W.R., S.N., D.J.E.), Vanderbilt University, Nashville, TN; Departments of Neurosurgery and Biomedical Engineering (J.D.R.), University of Utah, Salt Lake City; and Department of Pediatrics (S.B.R.), Vanderbilt Children's Hospital, Nashville, TN
| | - Dario J Englot
- From the Departments of Neurological Surgery (D.L.P., K.E.W., R.P.N., V.L.M., S.N., D.J.E.), Radiology and Radiological Sciences (V.L.M., D.J.E.), Biostatistics (V.L.M., S.W.R., D.J.E.), and Neurology (H.K.), Vanderbilt University Medical Center; Vanderbilt University Institute of Imaging Science (K.E.W., G.W.J., H.F.J.G., V.L.M., S.N., D.J.E.); Vanderbilt Institute for Surgery and Engineering (K.E.W., G.W.J., H.F.J.G., V.L.M., S.N., D.J.E.); Department of Biomedical Engineering (G.W.J., H.F.J.G., V.L.M., S.W.R., S.N., D.J.E.), Vanderbilt University, Nashville, TN; Departments of Neurosurgery and Biomedical Engineering (J.D.R.), University of Utah, Salt Lake City; and Department of Pediatrics (S.B.R.), Vanderbilt Children's Hospital, Nashville, TN
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Caciagli L, Paquola C, He X, Vollmar C, Centeno M, Wandschneider B, Braun U, Trimmel K, Vos SB, Sidhu MK, Thompson PJ, Baxendale S, Winston GP, Duncan JS, Bassett DS, Koepp MJ, Bernhardt BC. Disorganization of language and working memory systems in frontal versus temporal lobe epilepsy. Brain 2022; 146:935-953. [PMID: 35511160 PMCID: PMC9976988 DOI: 10.1093/brain/awac150] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 02/28/2022] [Accepted: 03/12/2022] [Indexed: 02/06/2023] Open
Abstract
Cognitive impairment is a common comorbidity of epilepsy and adversely impacts people with both frontal lobe (FLE) and temporal lobe (TLE) epilepsy. While its neural substrates have been investigated extensively in TLE, functional imaging studies in FLE are scarce. In this study, we profiled the neural processes underlying cognitive impairment in FLE and directly compared FLE and TLE to establish commonalities and differences. We investigated 172 adult participants (56 with FLE, 64 with TLE and 52 controls) using neuropsychological tests and four functional MRI tasks probing expressive language (verbal fluency, verb generation) and working memory (verbal and visuo-spatial). Patient groups were comparable in disease duration and anti-seizure medication load. We devised a multiscale approach to map brain activation and deactivation during cognition and track reorganization in FLE and TLE. Voxel-based analyses were complemented with profiling of task effects across established motifs of functional brain organization: (i) canonical resting-state functional systems; and (ii) the principal functional connectivity gradient, which encodes a continuous transition of regional connectivity profiles, anchoring lower-level sensory and transmodal brain areas at the opposite ends of a spectrum. We show that cognitive impairment in FLE is associated with reduced activation across attentional and executive systems, as well as reduced deactivation of the default mode system, indicative of a large-scale disorganization of task-related recruitment. The imaging signatures of dysfunction in FLE are broadly similar to those in TLE, but some patterns are syndrome-specific: altered default-mode deactivation is more prominent in FLE, while impaired recruitment of posterior language areas during a task with semantic demands is more marked in TLE. Functional abnormalities in FLE and TLE appear overall modulated by disease load. On balance, our study elucidates neural processes underlying language and working memory impairment in FLE, identifies shared and syndrome-specific alterations in the two most common focal epilepsies and sheds light on system behaviour that may be amenable to future remediation strategies.
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Affiliation(s)
- Lorenzo Caciagli
- Correspondence to: Lorenzo Caciagli, MD, PhD Department of Bioengineering University of Pennsylvania, 240 Skirkanich Hall 210 South 33rd Street, Philadelphia, PA 19104, USA E-mail: ;
| | - Casey Paquola
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute, Montreal, Quebec H3A 2B4, Canada
| | - Xiaosong He
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
| | - Christian Vollmar
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, UK,Department of Neurology, Ludwig-Maximilians-Universität, 81377 Munich, Germany
| | - Maria Centeno
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, UK,Epilepsy Unit, Hospital Clínic de Barcelona, IDIBAPS, 08036 Barcelona, Spain
| | - Britta Wandschneider
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, UK
| | - Urs Braun
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA,Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Karin Trimmel
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, UK,Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Sjoerd B Vos
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, UK,Centre for Medical Image Computing, University College London, London, UK,Neuroradiological Academic Unit, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Meneka K Sidhu
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, UK
| | - Pamela J Thompson
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, UK
| | - Sallie Baxendale
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, UK
| | - Gavin P Winston
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, UK,Department of Medicine, Division of Neurology, Queen’s University, Kingston, Ontario, Canada
| | - John S Duncan
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, UK
| | - Dani S Bassett
- Correspondence may also be addressed to: Dani S. Bassett, PhD E-mail:
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Middlebrooks EH, He X, Grewal SS, Keller SS. Neuroimaging and thalamic connectomics in epilepsy neuromodulation. Epilepsy Res 2022; 182:106916. [PMID: 35367691 DOI: 10.1016/j.eplepsyres.2022.106916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/05/2022] [Accepted: 03/27/2022] [Indexed: 11/03/2022]
Abstract
Neuromodulation is an increasingly utilized therapy for the treatment of people with drug-resistant epilepsy. To date, the most common and effective target has been the thalamus, which is known to play a key role in multiple forms of epilepsy. Neuroimaging has facilitated rapid developments in the understanding of functional targets, surgical and programming techniques, and the effects of thalamic stimulation. In this review, the role of neuroimaging in neuromodulation is explored. First, the structural and functional changes of the thalamus in common epilepsy syndromes are discussed as the rationale for neuromodulation of the thalamus. Next, methods for imaging different thalamic nuclei are presented, as well as rationale for the need of direct surgical targeting rather than reliance on traditional stereotactic coordinates. Lastly, we discuss the potential role of neuroimaging in assessing the effects of thalamic stimulation and as a potential biomarker for neuromodulation outcomes.
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Affiliation(s)
- Erik H Middlebrooks
- Department of Radiology, Mayo Clinic, Jacksonville, FL, USA; Department of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA.
| | - Xiaosong He
- Department of Psychology, University of Science and Technology of China, Hefei, Anhui, China
| | | | - Simon S Keller
- Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, UK
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8
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Yang T, Ren J, Zhang Y, Zhang T, Zhou H, Yang M, Li L, Lei D, Gong Q, Zhou D. Pretreatment Topological Disruptions of Whole-brain Networks Exist in Childhood Absence Epilepsy: A Resting-state EEG-fMRI Study. Epilepsy Res 2022. [DOI: 10.1016/j.eplepsyres.2022.106909] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 02/24/2022] [Accepted: 03/13/2022] [Indexed: 11/19/2022]
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9
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Nie L, Jiang Y, Lv Z, Pang X, Liang X, Chang W, Zheng J. A study of brain functional network and alertness changes in temporal lobe epilepsy with and without focal to bilateral tonic-clonic seizures. BMC Neurol 2022; 22:14. [PMID: 34996377 PMCID: PMC8740350 DOI: 10.1186/s12883-021-02525-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 12/13/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Temporal lobe epilepsy (TLE) is commonly refractory. Epilepsy surgery is an effective treatment strategy for refractory epilepsy, but patients with a history of focal to bilateral tonic-clonic seizures (FBTCS) have poor outcomes. Previous network studies on epilepsy have found that TLE and idiopathic generalized epilepsy with generalized tonic-clonic seizures (IGE-GTCS) showed altered global and nodal topological properties. Alertness deficits also were found in TLE. However, FBTCS is a common type of seizure in TLE, and the implications for alertness as well as the topological rearrangements associated with this seizure type are not well understood. METHODS We obtained rs-fMRI data and collected the neuropsychological assessment data from 21 TLE patients with FBTCS (TLE- FBTCS), 18 TLE patients without FBTCS (TLE-non- FBTCS) and 22 controls, and constructed their respective functional brain networks. The topological properties were analyzed using the graph theoretical approach and correlations between altered topological properties and alertness were analyzed. RESULTS We found that TLE-FBTCS patients showed more serious impairment in alertness effect, intrinsic alertness and phasic alertness than the patients with TLE-non-FBTCS. They also showed significantly higher small-worldness, normalized clustering coefficient (γ) and a trend of higher global network efficiency (gE) compared to TLE-non-FBTCS patients. The gE showed a significant negative correlation with intrinsic alertness for TLE-non-FBTCS patients. CONCLUSION Our findings show different impairments in brain network information integration, segregation and alertness between the patients with TLE-FBTCS and TLE-non-FBTCS, demonstrating that impairments of the brain network may underlie the disruptions in alertness functions.
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Affiliation(s)
- Liluo Nie
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, No.6, Shuangyong Road, Nanning, 530021, China
| | - Yanchun Jiang
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, No.6, Shuangyong Road, Nanning, 530021, China
| | - Zongxia Lv
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, No.6, Shuangyong Road, Nanning, 530021, China
| | - Xiaomin Pang
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, No.6, Shuangyong Road, Nanning, 530021, China
| | - Xiulin Liang
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, No.6, Shuangyong Road, Nanning, 530021, China
| | - Weiwei Chang
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, No.6, Shuangyong Road, Nanning, 530021, China
| | - Jinou Zheng
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, No.6, Shuangyong Road, Nanning, 530021, China.
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10
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Chen Y, Fallon N, Kreilkamp BAK, Denby C, Bracewell M, Das K, Pegg E, Mohanraj R, Marson AG, Keller SS. Probabilistic mapping of thalamic nuclei and thalamocortical functional connectivity in idiopathic generalised epilepsy. Hum Brain Mapp 2021; 42:5648-5664. [PMID: 34432348 PMCID: PMC8559489 DOI: 10.1002/hbm.25644] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 08/04/2021] [Accepted: 08/16/2021] [Indexed: 02/06/2023] Open
Abstract
It is well established that abnormal thalamocortical systems play an important role in the generation and maintenance of primary generalised seizures. However, it is currently unknown which thalamic nuclei and how nuclear‐specific thalamocortical functional connectivity are differentially impacted in patients with medically refractory and non‐refractory idiopathic generalised epilepsy (IGE). In the present study, we performed structural and resting‐state functional magnetic resonance imaging (MRI) in patients with refractory and non‐refractory IGE, segmented the thalamus into constituent nuclear regions using a probabilistic MRI segmentation method and determined thalamocortical functional connectivity using seed‐to‐voxel connectivity analyses. We report significant volume reduction of the left and right anterior thalamic nuclei only in patients with refractory IGE. Compared to healthy controls, patients with refractory and non‐refractory IGE had significant alterations of functional connectivity between the centromedian nucleus and cortex, but only patients with refractory IGE had altered cortical connectivity with the ventral lateral nuclear group. Patients with refractory IGE had significantly increased functional connectivity between the left and right ventral lateral posterior nuclei and cortical regions compared to patients with non‐refractory IGE. Cortical effects were predominantly located in the frontal lobe. Atrophy of the anterior thalamic nuclei and resting‐state functional hyperconnectivity between ventral lateral nuclei and cerebral cortex may be imaging markers of pharmacoresistance in patients with IGE. These structural and functional abnormalities fit well with the known importance of thalamocortical systems in the generation and maintenance of primary generalised seizures, and the increasing recognition of the importance of limbic pathways in IGE.
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Affiliation(s)
- Yachin Chen
- Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK.,The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Nicholas Fallon
- Department of Psychology, University of Liverpool, Liverpool, UK
| | - Barbara A K Kreilkamp
- Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK.,Department of Neurology, University Medicine Göttingen, Göttingen, Germany
| | | | - Martyn Bracewell
- The Walton Centre NHS Foundation Trust, Liverpool, UK.,Schools of Medical Sciences and Psychology, Bangor University, Bangor, UK
| | - Kumar Das
- The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Emily Pegg
- Department of Neurology, Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Salford, UK.,Division of Neuroscience and Experimental Psychology, Faculty of Biology, Medicine and Health, School of Biological Sciences, University of Manchester, Manchester, UK
| | - Rajiv Mohanraj
- Department of Neurology, Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Salford, UK.,Division of Neuroscience and Experimental Psychology, Faculty of Biology, Medicine and Health, School of Biological Sciences, University of Manchester, Manchester, UK
| | - Anthony G Marson
- Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK.,The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Simon S Keller
- Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK.,The Walton Centre NHS Foundation Trust, Liverpool, UK
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11
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Sanjari Moghaddam H, Sanjari Moghaddam A, Hasanzadeh A, Sanatian Z, Mafi A, Aarabi MH, Samimi M, Aghamollaii V, Gholipour T, Tafakhori A. A systematic review of resting-state and task-based fmri in juvenile myoclonic epilepsy. Brain Imaging Behav 2021. [PMID: 34786666 DOI: 10.1007/s11682-021-00595-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2021] [Indexed: 10/19/2022]
Abstract
Functional neuroimaging modalities have enhanced our understanding of juvenile myoclonic epilepsy (JME) underlying neural mechanisms. Due to its non-invasive, sensitive and analytical nature, functional magnetic resonance imaging (fMRI) provides valuable insights into relevant functional brain networks and their segregation and integration properties. We systematically reviewed the contribution of resting-state and task-based fMRI to the current understanding of the pathophysiology and the patterns of seizure propagation in JME Altogether, despite some discrepancies, functional findings suggest that corticothalamo-striato-cerebellar network along with default-mode network and salience network are the most affected networks in patients with JME. However, further studies are required to investigate the association between JME's main deficiencies, e.g., motor and cognitive deficiencies and fMRI findings. Moreover, simultaneous electroencephalography-fMRI (EEG-fMRI) studies indicate that alterations of these networks play a role in seizure modulation but fall short of identifying a causal relationship between altered functional properties and seizure propagation. This review highlights the complex pathophysiology of JME, which necessitates the design of more personalized diagnostic and therapeutic strategies in this group.
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12
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Modi S, He X, Chaudhary K, Hinds W, Crow A, Beloor-Suresh A, Sperling MR, Tracy JI. Multiple-brain systems dynamically interact during tonic and phasic states to support language integrity in temporal lobe epilepsy. Neuroimage Clin 2021; 32:102861. [PMID: 34688143 PMCID: PMC8536775 DOI: 10.1016/j.nicl.2021.102861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/10/2021] [Accepted: 10/13/2021] [Indexed: 11/18/2022]
Abstract
Unique brain dynamics occur during language task in left temporal lobe epilepsy (TLE). Multiple brain systems interact to implement compensated language status in TLE. Tonic/rest dynamics exert influence and may prime the level of phasic/task dynamics. Multi-network integrations are compensatory in patients with lower language skills.
An epileptogenic focus in the dominant temporal lobe can result in the reorganization of language systems in order to compensate for compromised functions. We studied the compensatory reorganization of language in the setting of left temporal lobe epilepsy (TLE), taking into account the interaction of language (L) with key non-language (NL) networks such as dorsal attention (DAN), fronto-parietal (FPN) and cingulo-opercular (COpN), with these systems providing cognitive resources helpful for successful language performance. We applied tools from dynamic network neuroscience to functional MRI data collected from 23 TLE patients and 23 matched healthy controls during the resting state (RS) and a sentence completion (SC) task to capture how the functional architecture of a language network dynamically changes and interacts with NL systems in these two contexts. We provided evidence that the brain areas in which core language functions reside dynamically interact with non-language functional networks to carry out linguistic functions. We demonstrated that abnormal integrations between the language and DAN existed in TLE, and were present both in tonic as well as phasic states. This integration was considered to reflect the entrainment of visual attention systems to the systems dedicated to lexical semantic processing. Our data made clear that the level of baseline integrations between the language subsystems and certain NL systems (e.g., DAN, FPN) had a crucial influence on the general level of task integrations between L/NL systems, with this a normative finding not unique to epilepsy. We also revealed that a broad set of task L/NL integrations in TLE are predictive of language competency, indicating that these integrations are compensatory for patients with lower overall language skills. We concluded that RS establishes the broad set of L/NL integrations available and primed for use during task, but that the actual use of those interactions in the setting of TLE depended on the level of language skill. We believe our analyses are the first to capture the potential compensatory role played by dynamic network reconfigurations between multiple brain systems during performance of a complex language task, in addition to testing for characteristics in both the phasic/task and tonic/resting state that are necessary to achieve language competency in the setting of temporal lobe pathology. Our analyses highlighted the intra- versus inter-system communications that form the basis of unique language processing in TLE, pointing to the dynamic reconfigurations that provided the broad multi-system support needed to maintain language skill and competency.
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Affiliation(s)
- Shilpi Modi
- Department of Neurology, Comprehensive Epilepsy Centre, Thomas Jefferson University, Philadelphia, PA, USA
| | - Xiaosong He
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA
| | - Kapil Chaudhary
- Department of Neurology, Comprehensive Epilepsy Centre, Thomas Jefferson University, Philadelphia, PA, USA
| | - Walter Hinds
- Department of Neurology, Comprehensive Epilepsy Centre, Thomas Jefferson University, Philadelphia, PA, USA
| | - Andrew Crow
- Department of Neurology, Comprehensive Epilepsy Centre, Thomas Jefferson University, Philadelphia, PA, USA
| | - Ashithkumar Beloor-Suresh
- Department of Neurology, Comprehensive Epilepsy Centre, Thomas Jefferson University, Philadelphia, PA, USA
| | - Michael R Sperling
- Department of Neurology, Comprehensive Epilepsy Centre, Thomas Jefferson University, Philadelphia, PA, USA
| | - Joseph I Tracy
- Department of Neurology, Comprehensive Epilepsy Centre, Thomas Jefferson University, Philadelphia, PA, USA.
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13
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Alper J, Seifert AC, Verma G, Huang KH, Jacob Y, Al Qadi A, Rutland JW, Patel S, Bederson J, Shrivastava RK, Delman BN, Balchandani P. Leveraging high-resolution 7-tesla MRI to derive quantitative metrics for the trigeminal nerve and subnuclei of limbic structures in trigeminal neuralgia. J Headache Pain 2021; 22:112. [PMID: 34556025 PMCID: PMC8461944 DOI: 10.1186/s10194-021-01325-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 09/07/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Trigeminal Neuralgia (TN) is a chronic neurological disease that is strongly associated with neurovascular compression (NVC) of the trigeminal nerve near its root entry zone. The trigeminal nerve at the site of NVC has been extensively studied but limbic structures that are potentially involved in TN have not been adequately characterized. Specifically, the hippocampus is a stress-sensitive region which may be structurally impacted by chronic TN pain. As the center of the emotion-related network, the amygdala is closely related to stress regulation and may be associated with TN pain as well. The thalamus, which is involved in the trigeminal sensory pathway and nociception, may play a role in pain processing of TN. The objective of this study was to assess structural alterations in the trigeminal nerve and subregions of the hippocampus, amygdala, and thalamus in TN patients using ultra-high field MRI and examine quantitative differences in these structures compared with healthy controls. METHODS Thirteen TN patients and 13 matched controls were scanned at 7-Tesla MRI with high resolution, T1-weighted imaging. Nerve cross sectional area (CSA) was measured and an automated algorithm was used to segment hippocampal, amygdaloid, and thalamic subregions. Nerve CSA and limbic structure subnuclei volumes were compared between TN patients and controls. RESULTS CSA of the posterior cisternal nerve on the symptomatic side was smaller in patients (3.75 mm2) compared with side-matched controls (5.77 mm2, p = 0.006). In TN patients, basal subnucleus amygdala volume (0.347 mm3) was reduced on the symptomatic side compared with controls (0.401 mm3, p = 0.025) and the paralaminar subnucleus volume (0.04 mm3) was also reduced on the symptomatic side compared with controls (0.05 mm3, p = 0.009). The central lateral thalamic subnucleus was larger in TN patients on both the symptomatic side (0.033 mm3) and asymptomatic side (0.035 mm3), compared with the corresponding sides in controls (0.025 mm3 on both sides, p = 0.048 and p = 0.003 respectively). The inferior and lateral pulvinar thalamic subnuclei were both reduced in TN patients on the symptomatic side (0.2 mm3 and 0.17 mm3 respectively) compared to controls (0.23 mm3, p = 0.04 and 0.18 mm3, p = 0.04 respectively). No significant findings were found in the hippocampal subfields analyzed. CONCLUSIONS These findings, generated through a highly sensitive 7 T MRI protocol, provide compelling support for the theory that TN neurobiology is a complex amalgamation of local structural changes within the trigeminal nerve and structural alterations in subnuclei of limbic structures directly and indirectly involved in nociception and pain processing.
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Affiliation(s)
- Judy Alper
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, 1470 Madison Avenue; Floor 1, New York, NY, 10029, USA.
- Department of Biomedical Engineering, City College of New York, New York, NY, USA.
| | - Alan C Seifert
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, 1470 Madison Avenue; Floor 1, New York, NY, 10029, USA
| | - Gaurav Verma
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, 1470 Madison Avenue; Floor 1, New York, NY, 10029, USA
| | - Kuang-Han Huang
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, 1470 Madison Avenue; Floor 1, New York, NY, 10029, USA
| | - Yael Jacob
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, 1470 Madison Avenue; Floor 1, New York, NY, 10029, USA
| | - Ameen Al Qadi
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, 1470 Madison Avenue; Floor 1, New York, NY, 10029, USA
| | - John W Rutland
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, 1470 Madison Avenue; Floor 1, New York, NY, 10029, USA
| | - Sheetal Patel
- Department of Neurosurgery, Mount Sinai Hospital, New York, NY, USA
| | - Joshua Bederson
- Department of Neurosurgery, Mount Sinai Hospital, New York, NY, USA
| | | | - Bradley N Delman
- Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Priti Balchandani
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, 1470 Madison Avenue; Floor 1, New York, NY, 10029, USA
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14
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Pegg EJ, McKavanagh A, Bracewell RM, Chen Y, Das K, Denby C, Kreilkamp BAK, Laiou P, Marson A, Mohanraj R, Taylor JR, Keller SS. Functional network topology in drug resistant and well-controlled idiopathic generalized epilepsy: a resting state functional MRI study. Brain Commun 2021; 3:fcab196. [PMID: 34514400 PMCID: PMC8417840 DOI: 10.1093/braincomms/fcab196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2021] [Indexed: 11/23/2022] Open
Abstract
Despite an increasing number of drug treatment options for people with idiopathic generalized epilepsy (IGE), drug resistance remains a significant issue and the mechanisms underlying it remain poorly understood. Previous studies have largely focused on potential cellular or genetic explanations for drug resistance. However, epilepsy is understood to be a network disorder and there is a growing body of literature suggesting altered topology of large-scale resting networks in people with epilepsy compared with controls. We hypothesize that network alterations may also play a role in seizure control. The aim of this study was to compare resting state functional network structure between well-controlled IGE (WC-IGE), drug resistant IGE (DR-IGE) and healthy controls. Thirty-three participants with IGE (10 with WC-IGE and 23 with DR-IGE) and 34 controls were included. Resting state functional MRI networks were constructed using the Functional Connectivity Toolbox (CONN). Global graph theoretic network measures of average node strength (an equivalent measure to mean degree in a network that is fully connected), node strength distribution variance, characteristic path length, average clustering coefficient, small-world index and average betweenness centrality were computed. Graphs were constructed separately for positively weighted connections and for absolute values. Individual nodal values of strength and betweenness centrality were also measured and ‘hub nodes’ were compared between groups. Outcome measures were assessed across the three groups and between both groups with IGE and controls. The IGE group as a whole had a higher average node strength, characteristic path length and average betweenness centrality. There were no clear differences between groups according to seizure control. Outcome metrics were sensitive to whether negatively correlated connections were included in network construction. There were no clear differences in the location of ‘hub nodes’ between groups. The results suggest that, irrespective of seizure control, IGE interictal network topology is more regular and has a higher global connectivity compared to controls, with no alteration in hub node locations. These alterations may produce a resting state network that is more vulnerable to transitioning to the seizure state. It is possible that the lack of apparent influence of seizure control on network topology is limited by challenges in classifying drug response. It is also demonstrated that network topological features are influenced by the sign of connectivity weights and therefore future methodological work is warranted to account for anticorrelations in graph theoretic studies.
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Affiliation(s)
- Emily J Pegg
- Department of Neurology, Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Salford, UK.,Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Andrea McKavanagh
- Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | | | - Yachin Chen
- Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - Kumar Das
- The Walton Centre NHS Foundation Trust, Liverpool, UK
| | | | - Barbara A K Kreilkamp
- Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK.,Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
| | - Petroula Laiou
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Anthony Marson
- Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - Rajiv Mohanraj
- Department of Neurology, Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Salford, UK.,Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Jason R Taylor
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.,Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Simon S Keller
- Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
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15
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Noorani A, Hung PSP, Zhang JY, Sohng K, Laperriere N, Moayedi M, Hodaie M. Pain relief reverses hippocampal abnormalities in trigeminal neuralgia. J Pain 2021; 23:141-155. [PMID: 34380093 DOI: 10.1016/j.jpain.2021.07.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 06/24/2021] [Accepted: 07/12/2021] [Indexed: 11/17/2022]
Abstract
Chronic pain patients frequently report memory and concentration difficulties. Objective testing in this population points to poor performance on memory and cognitive tests, and increased comorbid anxiety and depression. Recent evidence has suggested convergence between chronic pain and memory deficits onto the hippocampus. The hippocampus consists of heterogenous subfields involved in memory consolidation, behavior regulation, and stress modulation. Despite significant studies outlining hippocampal changes in human and chronic pain animal models, the effect of pain relief on hippocampal abnormalities remains unknown. Trigeminal neuralgia (TN) is a chronic neuropathic pain disorder which is highly amenable to surgical interventions, providing a unique opportunity to investigate the effect of pain relief. This study investigates the effect of pain relief on hippocampal subfields in TN. Anatomical MR images of 61 TN patients were examined before and 6 months after surgery. Treatment responders (n=47) reported 95% pain relief, whereas non-responders (n=14) reported 40% change in pain on average. At baseline, patients had smaller hippocampal volumes, compared to controls. After surgery, responders' hippocampal volumes normalized, largely driven by CA2/3, CA4 and dentate gyrus, which are involved in memory consolidation and neurogenesis. We propose that hippocampal atrophy in TN is pain-driven and successful treatment normalizes such abnormalities.
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Affiliation(s)
- Alborz Noorani
- Division of Brain, Imaging, and Behaviour - Systems Neuroscience, Krembil Research Institute, Toronto Western Hospital, University Health Network, Ontario, Canada; Department of Surgery and Institute of Medical Science, University of Toronto, Ontario, Canada; Collaborative Program in Neuroscience, University of Toronto, Ontario, Canada; Temerty Faculty of Medicine, University of Toronto, Ontario, Canada
| | - Peter Shih-Ping Hung
- Division of Brain, Imaging, and Behaviour - Systems Neuroscience, Krembil Research Institute, Toronto Western Hospital, University Health Network, Ontario, Canada; Department of Surgery and Institute of Medical Science, University of Toronto, Ontario, Canada; Collaborative Program in Neuroscience, University of Toronto, Ontario, Canada; Temerty Faculty of Medicine, University of Toronto, Ontario, Canada
| | - Jia Y Zhang
- Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Kaylee Sohng
- Division of Brain, Imaging, and Behaviour - Systems Neuroscience, Krembil Research Institute, Toronto Western Hospital, University Health Network, Ontario, Canada; Temerty Faculty of Medicine, University of Toronto, Ontario, Canada
| | - Normand Laperriere
- Temerty Faculty of Medicine, University of Toronto, Ontario, Canada; Radiation Medicine Program, Princess Margaret Hospital and University of Toronto, Toronto, Ontario, Canada
| | - Massieh Moayedi
- Collaborative Program in Neuroscience, University of Toronto, Ontario, Canada; Centre for Multimodal Sensorimotor and Pain Research, University of Toronto, Ontario, Canada; University of Toronto Centre for the Study of Pain, Toronto, Ontario, Canada; Division of Clinical & Computational Neuroscience, Krembil Research Institute, Toronto Western Hospital, University Health Network, Ontario Canada
| | - Mojgan Hodaie
- Division of Brain, Imaging, and Behaviour - Systems Neuroscience, Krembil Research Institute, Toronto Western Hospital, University Health Network, Ontario, Canada; Department of Surgery and Institute of Medical Science, University of Toronto, Ontario, Canada; Collaborative Program in Neuroscience, University of Toronto, Ontario, Canada; Temerty Faculty of Medicine, University of Toronto, Ontario, Canada; Division of Neurosurgery, Krembil Brain Institute, Toronto Western Hospital, University Health Network, Ontario, Canada.
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16
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Corrêa DG, Tijms BM, Dicks E, Rêgo C, Alves-Leon SV, Marcondes J, Gasparetto EL, van Duinkerken E. Effects of seizure burden on structural global brain networks in patients with unilateral hippocampal sclerosis. Brain Behav 2021; 11:e2237. [PMID: 34105906 PMCID: PMC8413824 DOI: 10.1002/brb3.2237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 05/08/2021] [Accepted: 05/23/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND AND PURPOSE Temporal lobe epilepsy secondary to hippocampal sclerosis is related to epileptogenic networks rather than a focal epileptogenic source. Graph-theoretical gray and white matter networks may help to identify alterations within these epileptogenic networks. METHODS Twenty-seven patients with hippocampal sclerosis and 14 controls underwent magnetic resonance imaging, including 3D-T1, fluid-attenuated inversion recovery, and diffusion tensor imaging. Subject-specific structural gray and white matter network properties (normalized path length, clustering, and small-worldness) were reconstructed. Group differences and differences between those with higher and lower seizure burden (<4 vs. ≥4 average monthly seizures in the last year) in network parameters were evaluated. Additionally, correlations between network properties and disease-related variables were calculated. RESULTS All patients with hippocampal sclerosis as one group did not have altered gray or white matter network properties (all p > .05). Patients with lower seizure burden had significantly lower gray matter small-worldness and normalized clustering compared to controls and those with higher seizure burden (all p < .04). A higher number of monthly seizures was significantly associated with increased gray and white matter small-worldness, indicating a more rigid network. CONCLUSION Overall, there were no differences in network properties in this group of patients with hippocampal sclerosis. However, patients with lower seizure burden had significantly lower gray matter network indices, indicating a more random organization. The correlation between higher monthly seizures and a more rigid network is driven by those with higher seizure burden, who presented a more rigid network compared to those with a lower seizure burden.
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Affiliation(s)
- Diogo Goulart Corrêa
- Clínica de Diagnóstico por Imagem (CDPI)/DASA, Avenida das Américas, Barra da Tijuca, Rio de Janeiro, Brazil.,Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro, Brazil
| | - Betty M Tijms
- Department of Neurology, Alzheimer Center, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands
| | - Ellen Dicks
- Department of Neurology, Alzheimer Center, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands
| | - Cláudia Rêgo
- Department of Neurology, Epilepsy Center, Hospital Universitário Clementino Fraga Filho, Federal University of Rio de Janeiro, Cidade Universitária, Ilha do Fundão, Rio de Janeiro, Brazil
| | - Soniza Vieira Alves-Leon
- Department of Neurology, Epilepsy Center, Hospital Universitário Clementino Fraga Filho, Federal University of Rio de Janeiro, Cidade Universitária, Ilha do Fundão, Rio de Janeiro, Brazil
| | - Jorge Marcondes
- Department of Neurology, Epilepsy Center, Hospital Universitário Clementino Fraga Filho, Federal University of Rio de Janeiro, Cidade Universitária, Ilha do Fundão, Rio de Janeiro, Brazil
| | - Emerson Leandro Gasparetto
- Clínica de Diagnóstico por Imagem (CDPI)/DASA, Avenida das Américas, Barra da Tijuca, Rio de Janeiro, Brazil.,Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro, Brazil
| | - Eelco van Duinkerken
- Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro, Brazil.,Department of Medical Psychology, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands.,Department of Internal Medicine, Amsterdam Diabetes Center, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands.,Post-Graduate Program in Neurology, Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
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17
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Liang X, Pang X, Zhao J, Yu L, Wu P, Li X, Wei W, Zheng J. Altered static and dynamic functional network connectivity in temporal lobe epilepsy with different disease duration and their relationships with attention. J Neurosci Res 2021; 99:2688-2705. [PMID: 34269468 DOI: 10.1002/jnr.24915] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/13/2021] [Accepted: 06/14/2021] [Indexed: 11/09/2022]
Abstract
The brain network alterations associated with temporal lobe epilepsy (TLE) progression are still unclear. The purpose of this study was to investigate altered patterns of static and dynamic functional network connectivity (sFNC and dFNC) in TLE with different durations of disease. In this study, 19 TLE patients with a disease duration of ≤5 years (TLE-SD), 24 TLE patients with a disease duration of >5 years (TLE-LD), and 21 healthy controls (HCs) underwent resting-state functional magnetic resonance imaging and attention network test. We used group independent component analysis to determine the target resting-state networks. Sliding window correlation and k-means clustering analysis methods were used to obtain different dFNC states, temporal properties, and temporal variability. We then compared sFNC and dFNC between groups and found that compared with HCs, TLE-SD patients had increased sFNC between the dorsal attention network and sensorimotor network/visual network (VN), but decreased sFNC between the inferior-posterior default mode network and VN. In the strongly connected dFNC state, TLE-SD patients spent more time, had greater mean dwell time, and showed greater inconsistent abnormal network connectivity. There was a significant negative correlation between the temporal variability of auditory network- left fronto-parietal network connectivity and orienting effect. No significant differences in sFNC and dFNC were detected between TLE-LD and HC groups. These findings suggest that the damage and functional brain network abnormalities gradually occur in TLE patients after the onset of epilepsy, which might lead to functional network reorganization and compensatory remodeling as the disease progresses.
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Affiliation(s)
- Xiulin Liang
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xiaomin Pang
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jingyuan Zhao
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Lu Yu
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Peirong Wu
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xinrong Li
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Wutong Wei
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jinou Zheng
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
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18
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Li Y, Zhu H, Chen Q, Yang L, Bao X, Chen F, Ma H, Xu H, Luo L, Zhang R. Evaluation of Brain Network Properties in Patients with MRI-Negative Temporal Lobe Epilepsy: An MEG Study. Brain Topogr 2021; 34:618-631. [PMID: 34173926 DOI: 10.1007/s10548-021-00856-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 06/13/2021] [Indexed: 11/25/2022]
Abstract
Abnormal functional brain networks of temporal lobe epilepsy (TLE) patients with structural abnormalities may partially reflect structural lesions rather than either TLE per se or functional compensatory processes. In this study, we sought to investigate the brain-network properties of intractable TLE patients apart from the effects of structural abnormalities. The brain network properties of 20 left and 23 right MRI-negative TLE patients and 22 healthy controls were evaluated using magnetoencephalographic recordings in six main frequency bands. A slowing of oscillatory brain activity was observed for the left or right TLE group vs. healthy controls. The TLE groups presented significantly increased functional connectivity in the delta, theta, lower alpha and beta bands, and significantly greater values in the normalized clustering coefficient and path length, and significantly smaller values in the weighted small-world measure in the theta band when compared to healthy controls. Alterations in global and regional band powers can be attributed to spectral slowing in TLE patients. The brain networks of TLE patients displayed abnormally high synchronization in multi-frequency bands and shifted toward a more regular architecture with worse network efficiency in the theta band. Without the contamination of structural lesions, these significant findings can be helpful for better understanding of the pathophysiological mechanism of TLE. The theta band can be considered as a preferred frequency band for investigating the brain-network dysfunction of MRI-negative intractable TLE patients.
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Affiliation(s)
- Yuejun Li
- Department of Functional Neurosurgery, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, 210029, Jiangsu, China
- Department of Magnetoencephalography, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Haitao Zhu
- Department of Functional Neurosurgery, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Qiqi Chen
- Department of Functional Neurosurgery, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, 210029, Jiangsu, China
- Department of Magnetoencephalography, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Lu Yang
- Department of Functional Neurosurgery, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Xincai Bao
- Library of Xinxiang Medical University, Xinxiang, 453003, Henan, China
| | - Fangqing Chen
- Department of Functional Neurosurgery, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Haiyan Ma
- Department of Functional Neurosurgery, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Honghao Xu
- Department of Functional Neurosurgery, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Lei Luo
- Department of Functional Neurosurgery, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Rui Zhang
- Department of Functional Neurosurgery, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, 210029, Jiangsu, China.
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19
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Hatlestad-Hall C, Bruña R, Erichsen A, Andersson V, Syvertsen MR, Skogan AH, Renvall H, Marra C, Maestú F, Heuser K, Taubøll E, Solbakk AK, Haraldsen IH. The organization of functional neurocognitive networks in focal epilepsy correlates with domain-specific cognitive performance. J Neurosci Res 2021; 99:2669-2687. [PMID: 34173259 DOI: 10.1002/jnr.24896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 04/28/2021] [Accepted: 05/15/2021] [Indexed: 11/10/2022]
Abstract
Understanding and diagnosing cognitive impairment in epilepsy remains a prominent challenge. New etiological models suggest that cognitive difficulties might not be directly linked to seizure activity, but are rather a manifestation of a broader brain pathology. Consequently, treating seizures is not sufficient to alleviate cognitive symptoms, highlighting the need for novel diagnostic tools. Here, we investigated whether the organization of three intrinsic, resting-state functional connectivity networks was correlated with domain-specific cognitive test performance. Using individualized EEG source reconstruction and graph theory, we examined the association between network small worldness and cognitive test performance in 23 patients with focal epilepsy and 17 healthy controls, who underwent a series of standardized pencil-and-paper and digital cognitive tests. We observed that the specific networks robustly correlated with test performance in distinct cognitive domains. Specifically, correlations were evident between the default mode network and memory in patients, the central-executive network and executive functioning in controls, and the salience network and social cognition in both groups. Interestingly, the correlations were evident in both groups, but in different domains, suggesting an alteration in these functional neurocognitive networks in focal epilepsy. The present findings highlight the potential clinical relevance of functional brain network dysfunction in cognitive impairment.
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Affiliation(s)
| | - Ricardo Bruña
- Center for Biomedical Technology, Technical University of Madrid, Pozuelo de Alarcón, Spain.,Department of Experimental Psychology, Complutense University of Madrid, Pozuelo de Alarcón, Spain.,Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - Aksel Erichsen
- Department of Neurology, Oslo University Hospital, Oslo, Norway.,Department of Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | | | - Marte Roa Syvertsen
- Department of Neurology, Drammen Hospital, Vestre Viken Health Care Trust, Drammen, Norway
| | - Annette Holth Skogan
- Division of Clinical Neuroscience, National Centre for Epilepsy, Oslo University Hospital, Oslo, Norway
| | - Hanna Renvall
- Department of Neuroscience and Biomedical Engineering, Aalto University, Helsinki, Finland.,BioMag Laboratory, HUS Diagnostic Center, Helsinki University Hospital, University of Helsinki and Aalto, Helsinki, Finland
| | - Camillo Marra
- Department of Neuroscience, Fondazione Policlinico Agostino Gemelli, Rome, Italy
| | - Fernando Maestú
- Center for Biomedical Technology, Technical University of Madrid, Pozuelo de Alarcón, Spain.,Department of Experimental Psychology, Complutense University of Madrid, Pozuelo de Alarcón, Spain.,Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - Kjell Heuser
- Department of Neurology, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Erik Taubøll
- Department of Neurology, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Anne-Kristin Solbakk
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway.,RITMO Centre for Interdisciplinary Studies in Rhythm, Time and Motion, University of Oslo, Oslo, Norway.,Department of Neurosurgery, Oslo University Hospital, Oslo, Norway.,Department of Neuropsychology, Helgeland Hospital, Mosjøen, Norway
| | - Ira H Haraldsen
- Department of Neurology, Oslo University Hospital, Oslo, Norway
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20
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Hatlestad-Hall C, Bruña R, Syvertsen MR, Erichsen A, Andersson V, Vecchio F, Miraglia F, Rossini PM, Renvall H, Taubøll E, Maestú F, Haraldsen IH. Source-level EEG and graph theory reveal widespread functional network alterations in focal epilepsy. Clin Neurophysiol 2021; 132:1663-1676. [PMID: 34044189 DOI: 10.1016/j.clinph.2021.04.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 03/19/2021] [Accepted: 04/20/2021] [Indexed: 01/15/2023]
Abstract
OBJECTIVE The hypersynchronous neuronal activity associated with epilepsy causes widespread functional network disruptions extending beyond the epileptogenic zone. This altered network topology is considered a mediator for non-seizure symptoms, such as cognitive impairment. The aim of this study was to investigate functional network alterations in focal epilepsy patients with good seizure control and high quality of life. METHODS We compared twenty-two focal epilepsy patients and sixteen healthy controls on graph metrics derived from functional connectivity of source-level resting-state EEG. Graph metrics were calculated over a range of network densities in five frequency bands. RESULTS We observed a significantly increased small world index in patients relative to controls. On the local level, two left-hemisphere regions displayed a shift towards greater alpha band "hubness". The findings were not mediated by age, sex or education, nor by age of epilepsy onset, duration or focus lateralisation. CONCLUSIONS Widespread functional network alterations are evident in focal epilepsy, even in a cohort characterised by successful anti-seizure medication therapy and high quality of life. These findings might support the position that functional network analysis could hold clinical relevance for epilepsy. SIGNIFICANCE Focal epilepsy is accompanied by global and local functional network aberrancies which might be implied in the sustenance of non-seizure symptoms.
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Affiliation(s)
| | - Ricardo Bruña
- Center for Biomedical Technology, Technical University of Madrid, Pozuelo de Alarcón, Spain; Department of Experimental Psychology, Complutense University of Madrid, Pozuelo de Alarcón, Spain; Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain.
| | - Marte Roa Syvertsen
- Department of Neurology, Drammen Hospital, Vestre Viken Health Care Trust, Drammen, Norway.
| | - Aksel Erichsen
- Department of Neurology, Oslo University Hospital, Oslo, Norway; Department of Nuclear Medicine, Oslo University Hospital, Oslo, Norway.
| | | | - Fabrizio Vecchio
- Brain Connectivity Laboratory, Department of Neuroscience and Neurorehabilitation, IRCCS San Raffaele Pisana, Rome, Italy.
| | - Francesca Miraglia
- Brain Connectivity Laboratory, Department of Neuroscience and Neurorehabilitation, IRCCS San Raffaele Pisana, Rome, Italy.
| | - Paolo M Rossini
- Brain Connectivity Laboratory, Department of Neuroscience and Neurorehabilitation, IRCCS San Raffaele Pisana, Rome, Italy.
| | - Hanna Renvall
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland; BioMag Laboratory, HUS Diagnostic Center, Helsinki University Hospital, University of Helsinki and Aalto University School of Science, Helsinki, Finland.
| | - Erik Taubøll
- Department of Neurology, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Fernando Maestú
- Center for Biomedical Technology, Technical University of Madrid, Pozuelo de Alarcón, Spain; Department of Experimental Psychology, Complutense University of Madrid, Pozuelo de Alarcón, Spain; Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain.
| | - Ira H Haraldsen
- Department of Neurology, Oslo University Hospital, Oslo, Norway.
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21
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Kukla B, Anthony M, Chen S, Turnbull A, Baran TM, Lin FV. Brain Small-Worldness Properties and Perceived Fatigue in Mild Cognitive Impairment. J Gerontol A Biol Sci Med Sci 2021; 77:541-546. [PMID: 33733662 DOI: 10.1093/gerona/glab084] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Perceived fatigue is among the most common complaints in older adults and is substantially influenced by diminished resources or impaired structure of widespread cortical and subcortical regions. Alzheimer's disease and its preclinical stage - mild cognitive impairment (MCI) - is considered a brain network disease. It is unknown, however, whether those with MCI will therefore perceive worse fatigue, and whether an impaired global brain network will worsen their experience of fatigue. METHODS In this pilot case-control study of age-, sex-, and education-matched MCI and their cognitively healthy counterparts (HC), perceived fatigue was measured using Multidimensional Fatigue Inventory, and diffusion tensor imaging (DTI) tractography data was analyzed using graph theory methods to explore small-worldness properties: segregation and integration. RESULTS Perceived fatigue was more severe in MCI than HC. Despite a trend for greater network alterations in MCI, there were no significant group differences in integration or segregation. Greater perceived fatigue was related to higher segregation across groups; more perceived fatigue was related to higher segregation and lower integration in MCI but not HC. CONCLUSIONS Findings of the present study support the notion that altered whole-brain small-worldness properties in brain aging or neurodegeneration may underpin perceived fatigue.
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Affiliation(s)
| | - Mia Anthony
- Department of Brain and Cognitive Sciences, University of Rochester
| | - Shuyi Chen
- Department of Brain and Cognitive Sciences, University of Rochester
| | - Adam Turnbull
- Department of Imaging Sciences, University of Rochester.,Elaine C. Hubbard Center for Nursing Research on Aging, University of Rochester
| | | | - Feng V Lin
- Department of Brain and Cognitive Sciences, University of Rochester.,Elaine C. Hubbard Center for Nursing Research on Aging, University of Rochester.,Department of Psychiatry, University of Rochester.,Department of Neuroscience, University of Rochester.,Department of Neurology, University of Rochester
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22
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Nakai Y, Nishibayashi H, Donishi T, Terada M, Nakao N, Kaneoke Y. Regional abnormality of functional connectivity is associated with clinical manifestations in individuals with intractable focal epilepsy. Sci Rep 2021; 11:1545. [PMID: 33452388 PMCID: PMC7810833 DOI: 10.1038/s41598-021-81207-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 01/04/2021] [Indexed: 01/29/2023] Open
Abstract
We explored regional functional connectivity alterations in intractable focal epilepsy brains using resting-state functional MRI. Distributions of the network parameters (corresponding to degree and eigenvector centrality) measured at each brain region for all 25 patients were significantly different from age- and sex-matched control data that were estimated by a healthy control dataset (n = 582, 18-84 years old). The number of abnormal regions whose parameters exceeded the mean + 2 SD of age- and sex-matched data for each patient were associated with various clinical parameters such as the duration of illness and seizure severity. Furthermore, abnormal regions for each patient tended to have functional connections with each other (mean ± SD = 58.6 ± 20.2%), the magnitude of which was negatively related to the quality of life. The abnormal regions distributed within the default mode network with significantly higher probability (p < 0.05) in 7 of 25 patients. We consider that the detection of abnormal regions by functional connectivity analysis using a large number of control datasets is useful for the numerical assessment of each patient's clinical conditions, although further study is necessary to elucidate etiology-specific abnormalities.
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Affiliation(s)
- Yasuo Nakai
- Department of Neurological Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8509, Japan.
| | - Hiroki Nishibayashi
- Department of Neurological Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8509, Japan
| | - Tomohiro Donishi
- Department of System Neurophysiology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8509, Japan
| | - Masaki Terada
- Wakayama-Minami Radiology Clinic, 870-2 Kimiidera, Wakayama, 641-0012, Japan
| | - Naoyuki Nakao
- Department of Neurological Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8509, Japan
| | - Yoshiki Kaneoke
- Department of System Neurophysiology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8509, Japan
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23
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Zhang J, Cheng J, Yang H. Effects of Rivastigmine on Brain Functional Networks in Patients With Alzheimer Disease Based on the Graph Theory. Clin Neuropharmacol 2021; 44:9-16. [PMID: 33337622 DOI: 10.1097/WNF.0000000000000427] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to explore the effect of rivastigmine on brain function in Alzheimer disease (AD) by analyzing brain functional network based on the graph theory. METHODS We enrolled 9 patients with mild to moderate AD who received rivastigmine treatment and 9 healthy controls (HC). Subsequently, we used resting-state functional magnetic resonance imaging data to establish the whole-brain functional network using a graph theory-based analysis. Furthermore, we compared systemic and local network indicators between pre- and posttreatment. RESULTS Patients with AD exhibited a posttreatment increase in the Mini-Mental State Examination scores and a decrease in the Alzheimer's Disease Assessment Scale cognitive subscale scores and activities of daily living. The systemic network for HC and patients with AD had good pre- and posttreatment clustering coefficients. There was no change in the Cp, Lp, Gamma, Lambda, and Sigma in patients with AD. There were no significant between-group differences in the pre- and posttreatment systemic network measures. Regarding the regional network, patients with AD showed increased betweenness centrality in the bilateral caudate nucleus and right superior temporal pole after treatment with rivastigmine. However, there was no between-group difference in the pre- and posttreatment betweenness centrality of these regions. There were no significant correlations between regional network measure changes and clinical score alterations in patients with AD. CONCLUSIONS There are similar systemic network properties between patients with AD and HC. Rivastigmine cannot alter systemic network attributes in patients with AD. However, it improves the topological properties of regional networks and between-node information transmission in patients with AD.
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Liang X, Pang X, Liu J, Zhao J, Yu L, Zheng J. Comparison of topological properties of functional brain networks with graph theory in temporal lobe epilepsy with different duration of disease. Ann Transl Med 2020; 8:1503. [PMID: 33313248 PMCID: PMC7729351 DOI: 10.21037/atm-20-6823] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background Our study was performed to measure the alterations in topological properties of the functional brain network of temporal lobe epilepsy (TLE) at different durations, exploring the potential progression and neuropathophysiological mechanisms of TLE. Methods Fifty-eight subjects, including 17 TLE patients with a disease duration of ≤5 years (TLE-SD), 20 TLE patients with a disease duration of >5 years (TLE-LD), and 21 healthy controls firstly underwent the Attention Network Test (ANT) to assess the alertness function and received the resting-state functional magnetic resonance imaging (rs-fMRI). Next, a functional brain network was set up, and then the related graph of theoretical network analysis was conducted. Finally, the correlation between network property and the neuropsychological score was analyzed. Results The global and local efficiencies of functional brain networks in TLE-SD patients significantly decreased and tended toward random alterations. Also, the degree centrality (DC) and nodal efficiency (Ne) in right medial pre-frontal thalamus (mPFtha) and right rostral temporal thalamus (rTtha) of TLE-SD patients significantly reduced. Further analysis showed that alertness was positively associated with the characteristic path length but negatively related to the global and local efficiencies in TLE-SD patients; alertness was negatively related to the Ne of mPFtha in TLE-LD patients. Conclusions Our study showed that the functional brain network of TLE patients might undergo compensatory reorganization as the disease progresses, which provides useful insights into the progression and mechanism of TLE.
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Affiliation(s)
- Xiulin Liang
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xiaomin Pang
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jinping Liu
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jingyuan Zhao
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Lu Yu
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jinou Zheng
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
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Sangare A, Marchi A, Pruvost-Robieux E, Soufflet C, Crepon B, Ramdani C, Chassoux F, Turak B, Landre E, Gavaret M. The Effectiveness of Vagus Nerve Stimulation in Drug-Resistant Epilepsy Correlates with Vagus Nerve Stimulation-Induced Electroencephalography Desynchronization. Brain Connect 2020; 10:566-577. [PMID: 33073582 PMCID: PMC7757623 DOI: 10.1089/brain.2020.0798] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Introduction: VNS is an adjunctive neuromodulation therapy for patients with drug-refractory epilepsy. The antiseizure effect of VNS is thought to be related to a diffuse modulation of functional connectivity but remains to be confirmed. Aim: To investigate electroencephalographic (EEG) metrics of functional connectivity in patients with drug-refractory epilepsy treated by vagus nerve stimulation (VNS), between VNS-stimulated “ON” and nonstimulated “OFF” periods and between responder (R) and nonresponder (NR) patients. Methods: Scalp-EEG was performed for 35 patients treated by VNS, using 21 channels and 2 additional electrodes on the neck to detect the VNS stimulation. Patients were defined as VNS responders if a reduction of seizure frequency of ∼50% was documented. We analyzed the synchronization in EEG time series during “ON” and “OFF” periods of stimulation, using average phase lag index (PLI) in signal space and phase-locking value (PLV) between 10 sources. Based on graph theory, we computed brain network models and analyzed minimum spanning tree (MST) for responder and nonresponder patients. Results: Among 35 patients treated by VNS for a median time of 7 years (range 4 months to 22 years), 20 were R and 15 were NR. For responder patients, PLI during ON periods was significantly lower than that during OFF periods in delta (p = 0.009), theta (p = 0.02), and beta (p = 0.04) frequency bands. For nonresponder patients, there were no significant differences between ON and OFF periods. Moreover, variations of seizure frequency with VNS correlated with the PLI OFF/ON ratio in delta (p = 0.02), theta (p = 0.04), and beta (p = 0.03) frequency bands. Our results were confirmed using PLV in theta band (p < 0.05). No significant differences in MST were observed between R and NR patients. Conclusion: The correlation between VNS-induced interictal EEG time-series desynchronization and decrease in seizure frequency suggested that VNS therapeutic impact might be related to changes in interictal functional connectivity.
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Affiliation(s)
- Aude Sangare
- Neurophysiology Department, GHU Paris Psychiatrie et Neurosciences, Sainte-Anne Hospital, Paris, France
| | - Angela Marchi
- Neurophysiology Department, GHU Paris Psychiatrie et Neurosciences, Sainte-Anne Hospital, Paris, France
| | - Estelle Pruvost-Robieux
- Neurophysiology Department, GHU Paris Psychiatrie et Neurosciences, Sainte-Anne Hospital, Paris, France.,Université de Paris, Paris, France
| | - Christine Soufflet
- Neurophysiology Department, GHU Paris Psychiatrie et Neurosciences, Sainte-Anne Hospital, Paris, France
| | - Benoit Crepon
- Neurophysiology Department, GHU Paris Psychiatrie et Neurosciences, Sainte-Anne Hospital, Paris, France
| | - Céline Ramdani
- Institut de Recherche Biomédicale des Armées (IRBA), Paris, France
| | - Francine Chassoux
- Neurosurgery and Epileptology Department, GHU Paris Psychiatrie et Neurosciences, Sainte-Anne Hospital, Paris, France
| | - Baris Turak
- Neurosurgery and Epileptology Department, GHU Paris Psychiatrie et Neurosciences, Sainte-Anne Hospital, Paris, France
| | - Elisabeth Landre
- Neurosurgery and Epileptology Department, GHU Paris Psychiatrie et Neurosciences, Sainte-Anne Hospital, Paris, France
| | - Martine Gavaret
- Neurophysiology Department, GHU Paris Psychiatrie et Neurosciences, Sainte-Anne Hospital, Paris, France.,Université de Paris, Paris, France.,INSERM UMR 1266, IPNP, Paris, France
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Jiang S, Luo C, Huang Y, Li Z, Chen Y, Li X, Pei H, Wang P, Wang X, Yao D. Altered Static and Dynamic Spontaneous Neural Activity in Drug-Naïve and Drug-Receiving Benign Childhood Epilepsy With Centrotemporal Spikes. Front Hum Neurosci 2020; 14:361. [PMID: 33005141 PMCID: PMC7485420 DOI: 10.3389/fnhum.2020.00361] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 08/07/2020] [Indexed: 11/13/2022] Open
Abstract
The present study aims to investigate intrinsic abnormalities of brain and the effect of antiepileptic treatment on brain activity in Benign childhood epilepsy with centrotemporal spikes (BECTS). Twenty-six drug-naïve patients (DNP) and 22 drug-receiving patients (DRP) with BECTS were collected in this study. Static amplitude of low frequency fluctuation (sALFF) and dynamic ALFF (dALFF) were applied to resting-state fMRI data. Functional connectivity (FC) analysis was further performed for affected regions identified by static and dynamic analysis. One-way analysis of variance and post hoc statistical analyses were performed for between-group differences. Abnormal sALFF and dALFF values were correlated with clinical features of patients. Compared with healthy controls (HC), DNP group demonstrated alterations of sALFF and/or dALFF in medial prefrontal cortex (MPFC), supplementary motor areas (SMA), cerebellum, hippocampus, pallidum and cingulate cortex, in which the values were close to normal in DRP. Notably, sALFF and dALFF showed specific sensitivity in detecting abnormalities in basal ganglia and cerebellum. Additionally, DRP showed additional changes in precuneus, inferior temporal gyrus, superior frontal gyrus and occipital visual cortex. Compared with HC, the DNP showed increased FC in default network and motion-related networks, and the DRP showed decreased FC in default network. The MPFC, hippocampus, SMA, basal ganglia and cerebellum are indicated to be intrinsically affected regions and effective therapeutic targets. And the FC profiles of default and motion-related networks might be potential core indicators for clinical treatment. This study revealed potential neuromodulatory targets and helped understand pathomechanism of BECTS. Static and dynamic analyses should be combined to investigate neuropsychiatric disorders.
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Affiliation(s)
- Sisi Jiang
- The Clinical Hospital of Chengdu Brain Science Institute, Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Sciences and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Cheng Luo
- The Clinical Hospital of Chengdu Brain Science Institute, Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Sciences and Technology, University of Electronic Science and Technology of China, Chengdu, China
- Research Unit of NeuroInformation, Chinese Academy of Medical Sciences, Chengdu, China
| | - Yang Huang
- The Clinical Hospital of Chengdu Brain Science Institute, Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Sciences and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Zhiliang Li
- The Clinical Hospital of Chengdu Brain Science Institute, Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Sciences and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Yan Chen
- The Clinical Hospital of Chengdu Brain Science Institute, Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Sciences and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiangkui Li
- The Clinical Hospital of Chengdu Brain Science Institute, Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Sciences and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Haonan Pei
- The Clinical Hospital of Chengdu Brain Science Institute, Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Sciences and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Pingfu Wang
- The Clinical Hospital of Chengdu Brain Science Institute, Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Sciences and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiaoming Wang
- Department of Neurology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Dezhong Yao
- The Clinical Hospital of Chengdu Brain Science Institute, Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Sciences and Technology, University of Electronic Science and Technology of China, Chengdu, China
- Research Unit of NeuroInformation, Chinese Academy of Medical Sciences, Chengdu, China
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Pourmotabbed H, Wheless JW, Babajani-Feremi A. Lateralization of epilepsy using intra-hemispheric brain networks based on resting-state MEG data. Hum Brain Mapp 2020; 41:2964-2979. [PMID: 32400923 PMCID: PMC7336137 DOI: 10.1002/hbm.24990] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 03/07/2020] [Accepted: 03/10/2020] [Indexed: 12/31/2022] Open
Abstract
Focal epilepsy originates within networks in one hemisphere. However, previous studies have investigated network topologies for the entire brain. In this study, magnetoencephalography (MEG) was used to investigate functional intra‐hemispheric networks of healthy controls (HCs) and patients with left‐ or right‐hemispheric temporal lobe or temporal plus extra‐temporal lobe epilepsy. 22 HCs, 25 left patients (LPs), and 16 right patients (RPs) were enrolled. The debiased weighted phase lag index was used to calculate functional connectivity between 246 brain regions in six frequency bands. Global efficiency, characteristic path length, and transitivity were computed for left and right intra‐hemispheric networks. The right global graph measures (GGMs) in the theta band were significantly different (p < .005) between RPs and both LPs and HCs. Right and left GGMs in higher frequency bands were significantly different (p < .05) between HCs and the patients. Right GGMs were used as input features of a Naïve‐Bayes classifier to classify LPs and RPs (78.0% accuracy) and all three groups (75.5% accuracy). The complete theta band brain networks were compared between LPs and RPs with network‐based statistics (NBS) and with the clustering coefficient (CC), nodal efficiency (NE), betweenness centrality (BC), and eigenvector centrality (EVC). NBS identified a subnetwork primarily composed of right intra‐hemispheric connections. Significantly different (p < .05) nodes were primarily in the right hemisphere for the CC and NE and primarily in the left hemisphere for the BC and EVC. These results indicate that intra‐hemispheric MEG networks may be incorporated in the diagnosis and lateralization of focal epilepsy.
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Affiliation(s)
- Haatef Pourmotabbed
- Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center, Memphis, Tennessee, USA.,Department of Biomedical Engineering, University of Memphis, Memphis, Tennessee, USA.,Department of Pediatrics, Division of Pediatric Neurology, University of Tennessee Health Science Center, Memphis, Tennessee, USA.,Neuroscience Institute & Le Bonheur Comprehensive Epilepsy Program, Le Bonheur Children's Hospital, Memphis, Tennessee, USA
| | - James W Wheless
- Department of Pediatrics, Division of Pediatric Neurology, University of Tennessee Health Science Center, Memphis, Tennessee, USA.,Neuroscience Institute & Le Bonheur Comprehensive Epilepsy Program, Le Bonheur Children's Hospital, Memphis, Tennessee, USA
| | - Abbas Babajani-Feremi
- Department of Biomedical Engineering, University of Memphis, Memphis, Tennessee, USA.,Department of Pediatrics, Division of Pediatric Neurology, University of Tennessee Health Science Center, Memphis, Tennessee, USA.,Neuroscience Institute & Le Bonheur Comprehensive Epilepsy Program, Le Bonheur Children's Hospital, Memphis, Tennessee, USA.,Department of Anatomy and Neurobiology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
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Ueda R, Matsuda H, Sato N, Iwasaki M, Sone D, Takeshita E, Shimizu-Motohashi Y, Ishiyama A, Saito T, Komaki H, Nakagawa E, Sugai K, Sasaki M, Kaga Y, Takeichi H, Inagaki M. Alteration of the anatomical covariance network after corpus callosotomy in pediatric intractable epilepsy. PLoS One 2019; 14:e0222876. [PMID: 31805047 DOI: 10.1371/journal.pone.0222876] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 09/08/2019] [Indexed: 12/20/2022] Open
Abstract
PURPOSE This study aimed to use graph theoretical analysis of anatomical covariance derived from structural MRI to reveal how the gray matter connectivity pattern is altered after corpus callosotomy (CC). MATERIALS AND METHODS We recruited 21 patients with epilepsy who had undergone CC. Enrollment criteria were applied: (1) no lesion identified on brain MRI; (2) no history of other brain surgery; and (3) age not younger than 3 years and not older than 18 years at preoperative MRI evaluation. The most common epilepsy syndrome was Lennox-Gastaut syndrome (11 patients). For voxel-based morphometry, the normalized gray matter images of pre-CC and post-CC patients were analyzed with SPM12 (voxel-level threshold of p<0.05 [familywise error-corrected]). Secondly, the images of both groups were subjected to graph theoretical analysis using the Graph Analysis Toolbox with SPM8. Each group was also compared with 32 age- and sex-matched control patients without brain diseases. RESULTS Comparisons between the pre- and post-CC groups revealed a significant reduction in seizure frequency with no change in mean intelligence quotient/developmental quotient levels. There was no relationship among the three groups in global network metrics or in targeted attack. A regional comparison of betweenness centrality revealed decreased connectivity to and from the right middle cingulate gyri and medial side of the right superior frontal gyrus and a partial shift in the distribution of betweenness centrality hubs to the normal location. Significantly lower resilience to random failure was found after versus before CC and versus controls (p = 0.0450 and p = 0.0200, respectively). CONCLUSION Graph theoretical analysis of anatomical covariance derived from structural imaging revealed two neural network effects of resection associated with seizure reduction: the reappearance of a structural network comparable to that in healthy children and reduced connectivity along the median line, including the middle cingulate gyrus.
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Abstract
Pharmacological treatment with antiepileptic medications (AEDs) in epilepsy is associated with a variety of neurocognitive side effects. However, the mechanisms underlying these side effects, and why certain brain anatomies are more affected still remain poorly understood. Advanced functional magnetic resonance imaging (fMRI) methods, such as pharmaco-fMRI, can investigate medication-related effects on brain activities using task and resting state fMRI and showing reproducible activation and deactivation patterns. This methodological approach has been used successfully to complement neuropsychological studies of AEDs. Here we review pharmaco-fMRI studies in people with epilepsy targeting the most-widely prescribed AEDs. Pharmco-fMRI has advanced our understanding of the impact of AEDs on specific brain networks and thus may provide potential biomarkers to move beyond the current “trial and error” approach when commencing anti-epileptic medication.
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Affiliation(s)
- Fenglai Xiao
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, China
| | - Matthias J Koepp
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, United Kingdom.,MRI Unit, Epilepsy Society, Chalfont St Peter, United Kingdom
| | - Dong Zhou
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, China
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30
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Roger E, Pichat C, Torlay L, David O, Renard F, Banjac S, Attyé A, Minotti L, Lamalle L, Kahane P, Baciu M. Hubs disruption in mesial temporal lobe epilepsy. A resting-state fMRI study on a language-and-memory network. Hum Brain Mapp 2019; 41:779-796. [PMID: 31721361 PMCID: PMC7268007 DOI: 10.1002/hbm.24839] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 09/23/2019] [Accepted: 10/09/2019] [Indexed: 12/13/2022] Open
Abstract
Mesial temporal lobe epilepsy (mTLE) affects the brain networks at several levels and patients suffering from mTLE experience cognitive impairment for language and memory. Considering the importance of language and memory reorganization in this condition, the present study explores changes of the embedded language‐and‐memory network (LMN) in terms of functional connectivity (FC) at rest, as measured with functional MRI. We also evaluate the cognitive efficiency of the reorganization, that is, whether or not the reorganizations support or allow the maintenance of optimal cognitive functioning despite the seizure‐related damage. Data from 37 patients presenting unifocal mTLE were analyzed and compared to 48 healthy volunteers in terms of LMN‐FC using two methods: pairwise correlations (region of interest [ROI]‐to‐ROI) and graph theory. The cognitive efficiency of the LMN‐FC reorganization was measured using correlations between FC parameters and language and memory scores. Our findings revealed a large perturbation of the LMN hubs in patients. We observed a hyperconnectivity of limbic areas near the dysfunctional hippocampus and mainly a hypoconnectivity for several cortical regions remote from the dysfunctional hippocampus. The loss of FC was more important in left mTLE (L‐mTLE) than in right (R‐mTLE) patients. The LMN‐FC reorganization may not be always compensatory and not always useful for patients as it may be associated with lower cognitive performance. We discuss the different connectivity patterns obtained and conclude that interpretation of FC changes in relation to neuropsychological scores is important to determine cognitive efficiency, suggesting the concept of “connectome” would gain to be associated with a “cognitome” concept.
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Affiliation(s)
- Elise Roger
- LPNC, CNRS, UMR 5105, University Grenoble Alpes, Grenoble, France
| | - Cedric Pichat
- LPNC, CNRS, UMR 5105, University Grenoble Alpes, Grenoble, France
| | - Laurent Torlay
- LPNC, CNRS, UMR 5105, University Grenoble Alpes, Grenoble, France
| | - Olivier David
- Grenoble Institute of Neuroscience, INSERM, Brain Stimulation and System Neuroscience, University Grenoble Alpes, Grenoble, France
| | | | - Sonja Banjac
- LPNC, CNRS, UMR 5105, University Grenoble Alpes, Grenoble, France
| | | | - Lorella Minotti
- Grenoble Institute of Neuroscience, Synchronisation et Modulation des Réseaux Neuronaux dans l'Epilepsie and Neurology Department, University Grenoble Alpes, Grenoble, France
| | | | - Philippe Kahane
- Grenoble Institute of Neuroscience, Synchronisation et Modulation des Réseaux Neuronaux dans l'Epilepsie and Neurology Department, University Grenoble Alpes, Grenoble, France
| | - Monica Baciu
- LPNC, CNRS, UMR 5105, University Grenoble Alpes, Grenoble, France
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31
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Kim JH, Kim JB, Suh S. Alteration of cerebello-thalamocortical spontaneous low-frequency oscillations in juvenile myoclonic epilepsy. Acta Neurol Scand 2019; 140:252-258. [PMID: 31177545 DOI: 10.1111/ane.13138] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 05/26/2019] [Accepted: 06/05/2019] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Altered thalamocortical network has been proposed to play a pivotal role in the principal pathophysiology underlying juvenile myoclonic epilepsy (JME). Recently, resting-state fMRI studies have provided converging evidence for thalamocortical dysconnectivity in patients with JME. Herein, we investigated the amplitude and spatial distribution of spontaneous low-frequency oscillations using analysis of fractional amplitude of low-frequency fluctuation (fALFF) in a large group of JME patients in comparison with controls. METHODS Volumetric MRI and resting-state fMRI were acquired in 75 patients with JME and 62 matched controls. After preprocessing of MRI data, fALFF was computed and then Z-transformed for standardization. fALFF was compared between controls and patients, and correlation analysis between regional fALFF and clinical parameters were performed in patients. RESULTS Compared with controls, JME patients revealed significant fALFF increases in the bilateral medial thalamus, insular cortex/inferior frontal gyrus, and cerebellum vermis (false discovery rate-corrected P < 0.05). There was no region of fALFF reduction in JME patients relative to controls. No significant correlation was observed between regional fALFF and disease duration or cumulative number of generalized tonic-clonic seizures. CONCLUSIONS We have shown alterations of low-frequency oscillations in the thalamus, insular cortex/inferior frontal gyrus, and cerebellum in patients with JME, implicating cerebello-thalamocortical network abnormality in the pathophysiology underlying JME. Our results could further support the recent concept that JME is a network epilepsy involving specific cortical and subcortical structures, especially the cerebello-thalamocortical network.
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Affiliation(s)
- Ji Hyun Kim
- Department of Neurology Korea University Guro Hospital, Korea University College of Medicine Seoul Korea
| | - Jung Bin Kim
- Department of Neurology Korea University Anam Hospital, Korea University College of Medicine Seoul Korea
| | - Sang‐il Suh
- Department of Radiology Korea University Guro Hospital, Korea University College of Medicine Seoul Korea
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He X, Bassett DS, Chaitanya G, Sperling MR, Kozlowski L, Tracy JI. Disrupted dynamic network reconfiguration of the language system in temporal lobe epilepsy. Brain 2019; 141:1375-1389. [PMID: 29554279 DOI: 10.1093/brain/awy042] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 01/05/2018] [Indexed: 11/12/2022] Open
Abstract
Temporal lobe epilepsy tends to reshape the language system causing maladaptive reorganization that can be characterized by task-based functional MRI, and eventually can contribute to surgical decision making processes. However, the dynamic interacting nature of the brain as a complex system is often neglected, with many studies treating the language system as a static monolithic structure. Here, we demonstrate that as a specialized and integrated system, the language network is inherently dynamic, characterized by rich patterns of regional interactions, whose transient dynamics are disrupted in patients with temporal lobe epilepsy. Specifically, we applied tools from dynamic network neuroscience to functional MRI data collected from 50 temporal lobe epilepsy patients and 30 matched healthy controls during performance of a verbal fluency task, as well as during rest. By assigning 16 language-related regions into four subsystems (i.e. bilateral frontal and temporal), we observed regional specialization in both the probability of transient interactions and the frequency of such changes, in both healthy controls and patients during task performance but not rest. Furthermore, we found that both left and right temporal lobe epilepsy patients displayed reduced interactions within the left frontal 'core' subsystem compared to the healthy controls, while left temporal lobe epilepsy patients were unique in showing enhanced interactions between the left frontal 'core' and the right temporal subsystems. Also, both patient groups displayed reduced flexibility in the transient interactions of the left temporal and right frontal subsystems, which formed the 'periphery' of the language network. Importantly, such group differences were again evident only during task condition. Lastly, through random forest regression, we showed that dynamic reconfiguration of the language system tracks individual differences in verbal fluency with superior prediction accuracy compared to traditional activation-based static measures. Our results suggest dynamic network measures may be an effective biomarker for detecting the language dysfunction associated with neurological diseases such as temporal lobe epilepsy, specifying both the type of neuronal communications that are missing in these patients and those that are potentially added but maladaptive. Further advancements along these lines, transforming how we characterize and map language networks in the brain, have a high probability of altering clinical decision making in neurosurgical centres.10.1093/brain/awy042_video1awy042media15754656112001.
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Affiliation(s)
- Xiaosong He
- Department of Neurology, Thomas Jefferson University, Philadelphia, PA, 19107, USA
| | - Danielle S Bassett
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, 19104, USA.,Department of Physics & Astronomy, University of Pennsylvania, Philadelphia, PA, 19104, USA.,Department of Electrical & Systems Engineering, University of Pennsylvania, Philadelphia, PA, 19104, USA.,Department of Neurology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Ganne Chaitanya
- Department of Neurology, Thomas Jefferson University, Philadelphia, PA, 19107, USA
| | - Michael R Sperling
- Department of Neurology, Thomas Jefferson University, Philadelphia, PA, 19107, USA
| | - Lauren Kozlowski
- Department of Neurology, Thomas Jefferson University, Philadelphia, PA, 19107, USA
| | - Joseph I Tracy
- Department of Neurology, Thomas Jefferson University, Philadelphia, PA, 19107, USA
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Vaculik MF, Noorani A, Hung PSP, Hodaie M. Selective hippocampal subfield volume reductions in classic trigeminal neuralgia. Neuroimage Clin 2019; 23:101911. [PMID: 31491821 PMCID: PMC6616529 DOI: 10.1016/j.nicl.2019.101911] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 05/24/2019] [Accepted: 06/25/2019] [Indexed: 12/26/2022]
Abstract
Trigeminal Neuralgia (TN) is a chronic neuropathic pain syndrome characterized by paroxysmal unilateral shock-like pains in the trigeminal territory most frequently attributed to neurovascular compression of the trigeminal nerve at its root entry zone. Recent advances in the study of TN suggest a possible central nervous system (CNS) role in modulation and maintenance of pain. TN and other chronic pain patients commonly experience alterations in cognition and affect, as well as abnormalities in CNS volume and microstructure in regions associated with pain perception, emotional modulation, and memory consolidation. However, the microstructural changes in the hippocampus, an important structure within the limbic system, have not been previously studied in TN patients. Here, we use grey matter analysis to assess whether TN pain is associated with altered hippocampal subfield volume in patients with classic TN. Anatomical magnetic resonance (MR) images of twenty-two right-sided TN patients and matched healthy controls underwent automated segmentation of hippocampal subfields using FreeSurfer v6.0. Right-sided TN patients had significant volumetric reductions in ipsilateral cornu ammois 1 (CA1), CA4, dentate gyrus, molecular layer, and hippocampus-amygdala transition area – resulting in decreased whole ipsilateral hippocampal volume, compared to healthy controls. Overall, we demonstrate selective hippocampal subfield volume reduction in patients with classic TN. These changes occur in subfields implicated as neural circuits for chronic pain processing. Selective subfield volume reduction suggests aberrant processes and circuitry reorganization, which may contribute to development and/or maintenance of TN symptoms. Selective Hippocampal subfields alteration in trigeminal neuralgia patients Ipsilateral hippocampal volume reduction in TN patients Females but not males show bilateral hippocampal volume reduction. Pain duration correlates with hippocampal volume reduction. Abnormal neurogenesis could explain hippocampal alterations.
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Affiliation(s)
- Michael Frantisek Vaculik
- Dalhousie Medical School, Dalhousie University, Halifax, Nova Scotia, Canada; Division of Brain, Imaging, and Behaviour - Systems Neuroscience, Krembil Brain Institute, Toronto Western Hospital, University Health Network, Ontario, Canada; Department of Surgery and Institute of Medical Science, Faculty of Medicine, University of Toronto, Ontario, Canada
| | - Alborz Noorani
- Division of Brain, Imaging, and Behaviour - Systems Neuroscience, Krembil Brain Institute, Toronto Western Hospital, University Health Network, Ontario, Canada; Department of Surgery and Institute of Medical Science, Faculty of Medicine, University of Toronto, Ontario, Canada; Collaborative Program in Neuroscience, University of Toronto, Ontario, Canada
| | - Peter Shih-Ping Hung
- Division of Brain, Imaging, and Behaviour - Systems Neuroscience, Krembil Brain Institute, Toronto Western Hospital, University Health Network, Ontario, Canada; Department of Surgery and Institute of Medical Science, Faculty of Medicine, University of Toronto, Ontario, Canada; Collaborative Program in Neuroscience, University of Toronto, Ontario, Canada
| | - Mojgan Hodaie
- Division of Brain, Imaging, and Behaviour - Systems Neuroscience, Krembil Brain Institute, Toronto Western Hospital, University Health Network, Ontario, Canada; Department of Surgery and Institute of Medical Science, Faculty of Medicine, University of Toronto, Ontario, Canada; Collaborative Program in Neuroscience, University of Toronto, Ontario, Canada; Division of Neurosurgery, Toronto Western Hospital, University Health Network, Ontario, Canada.
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He Y, Yang F, Yu Y, Grebogi C. Link Prediction Investigation of Dynamic Information Flow in Epilepsy. J Healthc Eng 2018; 2018:8102597. [PMID: 30057733 DOI: 10.1155/2018/8102597] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 02/03/2018] [Accepted: 04/19/2018] [Indexed: 12/27/2022]
Abstract
As a brain disorder, epilepsy is characterized with abnormal hypersynchronous neural firings. It is known that seizures initiate and propagate in different brain regions. Long-term intracranial multichannel electroencephalography (EEG) reflects broadband ictal activity under seizure occurrence. Network-based techniques are efficient in discovering brain dynamics and offering finger-print features for specific individuals. In this study, we adopt link prediction for proposing a novel workflow aiming to quantify seizure dynamics and uncover pathological mechanisms of epilepsy. A dataset of EEG signals was enrolled that recorded from 8 patients with 3 different types of pharmocoresistant focal epilepsy. Weighted networks are obtained from phase locking value (PLV) in subband EEG oscillations. Common neighbor (CN), resource allocation (RA), Adamic-Adar (AA), and Sorenson algorithms are brought in for link prediction performance comparison. Results demonstrate that RA outperforms its rivals. Similarity, matrix was produced from the RA technique performing on EEG networks later. Nodes are gathered to form sequences by selecting the ones with the highest similarity. It is demonstrated that variations are in accordance with seizure attack in node sequences of gamma band EEG oscillations. What is more, variations in node sequences monitor the total seizure journey including its initiation and termination.
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Xiao F, Caciagli L, Wandschneider B, Sander JW, Sidhu M, Winston G, Burdett J, Trimmel K, Hill A, Vollmar C, Vos SB, Ourselin S, Thompson PJ, Zhou D, Duncan JS, Koepp MJ. Effects of carbamazepine and lamotrigine on functional magnetic resonance imaging cognitive networks. Epilepsia 2018; 59:1362-1371. [PMID: 29897625 PMCID: PMC6216427 DOI: 10.1111/epi.14448] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2018] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To investigate the effects of sodium channel-blocking antiepileptic drugs (AEDs) on functional magnetic resonance imaging (fMRI) language network activations in patients with focal epilepsy. METHODS In a retrospective study, we identified patients who were treated at the time of language fMRI scanning with either carbamazepine (CBZ; n = 42) or lamotrigine (LTG; n = 42), but not another sodium channel-blocking AED. We propensity-matched 42 patients taking levetiracetam (LEV) as "patient-controls" and included further 42 age- and gender-matched healthy controls. After controlling for age, age at onset of epilepsy, gender, and antiepileptic comedications, we compared verbal fluency fMRI activations between groups and out-of-scanner psychometric measures of verbal fluency. RESULTS Patients on CBZ performed less well on a verbal fluency tests than those taking LTG or LEV. Compared to either LEV-treated patients or controls, patients taking CBZ showed decreased activations in left inferior frontal gyrus and patients on LTG showed abnormal deactivations in frontal and parietal default mode areas. All patient groups showed fewer activations in the putamen bilaterally compared to controls. In a post hoc analysis, out-of-scanner fluency scores correlated positively with left putamen activation. SIGNIFICANCE Our study provides evidence of AED effects on the functional neuroanatomy of language, which might explain subtle language deficits in patients taking otherwise well-tolerated sodium channel-blocking agents. Patients on CBZ showed dysfunctional frontal activation and more pronounced impairment of performance than patients taking LTG, which was associated only with failure to deactivate task-negative networks. As previously shown for working memory, LEV treatment did not affect functional language networks.
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Affiliation(s)
- Fenglai Xiao
- Department of Clinical and Experimental EpilepsyUniversity College London Institute of NeurologyLondonUK
- Department of NeurologyWest China Hospital of Sichuan UniversityChengduSichuanChina
- Magnetic Resonance Imaging UnitEpilepsy SocietyGerrards CrossUK
| | - Lorenzo Caciagli
- Department of Clinical and Experimental EpilepsyUniversity College London Institute of NeurologyLondonUK
- Magnetic Resonance Imaging UnitEpilepsy SocietyGerrards CrossUK
| | - Britta Wandschneider
- Department of Clinical and Experimental EpilepsyUniversity College London Institute of NeurologyLondonUK
| | - Josemir W. Sander
- Department of Clinical and Experimental EpilepsyUniversity College London Institute of NeurologyLondonUK
| | - Meneka Sidhu
- Department of Clinical and Experimental EpilepsyUniversity College London Institute of NeurologyLondonUK
- Magnetic Resonance Imaging UnitEpilepsy SocietyGerrards CrossUK
| | - Gavin Winston
- Department of Clinical and Experimental EpilepsyUniversity College London Institute of NeurologyLondonUK
- Magnetic Resonance Imaging UnitEpilepsy SocietyGerrards CrossUK
| | - Jane Burdett
- Magnetic Resonance Imaging UnitEpilepsy SocietyGerrards CrossUK
| | - Karin Trimmel
- Department of Clinical and Experimental EpilepsyUniversity College London Institute of NeurologyLondonUK
- Magnetic Resonance Imaging UnitEpilepsy SocietyGerrards CrossUK
- Department of NeurologyMedical University of ViennaViennaAustria
| | - Andrea Hill
- Magnetic Resonance Imaging UnitEpilepsy SocietyGerrards CrossUK
| | - Christian Vollmar
- Department of NeurologyEpilepsy CenterUniversity of MunichMunichGermany
| | - Sjoerd B. Vos
- Magnetic Resonance Imaging UnitEpilepsy SocietyGerrards CrossUK
- Wellcome/Engineering and Physical Sciences Research Council Centre for Interventional and Surgical SciencesUniversity College LondonLondonUK
- Translational Imaging GroupUniversity College LondonLondonUK
| | - Sebastien Ourselin
- Department of Clinical and Experimental EpilepsyUniversity College London Institute of NeurologyLondonUK
- Wellcome/Engineering and Physical Sciences Research Council Centre for Interventional and Surgical SciencesUniversity College LondonLondonUK
- Translational Imaging GroupUniversity College LondonLondonUK
| | - Pamela J. Thompson
- Department of Clinical and Experimental EpilepsyUniversity College London Institute of NeurologyLondonUK
- Magnetic Resonance Imaging UnitEpilepsy SocietyGerrards CrossUK
| | - Dong Zhou
- Department of NeurologyWest China Hospital of Sichuan UniversityChengduSichuanChina
| | - John S. Duncan
- Department of Clinical and Experimental EpilepsyUniversity College London Institute of NeurologyLondonUK
- Magnetic Resonance Imaging UnitEpilepsy SocietyGerrards CrossUK
| | - Matthias J. Koepp
- Department of Clinical and Experimental EpilepsyUniversity College London Institute of NeurologyLondonUK
- Magnetic Resonance Imaging UnitEpilepsy SocietyGerrards CrossUK
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Hayes DJ, Chen DQ, Zhong J, Lin A, Behan B, Walker M, Hodaie M. Affective Circuitry Alterations in Patients with Trigeminal Neuralgia. Front Neuroanat 2017; 11:73. [PMID: 28928638 PMCID: PMC5591854 DOI: 10.3389/fnana.2017.00073] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 08/11/2017] [Indexed: 11/24/2022] Open
Abstract
Trigeminal neuralgia (TN) is a severe chronic neuropathic facial pain disorder. Affect-related behavioral and structural brain changes have been noted across chronic pain disorders, but have not been well-studied in TN. We examined the potential impact of TN (37 patients: 23 with right-sided TN, 14 with left-sided TN), compared to age- and sex-matched healthy controls, on three major white matter tracts responsible for carrying affect-related signals—i.e., cingulum, fornix, and medial forebrain bundle. Diffusion magnetic resonance imaging (dMRI), deterministic multi-tensor tractography for tract modeling, and a model-driven region-of-interest approach was used. We also used volumetric gray matter analysis on key targets of these pathways (i.e., hippocampus, cingulate cortex subregions, nucleus accumbens, and ventral diencephalon). Hypotheses included: (1) successful modeling of tracts; (2) altered white matter microstructure of the cingulum and medial forebrain bundle (via changes in dMRI metrics such as fractional anisotropy, and mean, axial, and radial diffusivities) compared to controls; (3) no alterations in the control region of the fornix; (4) corresponding decreases in gray matter volumes. Results showed (1) all 325 tracts were successfully modeled, although 11 were partially complete; (2) The cingulum and medial forebrain bundle (MFB) were altered in those with TN, with dMRI metric changes in the middle (p = 0.001) and posterior cingulum (p < 0.0001), and the MFB near the ventral tegmental area (MFB-VTA) (p = 0.001). The posterior cingulum and MFB-VTA also showed unilateral differences between right- and left-sided TN patients; (3) No differences were noted at any fornix subdivision; (4) decreased volumes were noted for the hippocampus, posterior cingulate, nucleus accumbens, and ventral diencephalon. Together, these results support the notion of selectively altered affective circuits in patients with TN, which may be related to the experience of negative affect and the increased comorbidity of mood and anxiety disorders in this population.
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Affiliation(s)
- Dave J Hayes
- Psychology Department and Neuroscience Program, Union CollegeSchenectady, NY, United States.,Division of Brain, Imaging and Behaviour Systems Neuroscience and Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, Krembil Research Institute, University Health Network, University of TorontoToronto, ON, Canada
| | - David Q Chen
- Division of Brain, Imaging and Behaviour Systems Neuroscience and Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, Krembil Research Institute, University Health Network, University of TorontoToronto, ON, Canada
| | - Jidan Zhong
- Division of Brain, Imaging and Behaviour Systems Neuroscience and Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, Krembil Research Institute, University Health Network, University of TorontoToronto, ON, Canada
| | - Ariel Lin
- Psychology Department and Neuroscience Program, Union CollegeSchenectady, NY, United States
| | - Brendan Behan
- Division of Brain, Imaging and Behaviour Systems Neuroscience and Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, Krembil Research Institute, University Health Network, University of TorontoToronto, ON, Canada
| | - Matthew Walker
- Division of Brain, Imaging and Behaviour Systems Neuroscience and Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, Krembil Research Institute, University Health Network, University of TorontoToronto, ON, Canada
| | - Mojgan Hodaie
- Division of Brain, Imaging and Behaviour Systems Neuroscience and Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, Krembil Research Institute, University Health Network, University of TorontoToronto, ON, Canada
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Takeda K, Matsuda H, Miyamoto Y, Yamamoto H. Structural brain network analysis of children with localization-related epilepsy. Brain Dev 2017; 39:678-686. [PMID: 28487114 DOI: 10.1016/j.braindev.2017.04.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Revised: 04/08/2017] [Accepted: 04/14/2017] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Epilepsy is considered to arise from dysfunction in neural networks. Recent advances in neuroimaging and its analysis have made it possible to investigate both functional and structural connectivity in the brain. The aim of this study was to elucidate alterations in the structural connectivity in children with localization-related epilepsy using the mathematical method of graph theoretical analysis. METHODOLOGY Fifteen children with localization-related epilepsy (8 female subjects; mean age, 8.5±3.5years) as an epilepsy group and 23 children without a history of seizure (12 female subjects; mean age, 8.9±3.7years) as a control group underwent three-dimensional T1-weighted brain magnetic resonance imaging (MRI). Gray matter images segmented and spatially normalized from the MRIs of both groups were analyzed using statistical parametric mapping with the Graph Analysis Toolbox. We compared global networks (global efficiency, clustering coefficient and network strength) and regional networks (betweenness centrality and clustering) between patients and controls. RESULTS The global efficiency tended to be increased (p=0.081) and the global modularity was significantly increased (p=0.017) in the epilepsy group as compared with the control group. The epilepsy group showed locally decreased betweenness centrality mainly in the bilateral cingulate gyri, right perisylvian area, and bilateral precentral gyri, and locally increased clustering in the bilateral cingulate gyri, right perisylvian area, and medial frontal lobes as compared with the control group. The epilepsy group showed higher network resilience to random attack and targeted attack than the control group. Voxel-based morphometry did not show any difference between the two groups. CONCLUSIONS We observed globally increased structural connectivity along with excessive network robustness in patients with localization-related epilepsy. Local abnormality of connectivity was observed mainly in the cingulate gyrus, perisylvian area, and precentral gyrus. This alteration in the structural connectivity without any morphometric changes may be related to the underlying epileptogenicity.
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Affiliation(s)
- Kanako Takeda
- Division of Pediatrics, Kawasaki Municipal Tama Hospital, St. Marianna University School of Medicine, Japan; Department of Pediatrics, St. Marianna University School of Medicine, Japan; Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Japan.
| | - Hiroshi Matsuda
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Japan
| | - Yusaku Miyamoto
- Division of Pediatrics, Kawasaki Municipal Tama Hospital, St. Marianna University School of Medicine, Japan; Department of Pediatrics, St. Marianna University School of Medicine, Japan
| | - Hitoshi Yamamoto
- Department of Pediatrics, St. Marianna University School of Medicine, Japan
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Salinas FS, Szabó CÁ. Resting-state functional connectivity changes due to acute and short-term valproic acid administration in the baboon model of GGE. Neuroimage Clin 2017; 16:132-141. [PMID: 28794974 PMCID: PMC5537408 DOI: 10.1016/j.nicl.2017.07.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 07/14/2017] [Accepted: 07/15/2017] [Indexed: 12/14/2022]
Abstract
Resting-state functional connectivity (FC) is altered in baboons with genetic generalized epilepsy (GGE) compared to healthy controls (CTL). We compared FC changes between GGE and CTL groups after intravenous injection of valproic acid (VPA) and following one-week of orally administered VPA. Seven epileptic (2 females) and six CTL (3 females) baboons underwent resting-state fMRI (rs-fMRI) at 1) baseline, 2) after intravenous acute VPA administration (20 mg/kg), and 3) following seven-day oral, subacute VPA therapy (20–80 mg/kg/day). FC was evaluated using a data-driven approach, while regressing out the group-wise effects of age, gender and VPA levels. Sixteen networks were identified by independent component analysis (ICA). Each network mask was thresholded (z > 4.00; p < 0.001), and used to compare group-wise FC differences between baseline, intravenous and oral VPA treatment states between GGE and CTL groups. At baseline, FC was increased in most cortical networks of the GGE group but decreased in the thalamic network. After intravenous acute VPA, FC increased in the basal ganglia network and decreased in the parietal network of epileptic baboons to presumed nodes associated with the epileptic network. After oral VPA therapy, FC was decreased in GGE baboons only the orbitofrontal networks connections to the primary somatosensory cortices, reflecting a reversal from baseline comparisons. VPA therapy affects FC in the baboon model of GGE after a single intravenous dose—possibly by facilitating subcortical modulation of the epileptic network and suppressing seizure generation—and after short-term oral VPA treatment, reversing the abnormal baseline increases in FC in the orbitofrontal network. While there is a need to correlate these FC changes with simultaneous EEG recording and seizure outcomes, this study demonstrates the feasibility of evaluating rs-fMRI effects of antiepileptic medications even after short-term exposure. This resting-state fMRI study evaluates treatment-related functional connectivity (FC) changes in the baboon model of GGE. Pre-treatment FC is mostly increased in cortical networks, but decreased for the thalamic network in epileptic baboons. Treatment-related FC changes were noted both after single intravenous dose of VPA and short-term oral VPA treatment. FC studies may provide a novel approach to evaluate antiepileptic medication effects.
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Affiliation(s)
- Felipe S Salinas
- Research Imaging Institute, UT Health, San Antonio, United States.,South Texas Veterans Health Care System, San Antonio, TX, United States
| | - Charles Ákos Szabó
- Department of Neurology, UT Health, San Antonio, United States.,South Texas Comprehensive Epilepsy Center, UT Health, San Antonio, United States
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van Veenendaal TM, IJff DM, Aldenkamp AP, Lazeron RHC, Hofman PAM, de Louw AJA, Backes WH, Jansen JFA. Chronic antiepileptic drug use and functional network efficiency: A functional magnetic resonance imaging study. World J Radiol 2017; 9:287-294. [PMID: 28717415 PMCID: PMC5491656 DOI: 10.4329/wjr.v9.i6.287] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Revised: 02/24/2017] [Accepted: 03/24/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To increase our insight in the neuronal mechanisms underlying cognitive side-effects of antiepileptic drug (AED) treatment.
METHODS The relation between functional magnetic resonance-acquired brain network measures, AED use, and cognitive function was investigated. Three groups of patients with epilepsy with a different risk profile for developing cognitive side effects were included: A “low risk” category (lamotrigine or levetiracetam, n = 16), an “intermediate risk” category (carbamazepine, oxcarbazepine, phenytoin, or valproate, n = 34) and a “high risk” category (topiramate, n = 5). Brain connectivity was assessed using resting state functional magnetic resonance imaging and graph theoretical network analysis. The Computerized Visual Searching Task was used to measure central information processing speed, a common cognitive side effect of AED treatment.
RESULTS Central information processing speed was lower in patients taking AEDs from the intermediate and high risk categories, compared with patients from the low risk category. The effect of risk category on global efficiency was significant (P < 0.05, ANCOVA), with a significantly higher global efficiency for patient from the low category compared with the high risk category (P < 0.05, post-hoc test). Risk category had no significant effect on the clustering coefficient (ANCOVA, P > 0.2). Also no significant associations between information processing speed and global efficiency or the clustering coefficient (linear regression analysis, P > 0.15) were observed.
CONCLUSION Only the four patients taking topiramate show aberrant network measures, suggesting that alterations in functional brain network organization may be only subtle and measureable in patients with more severe cognitive side effects.
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Ballester-Plané J, Schmidt R, Laporta-Hoyos O, Junqué C, Vázquez É, Delgado I, Zubiaurre-Elorza L, Macaya A, Póo P, Toro E, de Reus MA, van den Heuvel MP, Pueyo R. Whole-brain structural connectivity in dyskinetic cerebral palsy and its association with motor and cognitive function. Hum Brain Mapp 2017; 38:4594-4612. [PMID: 28608616 DOI: 10.1002/hbm.23686] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 06/01/2017] [Indexed: 12/31/2022] Open
Abstract
Dyskinetic cerebral palsy (CP) has long been associated with basal ganglia and thalamus lesions. Recent evidence further points at white matter (WM) damage. This study aims to identify altered WM pathways in dyskinetic CP from a standardized, connectome-based approach, and to assess structure-function relationship in WM pathways for clinical outcomes. Individual connectome maps of 25 subjects with dyskinetic CP and 24 healthy controls were obtained combining a structural parcellation scheme with whole-brain deterministic tractography. Graph theoretical metrics and the network-based statistic were applied to compare groups and to correlate WM state with motor and cognitive performance. Results showed a widespread reduction of WM volume in CP subjects compared to controls and a more localized decrease in degree (number of links per node) and fractional anisotropy (FA), comprising parieto-occipital regions and the hippocampus. However, supramarginal gyrus showed a significantly higher degree. At the network level, CP subjects showed a bilateral pathway with reduced FA, comprising sensorimotor, intraparietal and fronto-parietal connections. Gross and fine motor functions correlated with FA in a pathway comprising the sensorimotor system, but gross motor also correlated with prefrontal, temporal and occipital connections. Intelligence correlated with FA in a network with fronto-striatal and parieto-frontal connections, and visuoperception was related to right occipital connections. These findings demonstrate a disruption in structural brain connectivity in dyskinetic CP, revealing general involvement of posterior brain regions with relative preservation of prefrontal areas. We identified pathways in which WM integrity is related to clinical features, including but not limited to the sensorimotor system. Hum Brain Mapp 38:4594-4612, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Júlia Ballester-Plané
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Barcelona, Spain.,Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.,Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain
| | - Ruben Schmidt
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Olga Laporta-Hoyos
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Barcelona, Spain.,Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.,Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain
| | - Carme Junqué
- Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.,Departament de Medicina, Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Élida Vázquez
- Servei de Radiologia Pediàtrica, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Ignacio Delgado
- Servei de Radiologia Pediàtrica, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Leire Zubiaurre-Elorza
- Departamento de Fundamentos y Métodos de la Psicología, Facultad de Psicología y Educación, Universidad de Deusto, Bilbo-Bizkaia, Spain
| | - Alfons Macaya
- Grup de Recerca en Neurologia Pediàtrica, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Pilar Póo
- Servei de Neurologia, Hospital Universitari Sant Joan de Déu, Barcelona, Spain
| | - Esther Toro
- Servei de Rehabilitació i Medicina Física, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Marcel A de Reus
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Martijn P van den Heuvel
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Roser Pueyo
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Barcelona, Spain.,Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.,Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain
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Wandschneider B, Koepp MJ. Pharmaco fMRI: Determining the functional anatomy of the effects of medication. Neuroimage Clin 2016; 12:691-697. [PMID: 27766202 PMCID: PMC5067101 DOI: 10.1016/j.nicl.2016.10.002] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 10/03/2016] [Indexed: 01/15/2023]
Abstract
Functional MRI studies have helped to elucidate underlying mechanisms in complex neurological and neuropsychiatric disorders. Disease processes often involve complex large-scale network interactions, extending beyond the presumed main disease focus. Given both the complexity of the clinical phenotype and the underlying dysfunctional brain circuits, so called pharmaco-fMRI (ph-MRI) studies probe pharmacological effects on functional neuro-anatomy, and can help to determine early treatment response, mechanisms of drug efficacy and side effects, and potentially advance CNS drug development. In this review, we discuss recent ph-MRI research in three major neuropsychiatric and neurological disorders and associated network alterations, namely selective serotonin and noradrenergic reuptake inhibitors in affective disorders and emotional processing circuits; antiepileptic drugs in epilepsy and cognitive networks; and stimulants in attention-deficit/hyperactivity disorder and networks of attention control. We conclude that ph-MRI studies show consistent and reproducible changes on disease relevant networks, and prove sensitive to early pharmacological effects on functional anatomy associated with disease. Further CNS drug research and development would benefit greatly from improved disease phenotyping, or biomarkers, using advanced imaging techniques.
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Key Words
- ACC, anterior cingulate cortex
- ADHD, attention-deficit/hyperactivity disorder
- AED, antiepileptic drugs
- BOLD, blood oxygen level-dependent signal
- Biomarker
- CBZ, carbamazepine
- CNS drug research
- CNS, central nervous system
- DAT, dopamine transporter
- Functional MRI
- JME, juvenile myoclonic epilepsy
- LEV, levetiracetam
- LTG, lamotrigine
- NaRI, noradrenergic reuptake inhibitors
- Neuroimaging
- OXC, oxcarbazepine
- Ph-MRI, pharmacological functional MRI
- Pharmacological
- SSRI, selective serotonin reuptake inhibitors
- TLE, temporal lobe epilepsy
- TMS, transcranial magnetic stimulation
- TPM, topiramate
- VPA, valproate
- ZNS, zonisamide
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Affiliation(s)
- Britta Wandschneider
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK; MRI Unit, Epilepsy Society, Chalfont St Peter, UK
| | - Matthias J Koepp
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK; MRI Unit, Epilepsy Society, Chalfont St Peter, UK
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Bharath RD, Chaitanya G, Panda R, Raghavendra K, Sinha S, Sahoo A, Gohel S, Biswal BB, Satishchandra P. Reduced small world brain connectivity in probands with a family history of epilepsy. Eur J Neurol 2016; 23:1729-1737. [PMID: 27564534 DOI: 10.1111/ene.13104] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Accepted: 06/10/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE The role of inheritance in ascertaining susceptibility to epilepsy is well established, although the pathogenetic mechanisms are still not very clear. Interviewing for a positive family history is a popular epidemiological tool in the understanding of this susceptibility. Our aim was to visualize and localize network abnormalities that could be associated with a positive family history in a group of patients with hot water epilepsy (HWE) using resting-state functional magnetic resonance imaging (rsfMRI). METHODS Graph theory analysis of rsfMRI (clustering coefficient γ; path length λ; small worldness σ) in probands with a positive family history of epilepsy (FHE+, 25) were compared with probands without FHE (FHE-, 33). Whether a closer biological relationship was associated with a higher likelihood of network abnormalities was also ascertained. RESULTS A positive family history of epilepsy had decreased γ, increased λ and decreased σ in bilateral temporofrontal regions compared to FHE- (false discovery rate corrected P ≤ 0.0062). These changes were more pronounced in probands having first degree relatives and siblings with epilepsy. Probands with multiple types of epilepsy in the family showed decreased σ in comparison to only HWE in the family. CONCLUSION Graph theory analysis of the rsfMRI can be used to understand the neurobiology of diseases like genetic susceptibility in HWE. Reduced small worldness, proportional to the degree of relationship, is consistent with the current understanding that disease severity is higher in closer biological relations.
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Affiliation(s)
- R D Bharath
- Department of Neuroimaging and Interventional Radiology (NIIR), National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - G Chaitanya
- Department of Clinical Neurosciences, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India.,Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - R Panda
- Department of Neuroimaging and Interventional Radiology (NIIR), National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - K Raghavendra
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - S Sinha
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - A Sahoo
- Department of Biomedical Engineering, New Jersey Institute of Technology (NJIT), Newark, NJ, USA
| | - S Gohel
- Department of Biomedical Engineering, New Jersey Institute of Technology (NJIT), Newark, NJ, USA
| | - B B Biswal
- Department of Biomedical Engineering, New Jersey Institute of Technology (NJIT), Newark, NJ, USA
| | - P Satishchandra
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
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Yasuda CL, Chen Z, Beltramini GC, Coan AC, Morita ME, Kubota B, Bergo F, Beaulieu C, Cendes F, Gross DW. Aberrant topological patterns of brain structural network in temporal lobe epilepsy. Epilepsia 2015; 56:1992-2002. [PMID: 26530395 DOI: 10.1111/epi.13225] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2015] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Although altered large-scale brain network organization in patients with temporal lobe epilepsy (TLE) has been shown using morphologic measurements such as cortical thickness, these studies, have not included critical subcortical structures (such as hippocampus and amygdala) and have had relatively small sample sizes. Here, we investigated differences in topological organization of the brain volumetric networks between patients with right TLE (RTLE) and left TLE (LTLE) with unilateral hippocampal atrophy. METHODS We performed a cross-sectional analysis of 86 LTLE patients, 70 RTLE patients, and 116 controls. RTLE and LTLE groups were balanced for gender (p = 0.64), seizure frequency (Mann-Whitney U test, p = 0.94), age (p = 0.39), age of seizure onset (p = 0.21), and duration of disease (p = 0.69). Brain networks were constructed by thresholding correlation matrices of volumes from 80 cortical/subcortical regions (parcellated with Freesurfer v5.3 https://surfer.nmr.mgh.harvard.edu/) that were then analyzed using graph theoretical approaches. RESULTS We identified reduced cortical/subcortical connectivity including bilateral hippocampus in both TLE groups, with the most significant interregional correlation increases occurring within the limbic system in LTLE and contralateral hemisphere in RTLE. Both TLE groups demonstrated less optimal topological organization, with decreased global efficiency and increased local efficiency and clustering coefficient. LTLE also displayed a more pronounced network disruption. Contrary to controls, hub nodes in both TLE groups were not distributed across whole brain, but rather found primarily in the paralimbic/limbic and temporal association cortices. Regions with increased centrality were concentrated in occipital lobes for LTLE and contralateral limbic/temporal areas for RTLE. SIGNIFICANCE These findings provide first evidence of altered topological organization of the whole brain volumetric network in TLE, with disruption of the coordinated patterns of cortical/subcortical morphology.
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Affiliation(s)
- Clarissa Lin Yasuda
- Division of Neurology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.,Laboratory of Neuroimaging, Department of Neurology, University of Campinas, Campinas, Brazil
| | - Zhang Chen
- Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada
| | - Guilherme Coco Beltramini
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas, Campinas, Brazil.,Institute of Physics "Gleb Wataghin", University of Campinas, Campinas, Brazil
| | - Ana Carolina Coan
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas, Campinas, Brazil
| | - Marcia Elisabete Morita
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas, Campinas, Brazil
| | - Bruno Kubota
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas, Campinas, Brazil
| | - Felipe Bergo
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas, Campinas, Brazil
| | - Christian Beaulieu
- Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada
| | - Fernando Cendes
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas, Campinas, Brazil
| | - Donald William Gross
- Division of Neurology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
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van Veenendaal TM, IJff DM, Aldenkamp AP, Hofman PAM, Vlooswijk MCG, Rouhl RPW, de Louw AJ, Backes WH, Jansen JFA. Metabolic and functional MR biomarkers of antiepileptic drug effectiveness: A review. Neurosci Biobehav Rev 2015; 59:92-9. [PMID: 26475992 DOI: 10.1016/j.neubiorev.2015.10.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 10/07/2015] [Accepted: 10/12/2015] [Indexed: 12/30/2022]
Abstract
As a large number of patients with epilepsy do not respond favorably to antiepileptic drugs (AEDs), a better understanding of treatment failure and the cause of adverse side effects is required. The working mechanisms of AEDs also alter neurotransmitter concentrations and brain activity, which can be measured using MR spectroscopy and functional MR imaging, respectively. This review presents an overview of clinical research of MR spectroscopy and functional MR imaging studies to the effects of AEDs on the brain. Despite the scarcity of studies associating MR findings to the effectiveness of AEDs, the current research shows clear potential regarding this matter. Several GABAergic AEDs have been shown to increase the GABA concentration, which was related to seizure reductions, while language problems due to topiramate have been associated with altered activation patterns measured with functional MR imaging. MR spectroscopy and functional MR imaging provide biomarkers that may predict individual treatment outcomes, and enable the assessment of mechanisms of treatment failure and cognitive side effects.
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Affiliation(s)
- Tamar M van Veenendaal
- Departments of Radiology and Nuclear Medicine, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The Netherlands; School for Mental Health and Neuroscience, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - Dominique M IJff
- School for Mental Health and Neuroscience, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands; Epilepsy Center Kempenhaeghe, PO Box 61, 5590 AB Heeze, The Netherlands
| | - Albert P Aldenkamp
- School for Mental Health and Neuroscience, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands; Epilepsy Center Kempenhaeghe, PO Box 61, 5590 AB Heeze, The Netherlands; Department of Neurology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The Netherlands; Department of Neurology, Gent University Hospital, De Pintelaan 185, 9000 Gent, Belgium; Faculty of Electrical Engineering, University of Technology Eindhoven, PO Box 513, 5600 MB Eindhoven, The Netherlands
| | - Paul A M Hofman
- Departments of Radiology and Nuclear Medicine, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The Netherlands; School for Mental Health and Neuroscience, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands; Epilepsy Center Kempenhaeghe, PO Box 61, 5590 AB Heeze, The Netherlands
| | - Marielle C G Vlooswijk
- School for Mental Health and Neuroscience, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands; Epilepsy Center Kempenhaeghe, PO Box 61, 5590 AB Heeze, The Netherlands; Department of Neurology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The Netherlands
| | - Rob P W Rouhl
- School for Mental Health and Neuroscience, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands; Epilepsy Center Kempenhaeghe, PO Box 61, 5590 AB Heeze, The Netherlands; Department of Neurology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The Netherlands
| | - Anton J de Louw
- Epilepsy Center Kempenhaeghe, PO Box 61, 5590 AB Heeze, The Netherlands; Department of Neurology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The Netherlands; Faculty of Electrical Engineering, University of Technology Eindhoven, PO Box 513, 5600 MB Eindhoven, The Netherlands
| | - Walter H Backes
- Departments of Radiology and Nuclear Medicine, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The Netherlands; School for Mental Health and Neuroscience, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - Jacobus F A Jansen
- Departments of Radiology and Nuclear Medicine, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The Netherlands; School for Mental Health and Neuroscience, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands.
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Geier C, Lehnertz K, Bialonski S. Time-dependent degree-degree correlations in epileptic brain networks: from assortative to dissortative mixing. Front Hum Neurosci 2015; 9:462. [PMID: 26347641 PMCID: PMC4542502 DOI: 10.3389/fnhum.2015.00462] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 08/06/2015] [Indexed: 11/30/2022] Open
Abstract
We investigate the long-term evolution of degree-degree correlations (assortativity) in functional brain networks from epilepsy patients. Functional networks are derived from continuous multi-day, multi-channel electroencephalographic data, which capture a wide range of physiological and pathophysiological activities. In contrast to previous studies which all reported functional brain networks to be assortative on average, even in case of various neurological and neurodegenerative disorders, we observe large fluctuations in time-resolved degree-degree correlations ranging from assortative to dissortative mixing. Moreover, in some patients these fluctuations exhibit some periodic temporal structure which can be attributed, to a large extent, to daily rhythms. Relevant aspects of the epileptic process, particularly possible pre-seizure alterations, contribute marginally to the observed long-term fluctuations. Our findings suggest that physiological and pathophysiological activity may modify functional brain networks in a different and process-specific way. We evaluate factors that possibly influence the long-term evolution of degree-degree correlations.
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Affiliation(s)
- Christian Geier
- Department of Epileptology, University of Bonn Bonn, Germany ; Helmholtz Institute for Radiation and Nuclear Physics, University of Bonn Bonn, Germany
| | - Klaus Lehnertz
- Department of Epileptology, University of Bonn Bonn, Germany ; Helmholtz Institute for Radiation and Nuclear Physics, University of Bonn Bonn, Germany ; Interdisciplinary Center for Complex Systems, University of Bonn Bonn, Germany
| | - Stephan Bialonski
- Max-Planck-Institute for the Physics of Complex Systems Dresden, Germany
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