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Katsurayama M, Silva LS, de Campos BM, Avelar WM, Cendes F, Yasuda CL. Disruption of Resting-State Functional Connectivity in Acute Ischemic Stroke: Comparisons Between Right and Left Hemispheric Insults. Brain Topogr 2024; 37:881-888. [PMID: 38302770 DOI: 10.1007/s10548-024-01033-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 01/01/2024] [Indexed: 02/03/2024]
Abstract
Few resting-state functional magnetic resonance imaging (RS-fMRI) studies evaluated the impact of acute ischemic changes on cerebral functional connectivity (FC) and its relationship with functional outcomes after acute ischemic stroke (AIS), considering the side of lesions. To characterize alterations of FC of patients with AIS by analyzing 12 large-scale brain networks (NWs) with RS-fMRI. Additionally, we evaluated the impact of the side (right (RH) or left (LH) hemisphere) of insult on the disruption of brain NWs. 38 patients diagnosed with AIS (17 RH and 21 LH) who performed 3T MRI scans up to 72 h after stroke were compared to 44 healthy controls. Images were processed and analyzed with the software toolbox UF2C with SPM12. For the first level, we generated individual matrices based on the time series extraction from 70 regions of interest (ROIs) from 12 functional NWs, constructing Pearson's cross-correlation; the second-level analysis included an analysis of covariance (ANCOVA) to investigate differences between groups. The statistical significance was determined with p < 0.05, after correction for multiple comparisons with false discovery rate (FDR) correction. Overall, individuals with LH insults developed poorer clinical outcomes after six months. A widespread pattern of lower FC was observed in the presence of LH insults, while a contralateral pattern of increased FC was identified in the group with RH insults. Our findings suggest that LH stroke causes a severe and widespread pattern of reduction of brain networks' FC, presumably related to the impairment in their long-term recovery.
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Affiliation(s)
- Marilise Katsurayama
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas, Cidade Universitária, Campinas, SP, 13083-970, Brazil
| | - Lucas Scárdua Silva
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas, Cidade Universitária, Campinas, SP, 13083-970, Brazil
| | - Brunno Machado de Campos
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas, Cidade Universitária, Campinas, SP, 13083-970, Brazil
| | - Wagner Mauad Avelar
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas, Cidade Universitária, Campinas, SP, 13083-970, Brazil
| | - Fernando Cendes
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas, Cidade Universitária, Campinas, SP, 13083-970, Brazil
| | - Clarissa Lin Yasuda
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas, Cidade Universitária, Campinas, SP, 13083-970, Brazil.
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Frassineti L, Catrambone V, Lanatà A, Valenza G. Impaired brain-heart axis in focal epilepsy: Alterations in information flow and implications for seizure dynamics. Netw Neurosci 2024; 8:541-556. [PMID: 38952812 PMCID: PMC11168720 DOI: 10.1162/netn_a_00367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 02/09/2024] [Indexed: 07/03/2024] Open
Abstract
This study delves into functional brain-heart interplay (BHI) dynamics during interictal periods before and after seizure events in focal epilepsy. Our analysis focuses on elucidating the causal interaction between cortical and autonomic nervous system (ANS) oscillations, employing electroencephalography and heart rate variability series. The dataset for this investigation comprises 47 seizure events from 14 independent subjects, obtained from the publicly available Siena Dataset. Our findings reveal an impaired brain-heart axis especially in the heart-to-brain functional direction. This is particularly evident in bottom-up oscillations originating from sympathovagal activity during the transition between preictal and postictal periods. These results indicate a pivotal role of the ANS in epilepsy dynamics. Notably, the brain-to-heart information flow targeting cardiac oscillations in the low-frequency band does not display significant changes. However, there are noteworthy changes in cortical oscillations, primarily originating in central regions, influencing heartbeat oscillations in the high-frequency band. Our study conceptualizes seizures as a state of hyperexcitability and a network disease affecting both cortical and peripheral neural dynamics. Our results pave the way for a deeper understanding of BHI in epilepsy, which holds promise for the development of advanced diagnostic and therapeutic approaches also based on bodily neural activity for individuals living with epilepsy.
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Affiliation(s)
- Lorenzo Frassineti
- Department of Information Engineering, Università degli Studi di Firenze, Firenze, Italy
| | - Vincenzo Catrambone
- Department of Information Engineering and Bioengineering & Robotics Research Center E. Piaggio, University of Pisa, Pisa, Italy
| | - Antonio Lanatà
- Department of Information Engineering, Università degli Studi di Firenze, Firenze, Italy
| | - Gaetano Valenza
- Department of Information Engineering and Bioengineering & Robotics Research Center E. Piaggio, University of Pisa, Pisa, Italy
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Javidi SS, He X, Ankeeta A, Zhang Q, Citro S, Sperling MR, Tracy JI. Edge-wise analysis reveals white matter connectivity associated with focal to bilateral tonic-clonic seizures. Epilepsia 2024; 65:1756-1767. [PMID: 38517477 PMCID: PMC11166520 DOI: 10.1111/epi.17960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 03/09/2024] [Accepted: 03/11/2024] [Indexed: 03/23/2024]
Abstract
OBJECTIVE Focal to bilateral tonic-clonic seizures (FBTCS) represent a challenging subtype of focal temporal lobe epilepsy (TLE) in terms of both severity and treatment response. Most studies have focused on regional brain analysis that is agnostic to the distribution of white matter (WM) pathways associated with a node. We implemented a more selective, edge-wise approach that allowed for identification of the individual connections unique to FBTCS. METHODS T1-weighted and diffusion-weighted images were obtained from 22 patients with solely focal seizures (FS), 43 FBTCS patients, and 65 age/sex-matched healthy participants (HPs), yielding streamline (STR) connectome matrices. We used diffusion tensor-derived STRs in an edge-wise approach to determine specific structural connectivity changes associated with seizure generalization in FBTCS compared to matched FS and HPs. Graph theory metrics were computed on both node- and edge-based connectivity matrices. RESULTS Edge-wise analyses demonstrated that all significantly abnormal cross-hemispheric connections belonged to the FBTCS group. Abnormal connections associated with FBTCS were mostly housed in the contralateral hemisphere, with graph metric values generally decreased compared to HPs. In FBTCS, the contralateral amygdala showed selective decreases in the structural connection pathways to the contralateral frontal lobe. Abnormal connections in TLE involved the amygdala, with the ipsilateral side showing increases and the contralateral decreases. All the FS findings indicated higher graph metrics for connections involving the ipsilateral amygdala. Data also showed that some FBTCS connectivity effects are moderated by aging, recent seizure frequency, and longer illness duration. SIGNIFICANCE Data showed that not all STR pathways are equally affected by the seizure propagation of FBTCS. We demonstrated two key biases, one indicating a large role for the amygdala in the propagation of seizures, the other pointing to the prominent role of cross-hemispheric and contralateral hemisphere connections in FBTCS. We demonstrated topographic reorganization in FBTCS, pointing to the specific WM tracts involved.
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Affiliation(s)
- Sam S Javidi
- Farber Institute for Neuroscience, Department of Neurology, Thomas Jefferson University, Philadelphia, PA
| | - Xiaosong He
- University of Science and Technology of China, Department of Psychology, Hefei, Anhui, P.R. China
| | - A Ankeeta
- Farber Institute for Neuroscience, Department of Neurology, Thomas Jefferson University, Philadelphia, PA
| | - Qirui Zhang
- Farber Institute for Neuroscience, Department of Neurology, Thomas Jefferson University, Philadelphia, PA
| | - Salvatore Citro
- Department of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Michael R Sperling
- Farber Institute for Neuroscience, Department of Neurology, Thomas Jefferson University, Philadelphia, PA
| | - Joseph I Tracy
- Farber Institute for Neuroscience, Department of Neurology, Thomas Jefferson University, Philadelphia, PA
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Huang Y, Wang N, Li W, Feng T, Zhang H, Fan X, Chen S, Wang Y, Shan Y, Wei P, Zhao G. Aberrant individual structure covariance network in patients with mesial temporal lobe epilepsy. Front Neurosci 2024; 18:1381385. [PMID: 38784092 PMCID: PMC11112066 DOI: 10.3389/fnins.2024.1381385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 04/08/2024] [Indexed: 05/25/2024] Open
Abstract
Objective Mesial temporal lobe epilepsy (mTLE) is a complex neurological disorder that has been recognized as a widespread global network disorder. The group-level structural covariance network (SCN) could reveal the structural connectivity disruption of the mTLE but could not reflect the heterogeneity at the individual level. Methods This study adopted a recently proposed individual structural covariance network (IDSCN) method to clarify the alternated structural covariance connection mode in mTLE and to associate IDSCN features with the clinical manifestations and regional brain atrophy. Results We found significant IDSCN abnormalities in the ipsilesional hippocampus, ipsilesional precentral gyrus, bilateral caudate, and putamen in mTLE patients than in healthy controls. Moreover, the IDSCNs of these areas were positively correlated with the gray matter atrophy rate. Finally, we identified several connectivities with weak associations with disease duration, frequency, and surgery outcome. Significance Our research highlights the role of hippo-thalamic-basal-cortical circuits in the pathophysiologic process of disrupted whole-brain morphological covariance networks in mTLE, and builds a bridge between brain-wide covariance network changes and regional brain atrophy.
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Affiliation(s)
- Yuda Huang
- Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Ningrui Wang
- Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China
- Beijing Municipal Geriatric Medical Research Center, Beijing, China
| | - Wei Li
- Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Tao Feng
- Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Huaqiang Zhang
- Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Xiaotong Fan
- Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Sichang Chen
- Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Yihe Wang
- Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Yongzhi Shan
- Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Penghu Wei
- Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China
- School of Public Health and Management, Ningxia Medical University, Yinchuan, China
- Clinical Research Center for Epilepsy Capital Medical University, Beijing, China
| | - Guoguang Zhao
- Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China
- School of Public Health and Management, Ningxia Medical University, Yinchuan, China
- Clinical Research Center for Epilepsy Capital Medical University, Beijing, China
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Janson A, Sainburg L, Akbarian B, Johnson GW, Rogers BP, Chang C, Englot DJ, Morgan VL. Indirect structural changes and reduced controllability after temporal lobe epilepsy resection. Epilepsia 2024; 65:675-686. [PMID: 38240699 PMCID: PMC10948308 DOI: 10.1111/epi.17889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/08/2023] [Accepted: 01/08/2024] [Indexed: 03/06/2024]
Abstract
OBJECTIVE To understand the potential behavioral and cognitive effects of mesial temporal resection for temporal lobe epilepsy (TLE) a method is required to characterize network-wide functional alterations caused by a discrete structural disconnection. The objective of this study was to investigate network-wide alterations in brain dynamics of patients with TLE before and after surgical resection of the seizure focus using average regional controllability (ARC), a measure of the ability of a node to influence network dynamics. METHODS Diffusion-weighted imaging (DWI) data were acquired in 27 patients with drug-resistant unilateral mesial TLE who underwent selective amygdalohippocampectomy. Imaging data were acquired before and after surgery and a presurgical and postsurgical structural connectome was generated from whole-brain tractography. Edge-wise strength, node strength, and node ARC were compared before and after surgery. Direct and indirect edge-wise strength changes were identified using patient-specific simulated resections. Direct edges were defined as primary edges disconnected by the resection zone itself. Indirect edges were secondary measured edge strength changes. Changes in node strength and ARC were then related to both direct and indirect edge changes. RESULTS We found nodes with significant postsurgical changes in both node strength and ARC surrounding the resection zone (paired t tests, p < .05, Bonferroni corrected). ARC identified additional postsurgical changes in nodes outside of the resection zone within the ipsilateral occipital lobe, which were associated with indirect edge-wise strength changes of the postsurgical network (Fisher's exact test, p < .001). These indirect edge-wise changes were facilitated through the "hub" nodes including the thalamus, putamen, insula, and precuneus. SIGNIFICANCE Discrete network disconnection from TLE resection results in widespread structural and functional changes not predicted by disconnection alone. These can be well characterized by dynamic controllability measures such as ARC and may be useful for investigating changes in brain function that may contribute to seizure recurrence and behavioral or cognitive changes after surgery.
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Affiliation(s)
- Andrew Janson
- Department of Radiology and Radiological Sciences, Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Lucas Sainburg
- Department of Radiology and Radiological Sciences, Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - Behnaz Akbarian
- Department of Radiology and Radiological Sciences, Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - Graham W Johnson
- Department of Radiology and Radiological Sciences, Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - Baxter P Rogers
- Department of Radiology and Radiological Sciences, Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - Catie Chang
- Department of Radiology and Radiological Sciences, Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
- Department of Electrical and Computer Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - Dario J Englot
- Department of Radiology and Radiological Sciences, Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
- Department of Electrical and Computer Engineering, Vanderbilt University, Nashville, Tennessee, USA
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Victoria L Morgan
- Department of Radiology and Radiological Sciences, Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Rigoni I, Padmasola GP, Sheybani L, Schaller K, Quairiaux C, Vulliemoz S. Reproducible network changes occur in a mouse model of temporal lobe epilepsy but do not correlate with disease severity. Neurobiol Dis 2024; 190:106382. [PMID: 38114050 DOI: 10.1016/j.nbd.2023.106382] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/27/2023] [Accepted: 12/13/2023] [Indexed: 12/21/2023] Open
Abstract
Studying the development of brain network disruptions in epilepsy is challenged by the paucity of data before epilepsy onset. Here, we used the unilateral, kainate mouse model of hippocampal epilepsy to investigate brain network changes before and after epilepsy onset and their stability across time. Using 32 epicranial electrodes distributed over the mouse hemispheres, we analyzed EEG epochs free from epileptic activity in 15 animals before and 28 days after hippocampal injection (group 1) and in 20 animals on two consecutive days (d28 and d29, group 2). Statistical dependencies between electrodes were characterized with the debiased-weighted phase lag index. We analyzed: a) graph metric changes from baseline to chronic stage (d28) in group 1; b) their reliability across d28 and d29, in group 2; c) their correlation with epileptic activity (EA: seizure, spike and fast-ripple rates), averaged over d28 and d29, in group 2. During the chronic stage, intra-hemispheric connections of the non-injected hemisphere strengthened, yielding an asymmetrical network in low (4-8 Hz) and high theta (8-12 Hz) bands. The contralateral hemisphere also became more integrated and segregated within the high theta band. Both network topology and EEG markers of EA were stable over consecutive days but not correlated with each other. Altogether, we show reproducible large-scale network modifications after the development of focal epilepsy. These modifications are mostly specific to the non-injected hemisphere. The absence of correlation with epileptic activity does not allow to specifically ascribe these network changes to mechanisms supporting EA or rather compensatory inhibition but supports the notion that epilepsy extends beyond the sole repetition of EA and impacts network that might not be involved in EA generation.
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Affiliation(s)
- Isotta Rigoni
- EEG and Epilepsy unit, Department of Neuroscience, University Hospital and Faculty of Medicine of Geneva, University of Geneva, Geneva, Switzerland.
| | - Guru Prasad Padmasola
- Department of Basic Neuroscience, Faculty of Medicine, University of Geneva, Geneva, Switzerland; Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
| | - Laurent Sheybani
- EEG and Epilepsy unit, Department of Neuroscience, University Hospital and Faculty of Medicine of Geneva, University of Geneva, Geneva, Switzerland; Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
| | - Karl Schaller
- Department of Neurosurgery, University Hospital and Faculty of Medicine of Geneva, Geneva, Switzerland
| | - Charles Quairiaux
- Department of Basic Neuroscience, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Serge Vulliemoz
- EEG and Epilepsy unit, Department of Neuroscience, University Hospital and Faculty of Medicine of Geneva, University of Geneva, Geneva, Switzerland
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Zhao X, Zhou Y, Li Y, Huang S, Zhu H, Zhou Z, Zhu S, Zhu W. The asymmetry of glymphatic system dysfunction in patients with temporal lobe epilepsy: A DTI-ALPS study. J Neuroradiol 2023; 50:562-567. [PMID: 37301366 DOI: 10.1016/j.neurad.2023.05.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 05/29/2023] [Accepted: 05/30/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND AND PURPOSE While the occurrence of glymphatic system dysfunction has been observed in temporal lobe epilepsy (TLE), the potential asymmetry of this system has yet to be investigated in the TLE context. We aimed to investigate the glymphatic system function in both hemispheres and to analyze asymmetric features of the glymphatic system in TLE patients using diffusion tensor image analysis along the perivascular space (DTI-ALPS) method. MATERIALS AND METHODS 43 patients (left TLE (LTLE), n = 20; right TLE (RTLE), n = 23) and 39 healthy controls (HC) were enrolled in this study. The DTI-ALPS index was calculated for the left (left ALPS index) and right (right ALPS index) hemispheres respectively. An asymmetry index (AI) was calculated by AI = (Right - Left)/ [(Right + Left)/2] to represent the asymmetric pattern. Independent two sample t-test, two-sample paired t-test or one-way ANOVA with Bonferroni correction were conducted to compare the differences in ALPS indices and AI among the groups. RESULTS Both left ALPS index (p = 0.040) and right ALPS index (p = 0.001) of RTLE patients were significantly decreased, while only left ALPS index of LTLE patients (p = 0.005) was reduced. Compared to contralateral ALPS index, the ipsilateral ALPS index was significantly decreased in TLE (p = 0.008) and RTLE (p = 0.009) patients. Leftward asymmetry of the glymphatic system was found in HC (p = 0.045) and RTLE (p = 0.009) patients. The LTLE patients presented reduced asymmetric traits when compared to RTLE patients (p = 0.029). CONCLUSION The TLE patients exhibited altered ALPS indices, which could be triggered by glymphatic system dysfunction. Altered ALPS indices were more severe in ipsilateral than in the contralateral hemisphere. Moreover, LTLE and RTLE patients exhibited different change patterns of the glymphatic system. In addition, glymphatic system function presented asymmetric patterns in both normal adult brain and RTLE patients.
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Affiliation(s)
- Xu Zhao
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yingying Zhou
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuanhao Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shanshan Huang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hongquan Zhu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhiqiang Zhou
- Department of Anesthesiology and Pain Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Suiqiang Zhu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Wenzhen Zhu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Süß AM, Hug M, Conradi N, Kienitz R, Rosenow F, Rampp S, Merkel N. Lateralization of delta band power in magnetoencephalography (MEG) in patients with unilateral focal epilepsy and its relation to verbal fluency. Brain Behav 2023; 13:e3257. [PMID: 37752097 PMCID: PMC10636394 DOI: 10.1002/brb3.3257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 08/22/2023] [Accepted: 08/31/2023] [Indexed: 09/28/2023] Open
Abstract
INTRODUCTION Delta power is a clinically established biomarker for abnormal brain processes. However, in patients with unilateral focal epilepsy (FE) it is still not well understood, how it relates to the epileptogenic zone and to neurocognitive functioning. The aim of the present study was thus to assess how delta power relates to the affected hemisphere, whether lateralization strength differs between the patients, and how changes in delta power correlate with cognitive functioning. METHOD We retrospectively studied patients with left (LFE) and right FE (RFE) who had undergone a resting-state magnetoencephalography measurement. We computed global and hemispheric delta power and lateralization indices and examined whether delta power correlates with semantic and letter verbal fluency (former being a marker for language and verbal memory, latter for executive functions) in 26 FE patients (15 LFE, 11 RFE) and 10 healthy controls. RESULTS Delta power was increased in FE patients compared to healthy controls. However, the increase across hemispheres was related to the site of the epileptic focus: On group level, LFE patients showed higher delta power in both hemispheres, whereas RFE patients primarily exhibited higher delta power in the ipsilateral right hemisphere. Both groups showed co-fluctuations of delta power between the hemispheres. Besides, delta power correlated negatively only with letter verbal fluency. CONCLUSION The findings confirm and provide further evidence that delta power is a marker of pathological activity and abnormal brain processes in FE. Delta power dynamics differ between patient groups, indicating that delta power could offer additional diagnostic value. The negative association of delta power and letter verbal fluency suggests that executive dysfunctions are related to low frequency abnormalities.
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Affiliation(s)
- Annika Melissa Süß
- Epilepsy Center Frankfurt Rhine‐MainCenter of Neurology and NeurosurgeryUniversity Hospital FrankfurtFrankfurt am MainGermany
- LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe University FrankfurtFrankfurt am MainGermany
| | - Marion Hug
- Department of NeurologyUniversity Hospital Frankfurt and Goethe UniversityFrankfurt am MainGermany
| | - Nadine Conradi
- Epilepsy Center Frankfurt Rhine‐MainCenter of Neurology and NeurosurgeryUniversity Hospital FrankfurtFrankfurt am MainGermany
- LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe University FrankfurtFrankfurt am MainGermany
| | - Ricardo Kienitz
- Epilepsy Center Frankfurt Rhine‐MainCenter of Neurology and NeurosurgeryUniversity Hospital FrankfurtFrankfurt am MainGermany
- LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe University FrankfurtFrankfurt am MainGermany
| | - Felix Rosenow
- Epilepsy Center Frankfurt Rhine‐MainCenter of Neurology and NeurosurgeryUniversity Hospital FrankfurtFrankfurt am MainGermany
- LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe University FrankfurtFrankfurt am MainGermany
| | - Stefan Rampp
- Department of NeurosurgeryUniversity Hospital ErlangenErlangenGermany
- Department of NeurosurgeryUniversity Hospital Halle (Saale)Halle (Saale)Germany
| | - Nina Merkel
- Epilepsy Center Frankfurt Rhine‐MainCenter of Neurology and NeurosurgeryUniversity Hospital FrankfurtFrankfurt am MainGermany
- Ernst Strüngmann Institute for Neuroscience in Cooperation with Max Planck SocietyFrankfurt am MainGermany
- LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe University FrankfurtFrankfurt am MainGermany
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da Silveira RV, Li LM, Castellano G. Texture-based brain networks for characterization of healthy subjects from MRI. Sci Rep 2023; 13:16421. [PMID: 37775531 PMCID: PMC10541866 DOI: 10.1038/s41598-023-43544-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 09/25/2023] [Indexed: 10/01/2023] Open
Abstract
Brain networks have been widely used to study the relationships between brain regions based on their dynamics using, e.g. fMRI or EEG, and to characterize their real physical connections using DTI. However, few studies have investigated brain networks derived from structural properties; and those have been based on cortical thickness or gray matter volume. The main objective of this work was to investigate the feasibility of obtaining useful information from brain networks derived from structural MRI, using texture features. We also wanted to verify if texture brain networks had any relation with established functional networks. T1-MR images were segmented using AAL and texture parameters from the gray-level co-occurrence matrix were computed for each region, for 760 subjects. Individual texture networks were used to evaluate the structural connections between regions of well-established functional networks; assess possible gender differences; investigate the dependence of texture network measures with age; and single out brain regions with different texture-network characteristics. Although around 70% of texture connections between regions belonging to the default mode, attention, and visual network were greater than the mean connection value, this effect was small (only between 7 and 15% of these connections were larger than one standard deviation), implying that texture-based morphology does not seem to subside function. This differs from cortical thickness-based morphology, which has been shown to relate to functional networks. Seventy-five out of 86 evaluated regions showed significant (ANCOVA, p < 0.05) differences between genders. Forty-four out of 86 regions showed significant (ANCOVA, p < 0.05) dependence with age; however, the R2 indicates that this is not a linear relation. Thalamus and putamen showed a very unique texture-wise structure compared to other analyzed regions. Texture networks were able to provide useful information regarding gender and age-related differences, as well as for singling out specific brain regions. We did not find a morphological texture-based subsidy for the evaluated functional brain networks. In the future, this approach will be extended to neurological patients to investigate the possibility of extracting biomarkers to help monitor disease evolution or treatment effectiveness.
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Affiliation(s)
- Rafael Vinícius da Silveira
- Department of Cosmic Rays and Chronology, Gleb Wataghin Physics Institute, University of Campinas - UNICAMP, R. Sérgio Buarque de Holanda, 777, Cidade Universitária Zeferino Vaz, Campinas, SP, 13083-859, Brazil.
- Brazilian Institute of Neuroscience and Neurotechnology - BRAINN, Campinas, SP, 13083-887, Brazil.
| | - Li Min Li
- Department of Neurology, School of Medical Sciences, University of Campinas - UNICAMP, R. Tessália Vieira de Camargo, 126, Cidade Universitária Zeferino Vaz, Campinas, SP, 13083-887, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology - BRAINN, Campinas, SP, 13083-887, Brazil
| | - Gabriela Castellano
- Department of Cosmic Rays and Chronology, Gleb Wataghin Physics Institute, University of Campinas - UNICAMP, R. Sérgio Buarque de Holanda, 777, Cidade Universitária Zeferino Vaz, Campinas, SP, 13083-859, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology - BRAINN, Campinas, SP, 13083-887, Brazil
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Pan R, Yang C, Li Z, Ren J, Duan Y. Magnetoencephalography-based approaches to epilepsy classification. Front Neurosci 2023; 17:1183391. [PMID: 37502686 PMCID: PMC10368885 DOI: 10.3389/fnins.2023.1183391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 06/12/2023] [Indexed: 07/29/2023] Open
Abstract
Epilepsy is a chronic central nervous system disorder characterized by recurrent seizures. Not only does epilepsy severely affect the daily life of the patient, but the risk of premature death in patients with epilepsy is three times higher than that of the normal population. Magnetoencephalography (MEG) is a non-invasive, high temporal and spatial resolution electrophysiological data that provides a valid basis for epilepsy diagnosis, and used in clinical practice to locate epileptic foci in patients with epilepsy. It has been shown that MEG helps to identify MRI-negative epilepsy, contributes to clinical decision-making in recurrent seizures after previous epilepsy surgery, that interictal MEG can provide additional localization information than scalp EEG, and complete excision of the stimulation area defined by the MEG has prognostic significance for postoperative seizure control. However, due to the complexity of the MEG signal, it is often difficult to identify subtle but critical changes in MEG through visual inspection, opening up an important area of research for biomedical engineers to investigate and implement intelligent algorithms for epilepsy recognition. At the same time, the use of manual markers requires significant time and labor costs, necessitating the development and use of computer-aided diagnosis (CAD) systems that use classifiers to automatically identify abnormal activity. In this review, we discuss in detail the results of applying various different feature extraction methods on MEG signals with different classifiers for epilepsy detection, subtype determination, and laterality classification. Finally, we also briefly look at the prospects of using MEG for epilepsy-assisted localization (spike detection, high-frequency oscillation detection) due to the unique advantages of MEG for functional area localization in epilepsy, and discuss the limitation of current research status and suggestions for future research. Overall, it is hoped that our review will facilitate the reader to quickly gain a general understanding of the problem of MEG-based epilepsy classification and provide ideas and directions for subsequent research.
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Affiliation(s)
- Ruoyao Pan
- Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Chunlan Yang
- Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Zhimei Li
- Department of Internal Neurology, Tiantan Hospital, Beijing, China
| | - Jiechuan Ren
- Department of Internal Neurology, Tiantan Hospital, Beijing, China
| | - Ying Duan
- Beijing Universal Medical Imaging Diagnostic Center, Beijing, China
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11
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Mason SL, Junges L, Woldman W, Facer-Childs ER, de Campos BM, Bagshaw AP, Terry JR. Classification of human chronotype based on fMRI network-based statistics. Front Neurosci 2023; 17:1147219. [PMID: 37342462 PMCID: PMC10277557 DOI: 10.3389/fnins.2023.1147219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 05/17/2023] [Indexed: 06/23/2023] Open
Abstract
Chronotype-the relationship between the internal circadian physiology of an individual and the external 24-h light-dark cycle-is increasingly implicated in mental health and cognition. Individuals presenting with a late chronotype have an increased likelihood of developing depression, and can display reduced cognitive performance during the societal 9-5 day. However, the interplay between physiological rhythms and the brain networks that underpin cognition and mental health is not well-understood. To address this issue, we use rs-fMRI collected from 16 people with an early chronotype and 22 people with a late chronotype over three scanning sessions. We develop a classification framework utilizing the Network Based-Statistic methodology, to understand if differentiable information about chronotype is embedded in functional brain networks and how this changes throughout the day. We find evidence of subnetworks throughout the day that differ between extreme chronotypes such that high accuracy can occur, describe rigorous threshold criteria for achieving 97.3% accuracy in the Evening and investigate how the same conditions hinder accuracy for other scanning sessions. Revealing differences in functional brain networks based on extreme chronotype suggests future avenues of research that may ultimately better characterize the relationship between internal physiology, external perturbations, brain networks, and disease.
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Affiliation(s)
- Sophie L. Mason
- School of Mathematics, College of Engineering and Physical Sciences, University of Birmingham, Birmingham, United Kingdom
- Centre for Systems Modelling and Quantitative Biomedicine, University of Birmingham, Birmingham, United Kingdom
| | - Leandro Junges
- Centre for Systems Modelling and Quantitative Biomedicine, University of Birmingham, Birmingham, United Kingdom
| | - Wessel Woldman
- Centre for Systems Modelling and Quantitative Biomedicine, University of Birmingham, Birmingham, United Kingdom
| | - Elise R. Facer-Childs
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
- Danny Frawley Centre for Health and Wellbeing, Melbourne, VIC, Australia
- Centre for Human Brain Health, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
- Faculty of Health and Medical Sciences, University of Surrey, Surrey, United Kingdom
| | | | - Andrew P. Bagshaw
- Centre for Human Brain Health, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - John R. Terry
- Centre for Systems Modelling and Quantitative Biomedicine, University of Birmingham, Birmingham, United Kingdom
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12
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Jiang Y, Li W, Qin Y, Zhang L, Tong X, Xiao F, Jiang S, Li Y, Gong Q, Zhou D, An D, Yao D, Luo C. In vivo characterization of magnetic resonance imaging-based T1w/T2w ratios reveals myelin-related changes in temporal lobe epilepsy. Hum Brain Mapp 2023; 44:2323-2335. [PMID: 36692056 PMCID: PMC10028664 DOI: 10.1002/hbm.26212] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 12/12/2022] [Accepted: 01/09/2023] [Indexed: 01/25/2023] Open
Abstract
Temporal lobe epilepsy (TLE) is the most common type of intractable epilepsy in adults. Although brain myelination alterations have been observed in TLE, it remains unclear how the myelination network changes in TLE. This study developed a novel method in characterization of myelination structural covariance network (mSCN) by T1-weighted and T2-weighted magnetic resonance imaging (MRI). The mSCNs were estimated in 42 left TLE (LTLE), 42 right TLE (RTLE) patients, and 41 healthy controls (HCs). The topology of mSCN was analyzed by graph theory. Voxel-wise comparisons of myelination laterality were also examined among the three groups. Compared to HC, both patient groups showed decreased myelination in frontotemporal regions, amygdala, and thalamus; however, the LTLE showed lower myelination in left medial temporal regions than RTLE. Moreover, the LTLE exhibited decreased global efficiency compared with HC and more increased connections than RTLE. The laterality in putamen was differently altered between the two patient groups: higher laterality at posterior putamen in LTLE and higher laterality at anterior putamen in RTLE. The putamen may play a transfer station role in damage spreading induced by epileptic seizures from the hippocampus. This study provided a novel workflow by combination of T1-weighted and T2-weighted MRI to investigate in vivo the myelin-related microstructural feature in epileptic patients first time. Disconnections of mSCN implicate that TLE is a system disorder with widespread disruptions at regional and network levels.
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Affiliation(s)
- Yuchao Jiang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
- High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of life Science and technology, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
| | - Wei Li
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Yingjie Qin
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Le Zhang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Xin Tong
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Fenglai Xiao
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Sisi Jiang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
- High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of life Science and technology, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
| | - Yunfang Li
- Southern Medical District, Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China
| | - Qiyong Gong
- Huaxi MR Research Center, Department of Radiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Dong Zhou
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Dongmei An
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Dezhong Yao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
- Research Unit of NeuroInformation, Chinese Academy of Medical Sciences, Chengdu, People's Republic of China
- Department of Neurology, First Affiliated Hospital of Hainan Medical University, Haikou, People's Republic of China
| | - Cheng Luo
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
- High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of life Science and technology, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
- Research Unit of NeuroInformation, Chinese Academy of Medical Sciences, Chengdu, People's Republic of China
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13
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Narasimhan S, González HFJ, Johnson GW, Wills KE, Paulo DL, Morgan VL, Englot DJ. Functional connectivity between mesial temporal and default mode structures may help lateralize surgical temporal lobe epilepsy. J Neurosurg 2022; 137:1571-1581. [PMID: 35364587 PMCID: PMC9525455 DOI: 10.3171/2022.1.jns212031] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 01/31/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The most common surgically treatable epilepsy syndrome is mesial temporal lobe epilepsy (mTLE). Preoperative noninvasive lateralization of mTLE is challenging in part due to rapid contralateral seizure spread. Abnormal connections in both the mesial temporal lobe and resting-state networks have been described in mTLE, but it is unclear if connectivity between these networks may aid in lateralization. METHODS In 52 patients with left mTLE (LmTLE) or right mTLE (RmTLE) and 52 matched control subjects, the authors acquired 20 minutes of resting-state functional MRI (fMRI) and evaluated functional connectivity of bilateral hippocampi and amygdalae with selected resting-state networks. They used Pearson correlation, network-based statistic, and dynamic causal modeling. Also, to evaluate the clinical utility of a resting-state connectivity model in lateralizing unilateral presurgical mTLE patients, they used receiver operating characteristic curve analysis. RESULTS RmTLE patients demonstrated decreased nondirected connectivity between the right hippocampus and default mode network compared with LmTLE patients and control subjects. Network-based statistic analysis revealed that the network with most decreased connectivity that distinguished LmTLE from RmTLE patients included the right hippocampus and amygdala, right lateral orbitofrontal cortices, and bilateral inferior parietal lobules, precuneus, and medial orbitofrontal cortices. Dynamic causal modeling analysis revealed that cross-hemispheric connectivity between hippocampi and amygdalae was predominantly inward toward the epileptogenic side. A regression model incorporating these connectivity patterns was used to accurately lateralize mTLE patients with an area under the receiver operating characteristic curve of 0.87. CONCLUSIONS Evaluating fMRI connectivity between mesial temporal structures and default mode network may aid in mTLE lateralization, reduce need for intracranial monitoring, and guide surgical planning.
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Affiliation(s)
- Saramati Narasimhan
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee
- Vanderbilt Institute for Surgery and Engineering, Nashville, Tennessee
- Department of Biomedical, Nashville, Tennessee
| | - Hernán F. J. González
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee
- Vanderbilt Institute for Surgery and Engineering, Nashville, Tennessee
- Department of Biomedical, Nashville, Tennessee
| | - Graham W. Johnson
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee
- Vanderbilt Institute for Surgery and Engineering, Nashville, Tennessee
- Department of Biomedical, Nashville, Tennessee
| | - Kristin E. Wills
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee
- Vanderbilt Institute for Surgery and Engineering, Nashville, Tennessee
| | - Danika L. Paulo
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Victoria L. Morgan
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee
- Vanderbilt Institute for Surgery and Engineering, Nashville, Tennessee
- Department of Biomedical, Nashville, Tennessee
| | - Dario J. Englot
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee
- Vanderbilt Institute for Surgery and Engineering, Nashville, Tennessee
- Department of Biomedical, Nashville, Tennessee
- Department of Electrical Engineering and Computer Science at Vanderbilt University, Nashville, Tennessee
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14
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Sumsky S, Greenfield LJ. Network analysis of preictal iEEG reveals changes in network structure preceding seizure onset. Sci Rep 2022; 12:12526. [PMID: 35869236 PMCID: PMC9307526 DOI: 10.1038/s41598-022-16877-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 07/18/2022] [Indexed: 12/05/2022] Open
Abstract
Seizures likely result from aberrant network activity and synchronization. Changes in brain network connectivity may underlie seizure onset. We used a novel method of rapid network model estimation from intracranial electroencephalography (iEEG) data to characterize pre-ictal changes in network structure prior to seizure onset. We analyzed iEEG data from 20 patients from the iEEG.org database. Using 10 s epochs sliding by 1 s intervals, a multiple input, single output (MISO) state space model was estimated for each output channel and time point with all other channels as inputs, generating sequential directed network graphs of channel connectivity. These networks were assessed using degree and betweenness centrality. Both degree and betweenness increased at seizure onset zone (SOZ) channels 37.0 ± 2.8 s before seizure onset. Degree rose in all channels 8.2 ± 2.2 s prior to seizure onset, with increasing connections between the SOZ and surrounding channels. Interictal networks showed low and stable connectivity. A novel MISO model-based network estimation method identified changes in brain network structure just prior to seizure onset. Increased connectivity was initially isolated within the SOZ and spread to non-SOZ channels before electrographic seizure onset. Such models could help confirm localization of SOZ regions.
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15
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Glutig K, Lange L, Krüger PC, Gräger S, de Vries H, Brandl U, Gaser C, Mentzel HJ. Differences in Cerebellar Volume as a Diagnostic and Prognostic Biomarker in Children and Adolescents With Epilepsy of Unknown Etiology. J Child Neurol 2022; 37:939-948. [PMID: 36113051 PMCID: PMC9703387 DOI: 10.1177/08830738221114241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION AND OBJECTIVE Epilepsy is one of the most common brain diseases during childhood and adolescence. Atrophy in different brain areas is possible during epilepsy. This study aimed to verify whether cerebellar volume differences could be detected by volume analysis using magnetic resonance imaging (MRI) in children with epilepsy. METHOD In this retrospective study, 41 children (3.1-18.8 years) with epilepsy of unknown etiology were included (duration of epilepsy 1.9 ± 3 years). A cranial MRI with a volumetric 3-dimensional, T1-weighted sequence was used for volume analysis. The MRIs of 26 patients with headache (5.3-17.1 years) were analyzed for comparison. A volume analysis of the cerebellum was performed using region-based morphometry. Total cerebellar volume, total white and gray matter volume, and 48 regional lobules (L), separated into white and gray matter, were calculated. Cerebellar volumes are presented in relative ratios as the volume fraction of cerebellar volume to total intracranial volume: CV/TIV. RESULTS The ratio of overall white matter volume was significantly lower in the case group (23.93 × 10-3, P = .039). A significantly lower ratio of regional white matter volume was detected in LV right (P = .031) and left (P = .014), in LVIIIB right (P = .011) and left (P = .019), and in LVIIIA left (P = .009). CONCLUSION Our results emphasize that volume analysis of the total cerebellar volume alone is insufficient to characterize cerebellar differences in children with epilepsy. Rather, in specific cerebellar region volume analysis using region-based morphometry, children with epilepsy showed significantly lower regional volumes of lobules, which are important for sensorimotor function (LV, LVIII) and higher cognitive function (crus I).
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Affiliation(s)
- Katja Glutig
- Department of Radiology, Section of Pediatric Radiology, University Hospital, Jena, Germany,Katja Glutig, Jena University Hospital, Department of Radiology, Section of Pediatric Radiology, Am Klinikum 1, 07747 Jena, Germany.
| | - Luisa Lange
- Department of Radiology, Section of Pediatric Radiology, University Hospital, Jena, Germany
| | - Paul-Christian Krüger
- Department of Radiology, Section of Pediatric Radiology, University Hospital, Jena, Germany
| | - Stephanie Gräger
- Department of Radiology, Section of Pediatric Radiology, University Hospital, Jena, Germany
| | - Heike de Vries
- Department of Neuropediatrics, University Children’s Hospital, Jena, Germany
| | - Ulrich Brandl
- Department of Neuropediatrics, University Children’s Hospital, Jena, Germany
| | - Christian Gaser
- Structural Brain Mapping Group, Departments of Psychiatry and Neurology, University Hospital, Jena, Germany
| | - Hans-Joachim Mentzel
- Department of Radiology, Section of Pediatric Radiology, University Hospital, Jena, Germany
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16
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Fleury M, Buck S, Binding LP, Caciagli L, Vos SB, Winston GP, Thompson P, Koepp MJ, Duncan JS, Sidhu MK. Episodic memory network connectivity in temporal lobe epilepsy. Epilepsia 2022; 63:2597-2622. [PMID: 35848050 PMCID: PMC9804196 DOI: 10.1111/epi.17370] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 07/14/2022] [Accepted: 07/15/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Temporal lobe epilepsy (TLE) affects brain networks and is associated with impairment of episodic memory. Temporal and extratemporal reorganization of memory functions is described in functional magnetic resonance imaging (fMRI) studies. Functional reorganizations have been shown at the local activation level, but network-level alterations have been underinvestigated. We aim to investigate the functional anatomy of memory networks using memory fMRI and determine how this relates to memory function in TLE. METHODS Ninety patients with unilateral TLE (43 left) and 29 controls performed a memory-encoding fMRI paradigm of faces and words with subsequent out-of-scanner recognition test. Subsequent memory event-related contrasts of words and faces remembered were generated. Psychophysiological interaction analysis investigated task-associated changes in functional connectivity seeding from the mesial temporal lobes (MTLs). Correlations between changes in functional connectivity and clinical memory scores, epilepsy duration, age at epilepsy onset, and seizure frequency were investigated, and between connectivity supportive of better memory and disease burden. Connectivity differences between controls and TLE, and between TLE with and without hippocampal sclerosis, were explored using these confounds as regressors of no interest. RESULTS Compared to controls, TLE patients showed widespread decreased connectivity between bilateral MTLs and frontal lobes, and increased local connectivity between the anterior MTLs bilaterally. Increased intrinsic connectivity within the bilateral MTLs correlated with better out-of-scanner memory performance in both left and right TLE. Longer epilepsy duration and higher seizure frequency were associated with decreased connectivity between bilateral MTLs and left/right orbitofrontal cortex (OFC) and insula, connections supportive of memory functions. TLE due to hippocampal sclerosis was associated with greater connectivity disruption within the MTL and extratemporally. SIGNIFICANCE Connectivity analyses showed that TLE is associated with temporal and extratemporal memory network reorganization. Increased bilateral functional connectivity within the MTL and connectivity to OFC and insula are efficient, and are disrupted by greater disease burden.
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Affiliation(s)
- Marine Fleury
- Department of Clinical and Experimental EpilepsyUniversity College London Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyBuckinghamshireUK
| | - Sarah Buck
- Department of Clinical and Experimental EpilepsyUniversity College London Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyBuckinghamshireUK
| | - Lawrence P. Binding
- Department of Clinical and Experimental EpilepsyUniversity College London Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyBuckinghamshireUK
- Department of Computer Science, Centre for Medical Image ComputingUniversity College LondonLondonUK
| | - Lorenzo Caciagli
- Department of Clinical and Experimental EpilepsyUniversity College London Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyBuckinghamshireUK
- Department of BioengineeringUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Sjoerd B. Vos
- Department of Clinical and Experimental EpilepsyUniversity College London Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyBuckinghamshireUK
- Neuroradiological Academic Unit, University College London Queen Square Institute of NeurologyUniversity College LondonLondonUK
| | - Gavin P. Winston
- Department of Clinical and Experimental EpilepsyUniversity College London Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyBuckinghamshireUK
- Division of Neurology, Department of MedicineQueen's UniversityKingstonOntarioCanada
| | - Pamela J. Thompson
- Department of Clinical and Experimental EpilepsyUniversity College London Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyBuckinghamshireUK
| | - Matthias J. Koepp
- Department of Clinical and Experimental EpilepsyUniversity College London Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyBuckinghamshireUK
| | - John S. Duncan
- Department of Clinical and Experimental EpilepsyUniversity College London Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyBuckinghamshireUK
| | - Meneka K. Sidhu
- Department of Clinical and Experimental EpilepsyUniversity College London Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyBuckinghamshireUK
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17
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Pizzanelli C, Pesaresi I, Milano C, Cecchi P, Fontanelli L, Giannoni S, Giorgi FS, Cosottini M, Bonanni E. Distinct limbic connectivity in left and right benign mesial temporal lobe epilepsy: Evidence from a resting state functional MRI study. Front Neurol 2022; 13:943660. [PMID: 36247782 PMCID: PMC9558280 DOI: 10.3389/fneur.2022.943660] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 09/12/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundFunctional connectivity (FC) studies showed that pharmaco-resistant mesial temporal lobe epilepsy (MTLE) affects not only the limbic system, but also several extra-limbic regions, including areas belonging to resting state networks. Less is known about FC in subjects with benign MTLE (i.e., sensitive to antiseizure medication, bMTLE).Aim and methodsWe evaluated FC of hippocampus and amygdala in subjects with bMTLE, distinguished based on the epileptic focus lateralization. We enrolled 19 patients (10 with left and 9 with right bMTLE) and 10 age-matched healthy subjects. Connectivity was investigated at rest by using a seed-based regression analyses approach with four regions of interest (left and right hippocampus, left and right amygdala). Patients were also tested with a neuropsychological battery and their scores were correlated with fMRI data.Results and conclusionsOur study documented an asymmetrical disruption of FC in bMTLE, in relation to the side of the focus. Right subjects only exhibited limited altered connections, while left subjects—who performed worse in verbal memory tests—showed a wide bilateral hypoconnectivity of hippocampus and amygdala with areas belonging to language and memory network. The strength of FC between left limbic areas and language and memory network correlated with better performances in verbal memory tests. Moreover, we observed an increased FC with areas of default mode network, more pronounced in left subjects, a possible attempt to compensate cognitive deficit but without effectiveness.We believe that these findings could help to better characterize bMTLE, in which a dysfunction of limbic connectivity is detectable despite well-controlled epilepsy.
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Affiliation(s)
- Chiara Pizzanelli
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
- *Correspondence: Chiara Pizzanelli
| | | | - Chiara Milano
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
| | - Paolo Cecchi
- Department of Translational Research and New Technologies in Medicine and Surgery, Neuroradiology Unit, University of Pisa, Pisa, Italy
| | - Lorenzo Fontanelli
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
| | - Sara Giannoni
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
| | - Filippo Sean Giorgi
- Department of Translational Research and New Technologies in Medicine and Surgery, Human Anatomy, University of Pisa, Pisa, Italy
| | - Mirco Cosottini
- Neuroradiology Unit, Pisa University Hospital, Pisa, Italy
- Department of Translational Research and New Technologies in Medicine and Surgery, Neuroradiology Unit, University of Pisa, Pisa, Italy
| | - Enrica Bonanni
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
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18
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Ballerini A, Tondelli M, Talami F, Molinari MA, Micalizzi E, Giovannini G, Turchi G, Malagoli M, Genovese M, Meletti S, Vaudano AE. Amygdala subnuclear volumes in temporal lobe epilepsy with hippocampal sclerosis and in non-lesional patients. Brain Commun 2022; 4:fcac225. [PMID: 36213310 PMCID: PMC9536297 DOI: 10.1093/braincomms/fcac225] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 05/12/2022] [Accepted: 09/05/2022] [Indexed: 11/28/2022] Open
Abstract
Together with hippocampus, the amygdala is important in the epileptogenic network of patients with temporal lobe epilepsy. Recently, an increase in amygdala volumes (i.e. amygdala enlargement) has been proposed as morphological biomarker of a subtype of temporal lobe epilepsy patients without MRI abnormalities, although other data suggest that this finding might be unspecific and not exclusive to temporal lobe epilepsy. In these studies, the amygdala is treated as a single entity, while instead it is composed of different nuclei, each with peculiar function and connection. By adopting a recently developed methodology of amygdala's subnuclei parcellation based of high-resolution T1-weighted image, this study aims to map specific amygdalar subnuclei participation in temporal lobe epilepsy due to hippocampal sclerosis (n = 24) and non-lesional temporal lobe epilepsy (n = 24) with respect to patients with focal extratemporal lobe epilepsies (n = 20) and healthy controls (n = 30). The volumes of amygdala subnuclei were compared between groups adopting multivariate analyses of covariance and correlated with clinical variables. Additionally, a logistic regression analysis on the nuclei resulting statistically different across groups was performed. Compared with other populations, temporal lobe epilepsy with hippocampal sclerosis showed a significant atrophy of the whole amygdala (p Bonferroni = 0.040), particularly the basolateral complex (p Bonferroni = 0.033), while the non-lesional temporal lobe epilepsy group demonstrated an isolated hypertrophy of the medial nucleus (p Bonferroni = 0.012). In both scenarios, the involved amygdala was ipsilateral to the epileptic focus. The medial nucleus demonstrated a volume increase even in extratemporal lobe epilepsies although contralateral to the seizure onset hemisphere (p Bonferroni = 0.037). Non-lesional patients with psychiatric comorbidities showed a larger ipsilateral lateral nucleus compared with those without psychiatric disorders. This exploratory study corroborates the involvement of the amygdala in temporal lobe epilepsy, particularly in mesial temporal lobe epilepsy and suggests a different amygdala subnuclei engagement depending on the aetiology and lateralization of epilepsy. Furthermore, the logistic regression analysis indicated that the basolateral complex and the medial nucleus of amygdala can be helpful to differentiate temporal lobe epilepsy with hippocampal sclerosis and with MRI negative, respectively, versus controls with a consequent potential clinical yield. Finally, the present results contribute to the literature about the amygdala enlargement in temporal lobe epilepsy, suggesting that the increased volume of amygdala can be regarded as epilepsy-related structural changes common across different syndromes whose meaning should be clarified.
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Affiliation(s)
- Alice Ballerini
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena 41125, Italy
| | | | - Francesca Talami
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena 41125, Italy
| | | | - Elisa Micalizzi
- PhD Program in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena 41121, Italy
| | - Giada Giovannini
- Neurology Unit, OCB Hospital, AOU Modena, Modena 41126, Italy
- PhD Program in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena 41121, Italy
| | - Giulia Turchi
- Neurology Unit, OCB Hospital, AOU Modena, Modena 41126, Italy
| | | | | | - Stefano Meletti
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena 41125, Italy
- Neurology Unit, OCB Hospital, AOU Modena, Modena 41126, Italy
| | - Anna Elisabetta Vaudano
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena 41125, Italy
- Neurology Unit, OCB Hospital, AOU Modena, Modena 41126, Italy
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19
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Cutia CA, Leverton LK, Ge X, Youssef R, Raetzman LT, Christian-Hinman CA. Phenotypic differences based on lateralization of intrahippocampal kainic acid injection in female mice. Exp Neurol 2022; 355:114118. [PMID: 35597270 PMCID: PMC10462257 DOI: 10.1016/j.expneurol.2022.114118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 04/17/2022] [Accepted: 05/13/2022] [Indexed: 11/23/2022]
Abstract
Clinical evidence indicates that patients with temporal lobe epilepsy (TLE) often show differential outcomes of comorbid conditions in relation to the lateralization of the seizure focus. A particularly strong relationship exists between the side of seizure focus and the propensity for distinct reproductive endocrine comorbidities in women with TLE. Therefore, here we evaluated whether targeting of left or right dorsal hippocampus for intrahippocampal kainic acid (IHKA) injection, a model of TLE, produces different outcomes in hippocampal granule cell dispersion, body weight gain, and multiple measures of reproductive endocrine dysfunction in female mice. One, two, and four months after IHKA or saline injection, in vivo measurements of estrous cycles and weight were followed by ex vivo examination of hippocampal dentate granule cell dispersion, circulating ovarian hormone and corticosterone levels, ovarian morphology, and pituitary gene expression. IHKA mice with right-targeted injection (IHKA-R) showed greater granule cell dispersion and pituitary Fshb expression compared to mice with left-targeted injection (IHKA-L). By contrast, pituitary expression of Lhb and Gnrhr were higher in IHKA-L mice compared to IHKA-R, but these values were not different from respective saline-injected controls. IHKA-L mice also showed an increased rate of weight gain compared to IHKA-R mice. Increases in estrous cycle length, however, were similar in both IHKA-L and IHKA-R mice. These findings indicate that although major reproductive endocrine dysfunction phenotypes present similarly after targeting left or right dorsal hippocampus for IHKA injection, distinct underlying mechanisms based on lateralization of epileptogenic insult may contribute to produce similar emergent reproductive endocrine outcomes.
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Affiliation(s)
- Cathryn A Cutia
- Neuroscience Program, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA
| | - Leanna K Leverton
- Department of Molecular and Integrative Physiology, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA
| | - Xiyu Ge
- Department of Molecular and Integrative Physiology, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA
| | - Rana Youssef
- Department of Molecular and Integrative Physiology, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA
| | - Lori T Raetzman
- Neuroscience Program, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA; Department of Molecular and Integrative Physiology, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA
| | - Catherine A Christian-Hinman
- Neuroscience Program, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA; Department of Molecular and Integrative Physiology, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA; Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA.
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20
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Almeida SRM, Stefano Filho CA, Vicentini J, Novi SL, Mesquita RC, Castellano G, Li LM. Modeling functional network topology following stroke through graph theory: functional reorganization and motor recovery prediction. Braz J Med Biol Res 2022; 55:e12036. [PMID: 35976269 PMCID: PMC9377533 DOI: 10.1590/1414-431x2022e12036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 06/10/2022] [Indexed: 11/21/2022] Open
Abstract
The study of functional reorganization following stroke has been steadily growing
supported by advances in neuroimaging techniques, such as functional magnetic
resonance imaging (fMRI). Concomitantly, graph theory has been increasingly
employed in neuroscience to model the brain's functional connectivity (FC) and
to investigate it in a variety of contexts. The aims of this study were: 1) to
investigate the reorganization of network topology in the ipsilesional (IL) and
contralesional (CL) hemispheres of stroke patients with (motor stroke group) and
without (control stroke group) motor impairment, and 2) to predict motor
recovery through the relationship between local topological variations of the
functional network and increased motor function. We modeled the brain's FC as a
graph using fMRI data, and we characterized its interactions with the following
graph metrics: degree, clustering coefficient, characteristic path length, and
betweenness centrality (BC). For both patient groups, BC yielded the largest
variations between the two analyzed time points, especially in the motor stroke
group. This group presented significant correlations (P<0.05) between average
BC changes and the improvements in upper-extremity Fugl-Meyer (UE-FM) scores at
the primary sensorimotor cortex and the supplementary motor area for the CL
hemisphere. These regions participate in processes related to the selection,
planning, and execution of movement. Generally, higher increases in average BC
over these areas were related to larger improvements in UE-FM assessment.
Although the sample was small, these results suggest the possibility of using BC
as an indication of brain plasticity mechanisms following stroke.
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Affiliation(s)
- S R M Almeida
- Departamento de Neurologia, Faculdade de Ciências Médicas, Universidade de Campinas, Campinas, SP, Brasil.,BRAINN (Brazilian Institute of Neuroscience and Neurotechnology), Campinas, SP, Brasil
| | - C A Stefano Filho
- BRAINN (Brazilian Institute of Neuroscience and Neurotechnology), Campinas, SP, Brasil.,Grupo de Neurofísica, Instituto de Física "Gleb Wataghin", Universidade de Campinas, Campinas, SP, Brasil
| | - J Vicentini
- Departamento de Neurologia, Faculdade de Ciências Médicas, Universidade de Campinas, Campinas, SP, Brasil.,BRAINN (Brazilian Institute of Neuroscience and Neurotechnology), Campinas, SP, Brasil
| | - S L Novi
- BRAINN (Brazilian Institute of Neuroscience and Neurotechnology), Campinas, SP, Brasil.,Grupo de Neurofísica, Instituto de Física "Gleb Wataghin", Universidade de Campinas, Campinas, SP, Brasil
| | - R C Mesquita
- BRAINN (Brazilian Institute of Neuroscience and Neurotechnology), Campinas, SP, Brasil.,Grupo de Neurofísica, Instituto de Física "Gleb Wataghin", Universidade de Campinas, Campinas, SP, Brasil
| | - G Castellano
- BRAINN (Brazilian Institute of Neuroscience and Neurotechnology), Campinas, SP, Brasil.,Grupo de Neurofísica, Instituto de Física "Gleb Wataghin", Universidade de Campinas, Campinas, SP, Brasil
| | - L M Li
- Departamento de Neurologia, Faculdade de Ciências Médicas, Universidade de Campinas, Campinas, SP, Brasil.,BRAINN (Brazilian Institute of Neuroscience and Neurotechnology), Campinas, SP, Brasil
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21
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Lourenço RB, Campos BM, Rizzi L, de Souza MS, Forlenza OV, Talib LL, Joaquim HPG, Cendes F, Balthazar MLF. Functional connectome analysis in Mild Cognitive Impairment: Comparing AD continuum and Suspected Non-Alzheimer Pathology. Brain Connect 2022; 12:774-783. [PMID: 35412854 DOI: 10.1089/brain.2021.0154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
INTRODUCTION Research in brain resting-state functional connectivity (FC) analysis in mild cognitive impairment (MCI) has conflicting results. This work intends to find differences in resting-state FC of MCI subjects due to Alzheimer´s disease continuum (MCI-AD) or suspected non-Alzheimer pathology (MCI-SNAP). METHODS 92 subjects over 55 years old were enrolled. MCI and controls were grouped using clinical dementia rating and neuropsychological data. CSF biomarkers were collected from MCI subjects, resulting in 32 MCI-AD, 25 MCI-SNAP, and 35 controls. A ROI-to-ROI analysis was carried out looking at inter and intranetwork interactions selecting the following networks: default mode (DMN), salience (SN), visuospatial (VN), and executive. Pearson correlation coefficients, converted to Z-scores were compared by T-tests with alpha set to 0.05, FDR corrected. RESULTS Groups were similar in age, education and demographic measures, there were no differences in neuropsychological data between the MCI groups. The ROI-to-ROI analysis MCI-AD versus MCI-SNAP showed no differences. MCI-AD versus controls showed decreased FC between ROIs of the SN and between ROIs from SN and VN. MCI-SNAP versus controls showed increased FC between a ROI of DMN and VN. DISCUSSION SN, DMN, and VN are multimodal networks with high value/high cost and may be more vulnerable to AD pathogenic processes. SN and VN were affected in the MCI-AD group, with maintained anticorrelation between DMN and VN. This may indicate subthreshold DMN dysfunction. The result in MCI-SNAP, although discrete, reflects a rearrangement of brain FC, as DMN and VN are expected to be anticorrelated. More research is necessary to confirm these findings.
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Affiliation(s)
- Rafael Brandes Lourenço
- State University of Campinas Faculty of Medical Sciences, 67791, Neurology, Cidade Universitária Zeferino Vaz - Barão Geraldo, Campinas, São Paulo, Brazil, 13083-970;
| | - Brunno Machado Campos
- State University of Campinas Faculty of Medical Sciences, 67791, Neurology, Campinas, São Paulo, Brazil;
| | - Liara Rizzi
- State University of Campinas Faculty of Medical Sciences, 67791, Neurology, Campinas, São Paulo, Brazil;
| | - Milene Sakzenian de Souza
- State University of Campinas Faculty of Medical Sciences, 67791, Neurology, Campinas, São Paulo, Brazil;
| | - Orestes Vicente Forlenza
- University of São Paulo Study Centre of the Institute of Psychiatry, 363307, LIM-27, Sao Paulo, São Paulo, Brazil;
| | - Leda Leme Talib
- University of São Paulo Study Centre of the Institute of Psychiatry, 363307, LIM-27, Sao Paulo, São Paulo, Brazil;
| | | | - Fernando Cendes
- State University of Campinas Faculty of Medical Sciences, 67791, Neurology, Campinas, São Paulo, Brazil;
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22
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Gholipour T, You X, Stufflebeam SM, Loew M, Koubeissi MZ, Morgan VL, Gaillard WD. Common functional connectivity alterations in focal epilepsies identified by machine learning. Epilepsia 2022; 63:629-640. [PMID: 34984672 PMCID: PMC9022014 DOI: 10.1111/epi.17160] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/20/2021] [Accepted: 12/21/2021] [Indexed: 02/04/2023]
Abstract
OBJECTIVE This study was undertaken to identify shared functional network characteristics among focal epilepsies of different etiologies, to distinguish epilepsy patients from controls, and to lateralize seizure focus using functional connectivity (FC) measures derived from resting state functional magnetic resonance imaging (MRI). METHODS Data were taken from 103 adult and 65 pediatric focal epilepsy patients (with or without lesion on MRI) and 109 controls across four epilepsy centers. We used three whole-brain FC measures: parcelwise connectivity matrix, mean FC, and degree of FC. We trained support vector machine models with fivefold cross-validation (1) to distinguish patients from controls and (2) to lateralize the hemisphere of seizure onset in patients. We reported the regions and connections with the highest importance from each model as the common FC differences between the compared groups. RESULTS FC measures related to the default mode and limbic networks had higher importance relative to other networks for distinguishing epilepsy patients from controls. In lateralization models, regions related to somatosensory, visual, default mode, and basal ganglia showed higher importance. The epilepsy versus control classification model trained using a 400-parcel connectivity matrix achieved a median testing accuracy of 75.6% (median area under the curve [AUC] = .83) in repeated independent testing. Lateralization accuracy using the 400-parcel connectivity matrix reached a median accuracy of 64.0% (median AUC = .69). SIGNIFICANCE Machine learning models revealed common FC alterations in a heterogeneous group of patients with focal epilepsies. The distribution of the most altered regions supports the hypothesis that shared functional alteration exists beyond the seizure onset zone and its epileptic network. We showed that FC measures can distinguish patients from controls, and further lateralize focal epilepsies. Future studies are needed to confirm these findings by using larger numbers of epilepsy patients.
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Affiliation(s)
- Taha Gholipour
- Department of Neurology, George Washington University, Washington, District of Columbia, USA.,Center for Neuroscience, Children's National Hospital, Washington, District of Columbia, USA.,Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts, USA
| | - Xiaozhen You
- Center for Neuroscience, Children's National Hospital, Washington, District of Columbia, USA
| | - Steven M Stufflebeam
- Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts, USA
| | - Murray Loew
- Department of Biomedical Engineering, George Washington University, Washington, District of Columbia, USA
| | - Mohamad Z Koubeissi
- Department of Neurology, George Washington University, Washington, District of Columbia, USA
| | | | - William D Gaillard
- Department of Neurology, George Washington University, Washington, District of Columbia, USA.,Center for Neuroscience, Children's National Hospital, Washington, District of Columbia, USA
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23
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Zhao X, Kang H, Zhou Z, Hu Y, Li J, Li S, Li J, Zhu W. Interhemispheric functional connectivity asymmetry is distinctly affected in left and right mesial temporal lobe epilepsy. Brain Behav 2022; 12:e2484. [PMID: 35166072 PMCID: PMC8933759 DOI: 10.1002/brb3.2484] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 11/15/2021] [Accepted: 12/14/2021] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION The differences of functional connectivity (FC) and functional asymmetry between left and right mesial temporal lobe epilepsy with hippocampal sclerosis (LMTLE and RMTLE) have not been completely clarified yet. The purpose of the present study is to investigate the FC changes and the FC asymmetric patterns of MTLE, and to compare the differences in FC and functional asymmetry between LMTLE and RMTLE. METHODS In total, 12 LMTLE, 11 RMTLE patients, and 23 healthy controls (HC) were included. Region of interest (ROI)-based analysis was used to evaluate FC. The right functional connectivity (rFC) and left functional connectivity (lFC) of each ROI were calculated. Asymmetry index (AI) was calculated based on the following formula: AI=100×(rFC-lFC)/[(rFC+lFC)/2]${\rm{AI\ }} = {\rm{\ }}100{\rm{\ }} \times {\rm{\ }}( {{\rm{rFC}} - {\rm{lFC}}} )/[ {( {{\rm{rFC}} + {\rm{lFC}}} )/2} ]$ . Paired t-test and univariate analysis of variance were used to analyze FC asymmetry. Linear correlation analysis was performed between significant FC changes and lateralized ROIs and epilepsy onset age and duration. RESULTS LMTLE and RMTLE patients showed different patterns of alteration in FC and functional asymmetry when compared with controls. RMTLE presented more extensive FC abnormalities than LMTLE. Regions in ipsilateral temporal lobe presented as central regions of abnormalities in both patient groups. In addition, the asymmetric characteristics of FC were reduced in MTLE compared with HC, with even more pronounced reduction for RMTLE group. Meanwhile, ROIs presented FC AI differences among the three groups were mostly involving left temporal lobe (L_hippo, L_amyg, L_TP, L_aMTG, and L_pTFusC). No correlation was found between significant FC changes and lateralized ROIs and epilepsy onset age and duration. CONCLUSION The FC and asymmetric features of MTLE are altered and involve both the temporal lobe and extra-temporal lobe. Furthermore, the altered FC and asymmetric features were distinctly affected in LMTLE and RMTLE compared to controls.
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Affiliation(s)
- Xu Zhao
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huicong Kang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhiqiang Zhou
- Department of Anesthesiology and Pain Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ying Hu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Juan Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shihui Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jia Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenzhen Zhu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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24
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Sainburg LE, Little AA, Johnson GW, Janson AP, Levine KK, González HFJ, Rogers BP, Chang C, Englot DJ, Morgan VL. Characterization of resting functional MRI activity alterations across epileptic foci and networks. Cereb Cortex 2022; 32:5555-5568. [PMID: 35149867 PMCID: PMC9753043 DOI: 10.1093/cercor/bhac035] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 01/19/2022] [Accepted: 01/24/2022] [Indexed: 01/25/2023] Open
Abstract
Brain network alterations have been studied extensively in patients with mesial temporal lobe epilepsy (mTLE) and other focal epilepsies using resting-state functional magnetic resonance imaging (fMRI). However, little has been done to characterize the basic fMRI signal alterations caused by focal epilepsy. Here, we characterize how mTLE affects the fMRI signal in epileptic foci and networks. Resting-state fMRI and diffusion MRI were collected from 47 unilateral mTLE patients and 96 healthy controls. FMRI activity, quantified by amplitude of low-frequency fluctuations, was increased in the epileptic focus and connected regions in mTLE. Evidence for spread of this epileptic fMRI activity was found through linear relationships of regional activity across subjects, the association of these relationships with functional connectivity, and increased activity along white matter tracts. These fMRI activity increases were found to be dependent on the epileptic focus, where the activity was related to disease severity, suggesting the focus to be the origin of these pathological alterations. Furthermore, we found fMRI activity decreases in the default mode network of right mTLE patients with different properties than the activity increases found in the epileptic focus. This work provides insights into basic fMRI signal alterations and their potential spread across networks in focal epilepsy.
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Affiliation(s)
- Lucas E Sainburg
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37212, USA,Department of Radiology and Radiological Sciences, Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN 37212, USA
| | - Aubrey A Little
- Department of Biomedical Engineering, Yale University, New Haven, CT 06520, USA
| | - Graham W Johnson
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37212, USA,Department of Radiology and Radiological Sciences, Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN 37212, USA
| | - Andrew P Janson
- Department of Radiology and Radiological Sciences, Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN 37212, USA
| | - Kaela K Levine
- Department of Radiology and Radiological Sciences, Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN 37212, USA
| | - Hernán F J González
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37212, USA,Department of Radiology and Radiological Sciences, Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN 37212, USA
| | - Baxter P Rogers
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37212, USA,Department of Radiology and Radiological Sciences, Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN 37212, USA
| | - Catie Chang
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37212, USA,Department of Radiology and Radiological Sciences, Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN 37212, USA,Department of Electrical and Computer Engineering, Vanderbilt University, Nashville, TN 37212, USA
| | - Dario J Englot
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37212, USA,Department of Radiology and Radiological Sciences, Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN 37212, USA,Department of Electrical and Computer Engineering, Vanderbilt University, Nashville, TN 37212, USA,Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN 37212, USA
| | - Victoria L Morgan
- Corresponding author: Department of Radiology and Radiological Sciences, Institute of Imaging Science, Vanderbilt University Medical Center, R0102 Medical Center North, 1161 21st Ave South, Nashville, TN 37232, USA.
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25
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Fallahi A, Pooyan M, Habibabadi JM, Hashemi-Fesharaki SS, Tabatabaei NH, Ay M, Nazem-Zadeh MR. A novel approach for extracting functional brain networks involved in mesial temporal lobe epilepsy based on self organizing maps. INFORMATICS IN MEDICINE UNLOCKED 2022. [DOI: 10.1016/j.imu.2022.100876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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26
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De Campos BM, Centeno M, Coan AC, Cendes F. Editorial: Advances and Applications of the EEG-fMRI Technique on Epilepsies. Front Neurol 2022; 12:827705. [PMID: 35095750 PMCID: PMC8792785 DOI: 10.3389/fneur.2021.827705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 12/14/2021] [Indexed: 11/18/2022] Open
Affiliation(s)
- Brunno Machado De Campos
- Neuroimaging Laboratory, Department of Neurology, University of Campinas, Campinas, Brazil.,Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), São Paulo, Brazil
| | - Maria Centeno
- Department of Neurology, Hospital Clinic Barcelona, Barcelona, Spain
| | - Ana Carolina Coan
- Neuroimaging Laboratory, Department of Neurology, University of Campinas, Campinas, Brazil.,Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), São Paulo, Brazil
| | - Fernando Cendes
- Neuroimaging Laboratory, Department of Neurology, University of Campinas, Campinas, Brazil.,Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), São Paulo, Brazil
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27
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Shurtleff HA, Poliakov A, Barry D, Wright JN, Warner MH, Novotny EJ, Marashly A, Buckley R, Goldstein HE, Hauptman JS, Ojemann JG, Shaw DWW. A clinically applicable functional MRI memory paradigm for use with pediatric patients. Epilepsy Behav 2022; 126:108461. [PMID: 34896785 DOI: 10.1016/j.yebeh.2021.108461] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 11/19/2021] [Accepted: 11/24/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Clinically employable functional MRI (fMRI) memory paradigms are not yet established for pediatric patient epilepsy surgery workups. Seeking to establish such a paradigm, we evaluated the effectiveness of memory fMRI tasks we developed by quantifying individual activation in a clinical pediatric setting, analyzing patterns of activation relative to the side of temporal lobe (TL) pathology, and comparing fMRI and Wada test results. METHODS We retrospectively identified 72 patients aged 6.7-20.9 years with pathology (seizure focus and/or tumor) limited to the TL who had attempted memory and language fMRI tasks over a 9-year period as part of presurgical workups. Memory fMRI tasks required visualization of autobiographical memories in a block design alternating with covert counting. Language fMRI protocols involved verb and sentence generation. Scans were both qualitatively interpreted and quantitatively assessed for blood oxygenation level dependent (BOLD) signal change using region of interest (ROI) masks. We calculated the percentage of successfully scanned individual cases, compared 2 memory task activation masks in cases with left versus right TL pathology, and compared fMRI with Wada tests when available. Patients who had viable fMRI and Wada tests had generally concordant results. RESULTS Of the 72 cases, 60 (83%), aged 7.6-20.9 years, successfully performed the memory fMRI tasks and 12 (17%) failed. Eleven of 12 unsuccessful scans were due to motion and/or inability to perform the tasks, and the success of a twelfth was indeterminate due to orthodontic metal artifact. Seven of the successful 60 cases had distorted anatomy that precluded employing predetermined masks for quantitative analysis. Successful fMRI memory studies showed bilateral mesial temporal activation and quantitatively demonstrated: (1) left activation (L-ACT) less than right activation (R-ACT) in cases with left temporal lobe (L-TL) pathology, (2) nonsignificant R-ACT less than L-ACT in cases with right temporal lobe (R-TL) pathology, and (3) lower L-ACT plus R-ACT activation for cases with L-TL versus R-TL pathology. Patients who had viable fMRI and Wada tests had generally concordant results. SIGNIFICANCE This study demonstrates evidence of an fMRI memory task paradigm that elicits reliable activation at the individual level and can generally be accomplished in clinically involved pediatric patients. This autobiographical memory paradigm showed activation in mesial TL structures, and cases with left compared to right TL pathology showed differences in activation consistent with extant literature in TL epilepsy. Further studies will be required to assess outcome prediction.
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Affiliation(s)
- Hillary A Shurtleff
- Neurosciences Institute, Seattle Children's Hospital, United States; Center for Integrated Brain Research Seattle Children's, United States.
| | | | - Dwight Barry
- Clinical Analytics, Seattle Children's Hospital, United States
| | - Jason N Wright
- Radiology, Seattle Children's Hospital, United States; Department of Radiology, University of Washington School of Medicine, United States
| | - Molly H Warner
- Neurosciences Institute, Seattle Children's Hospital, United States; Center for Integrated Brain Research Seattle Children's, United States
| | - Edward J Novotny
- Neurosciences Institute, Seattle Children's Hospital, United States; Center for Integrated Brain Research Seattle Children's, United States; Neurology, Seattle Children's Hospital, United States; Department of Neurology, University of Washington School of Medicine, United States
| | - Ahmad Marashly
- Neurosciences Institute, Seattle Children's Hospital, United States; Center for Integrated Brain Research Seattle Children's, United States; Neurology, Seattle Children's Hospital, United States; Department of Neurology, University of Washington School of Medicine, United States
| | - Robert Buckley
- Department of Neurological Surgery, University of Washington School of Medicine, United States
| | - Hannah E Goldstein
- Neurosciences Institute, Seattle Children's Hospital, United States; Department of Neurological Surgery, University of Washington School of Medicine, United States; Neurological Surgery, Seattle Children's Hospital, United States
| | - Jason S Hauptman
- Neurosciences Institute, Seattle Children's Hospital, United States; Department of Neurological Surgery, University of Washington School of Medicine, United States; Neurological Surgery, Seattle Children's Hospital, United States
| | - Jeffrey G Ojemann
- Neurosciences Institute, Seattle Children's Hospital, United States; Center for Integrated Brain Research Seattle Children's, United States; Department of Neurological Surgery, University of Washington School of Medicine, United States; Neurological Surgery, Seattle Children's Hospital, United States
| | - Dennis W W Shaw
- Radiology, Seattle Children's Hospital, United States; Department of Radiology, University of Washington School of Medicine, United States
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28
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Functional connectivity of hippocampus in temporal lobe epilepsy depends on hippocampal dominance: a systematic review of the literature. J Neurol 2022; 269:221-232. [PMID: 33564915 DOI: 10.1007/s00415-020-10391-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 12/27/2020] [Accepted: 12/28/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Lateralized alterations in hippocampal function in the resting-state have been demonstrated for patients with temporal lobe epilepsy (TLE). However, resting-state fMRI of the hippocampus has yet to be substantiated as an adjunct to standard pre-operative assessments of the seizure focus. OBJECTIVE Here we report the results of a systematic review of resting-state fMRI studies investigating laterality of hippocampal network connectivity in TLE patients. METHODS A search of the PubMed, SCOPUS, Web of Science, and Embase databases for full-length articles written in English was conducted through June 2020 using the following terms: 'resting state fMRI,' 'hippocampus,' 'epilepsy,' and 'laterality.' RESULTS Our literature search yielded a total of 42 papers. After excluding studies that did not include patients with epilepsy, utilize resting-state fMRI, or explore the relationship between functional connectivity and disease lateralization, 20 publications were selected for inclusion. From these studies, a total of 528 patients, 258 with left TLE and 270 with right TLE, and 447 healthy controls were included. Of the 20 studies included, 18 found that patients with TLE demonstrated decreased hippocampal functional connectivity ipsilateral to the epileptogenic focus and 10 additionally reported increased hippocampal functional connectivity contralateral to the epileptogenic focus. Several studies demonstrated that the duration of disease was correlated with these changes in functional connectivity. This implies that a compensatory mechanism may be present in patients with treatment-refractory TLE. CONCLUSION The consistency of this hippocampal connectivity pattern across multiple studies suggests resting-state fMRI may be useful as a non-invasive diagnostic tool for preoperative evaluation of TLE patients.
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Stefano Filho CA, Attux RRDF, Castellano G. Motor imagery practice and feedback effects on functional connectivity. J Neural Eng 2021; 18:066048. [PMID: 34933292 DOI: 10.1088/1741-2552/ac456d] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
- Objective: the use of motor imagery (MI) in motor rehabilitation protocols has been increasingly investigated as a potential technique for enhancing traditional treatments, yielding better clinical outcomes. However, since MI performance can be challenging, practice is usually required. This demands appropriate training, actively engaging the MI-related brain areas, consequently enabling the user to properly benefit from it. The role of feedback is central for MI practice. Yet, assessing which underlying neural changes are feedback-specific or purely due to MI practice is still a challenging effort, mainly due to the difficulty in isolating their contributions. In this work, we aimed to assess functional connectivity (FC) changes following MI practice that are either extrinsic or specific to feedback. APPROACH to achieve this, we investigated FC, using graph theory, in electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) data, during MI performance and at resting-state (rs), respectively. Thirty healthy subjects were divided into three groups, receiving no feedback (control), "false" feedback (sham) or actual neurofeedback (active). Participants underwent 12 to 13 hands-MI EEG sessions and pre- and post-MI training fMRI exams. MAIN RESULTS following MI practice, control participants presented significant increases in degree and in eigenvector centrality for occipital nodes at rs-fMRI scans, whereas sham-feedback produced similar effects, but to a lesser extent. Therefore, MI practice, by itself, seems to stimulate visual information processing mechanisms that become apparent during basal brain activity. Additionally, only the active group displayed decreases in inter-subject FC patterns, both during MI performance and at rs-fMRI. SIGNIFICANCE hence, actual neurofeedback impacted FC by disrupting common inter-subject patterns, suggesting that subject-specific neural plasticity mechanisms become important. Future studies should consider this when designing experimental NFBT protocols and analyses.
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Affiliation(s)
| | - Romis Ribeiro de Faisol Attux
- Laboratory of Signal Processing for Communications, School of Electrical and Computer Engineering, University of Campinas, Laboratório de Processamento de Sinais para Comunicações, Campinas, São Paulo, 13083-852, BRAZIL
| | - Gabriela Castellano
- Department of Cosmic Rays and Chronology, University of Campinas - UNICAMP, Institute of Physics Gleb Wataghin, R. Sérgio Buarque de Holanda, nº 777, Cidade Universitária, Campinas, SP, 13083-859, BRAZIL
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Zhou X, Zhang Z, Yu L, Fan B, Wang M, Jiang B, Su Y, Li P, Zheng J. Disturbance of functional and effective connectivity of the salience network involved in attention deficits in right temporal lobe epilepsy. Epilepsy Behav 2021; 124:108308. [PMID: 34536737 DOI: 10.1016/j.yebeh.2021.108308] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/04/2021] [Accepted: 08/23/2021] [Indexed: 12/23/2022]
Abstract
The salience network (SN) acts as a switch that generates transient control signals to regulate the executive control network (ECN) and the default mode network (DMN) and has been implicated in cognitive processes. Temporal lobe epilepsy (TLE) is usually accompanied by different types of cognitive deficits, but whether it is associated with dysfunctional connectivity of the SN remains unknown. To address this, thirty-six patients with right TLE (rTLE) and thirty-six healthy controls (HCs) were recruited for the present study. All of the participants were subjected to attention network test (ANT) and resting-state functional resonance imaging (rs-fMRI) scanning. The patient group showed deficits in attention performance. Moreover, the functional connectivity (FC) and effective connectivity (EC) were analyzed based on key SN hubs (the anterior cingulate cortex (ACC) and the bilateral anterior insula (AI)). When compared with those in the HC group, the ACC showed increased FC with the left middle frontal gyrus and the left precentral gyrus, and the right AI showed decreased FC with the right precuneus and the right superior occipital gyrus in the patient group. The EC analysis revealed an increased inflow of information from the left middle temporal gyrus to the ACC and the right AI and an increased outflow of information from the bilateral AI to the left middle frontal gyrus. Furthermore, in the correlation analysis, the abnormal EC from the right AI to the left middle temporal gyrus was positively correlated with the executive control effect. These findings demonstrated aberrant modulation of the SN in rTLE, which was particularly characterized by dysfunctional connectivity between the SN and key brain regions in the DMN and ECN. Elucidation of this effect may further contribute to the comprehensive understanding of the neural mechanisms of the SN in regard to attention deficits in patients with TLE.
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Affiliation(s)
- Xia Zhou
- Department of Neurology, the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China
| | - Zhao Zhang
- Department of Neurology, the Fifth Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Lu Yu
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Binglin Fan
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Minli Wang
- Department of Neurology, the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China
| | - Binjian Jiang
- Department of Neurology, the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China
| | - Yuying Su
- Department of Neurology, the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China
| | - Peihu Li
- Department of Neurology, the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China
| | - Jinou Zheng
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China.
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Hijacking of hippocampal-cortical oscillatory coupling during sleep in temporal lobe epilepsy. Epilepsy Behav 2021; 121:106608. [PMID: 31740330 DOI: 10.1016/j.yebeh.2019.106608] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 10/11/2019] [Accepted: 10/11/2019] [Indexed: 11/21/2022]
Abstract
Memory impairment is the most common cognitive deficit in patients with temporal lobe epilepsy (TLE). This type of epilepsy is currently regarded as a network disease because of its brain-wide alterations in functional connectivity between temporal and extra-temporal regions. In patients with TLE, network dysfunctions can be observed during ictal states, but are also described interictally during rest or sleep. Here, we examined the available literature supporting the hypothesis that hippocampal-cortical coupling during sleep is hijacked in TLE. First, we look at studies showing that the coordination between hippocampal sharp-wave ripples (100-200 Hz), corticothalamic spindles (9-16 Hz), and cortical delta waves (1-4 Hz) during nonrapid eye movement (NREM) sleep is critical for spatial memory consolidation. Then, we reviewed studies showing that animal models of TLE display precise coordination between hippocampal interictal epileptiform discharges (IEDs) and spindle oscillations in the prefrontal cortex. This aberrant oscillatory coupling seems to surpass the physiological ripple-delta-spindle coordination, which could underlie memory consolidation impairments. We also discuss the role of rapid eye movement (REM) sleep for local synaptic plasticity and memory. Sleep episodes of REM provide windows of opportunity for reactivation of expression of immediate early genes (i.e., zif-268 and Arc). Besides, hippocampal theta oscillations during REM sleep seem to be critical for memory consolidation of novel object place recognition task. However, it is still unclear which extend this particular phase of sleep is affected in TLE. In this context, we show some preliminary results from our group, suggesting that hippocampal theta-gamma phase-amplitude coupling is exacerbated during REM in a model of basolateral amygdala fast kindling. In conclusion, there is an increasing body of evidence suggesting that circuits responsible for memory consolidation during sleep seem to be gradually coopted and degraded in TLE. This article is part of the Special Issue "NEWroscience 2018".
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Zanão TA, Lopes TM, de Campos BM, Yasuda CL, Cendes F. Patterns of default mode network in temporal lobe epilepsy with and without hippocampal sclerosis. Epilepsy Behav 2021; 121:106523. [PMID: 31645315 DOI: 10.1016/j.yebeh.2019.106523] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 08/22/2019] [Accepted: 08/23/2019] [Indexed: 10/25/2022]
Abstract
The default mode network (DMN) consists of the deactivation of specific regions during the performance of cognitive tasks and activation during resting or mind wandering. Several pieces of evidence indicate the impairment of DMN in patients with mesial temporal lobe epilepsy (MTLE). However, most of these studies combined different underlying etiologies, failing to disentangle the influence of seizures and presence and side of hippocampal sclerosis (HS). We included 119 patients with MTLE divided into right-HS (n = 42), left-HS (n = 46), and magnetic resonance imaging (MRI)-negative MTLE (n = 31) and controls (n = 59). All underwent resting-state seed-based functional connectivity (FC), with a seed placed at the posterior cingulate cortex (PCC), an essential node for the DMN. To access group inferences, we used an SPM (Statistical Parametric Mapping) full-factorial model to compare patterns of activation using pairwise comparisons among all groups. Our results indicate a different pattern of DMN FC when controlling for side and presence of HS. The group with right-HS had increased FC in the left angular gyrus and the left middle occipital gyrus, when compared to controls, and increased FC of the left hippocampus when compared to the group with left-HS. The MRI-negative group had increased FC of the left hippocampus, left ventral diencephalon, and left fusiform gyrus as compared to left-HS, but did not show any areas of reduced FC compared to controls. By contrast, the group with left-HS did not show areas of increased FC compared to controls or the right-HS and had reduced FC in the left hippocampus compared to controls. Hence, the right-HS presented increased FC in areas related to the DMN in the left hemisphere; the MRI-negative group also showed increased FC in left-sided structures close to temporal lobe when compared to left-HS, probably indicating engagement in a compensatory system. In a subanalysis considering only the MRI-negative with left-sided EEG (electroencephalogram) subgroup, we found differences against controls, with left angular gyrus more connected in the first group, but no significant differences when compared to the group with left-HS. We conclude that the origin of seizures on the left hemisphere seems to engender a less prominent capacity of recruiting other neighbor areas related to DMN as compared to right-HS and controls. Considering recent studies that have revealed the importance of DMN for cognitive skills and memory, our findings may indicate that deficiencies exhibited by patients with left-HS temporal lobe epilepsy (TLE) in connecting to the DMN could be a surrogate marker of their known worse neuropsychological performance. Further studies with direct comparisons between cognitive tests and FC within the DMN are needed to validate these findings, especially for MRI-negative patients. This article is part of the Special Issue "NEWroscience 2018".
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Affiliation(s)
- Tamires Araujo Zanão
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas - UNICAMP, Campinas, SP, Brazil
| | - Tatila Martins Lopes
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas - UNICAMP, Campinas, SP, Brazil
| | - Brunno Machado de Campos
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas - UNICAMP, Campinas, SP, Brazil
| | - Clarissa Lin Yasuda
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas - UNICAMP, Campinas, SP, Brazil
| | - Fernando Cendes
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas - UNICAMP, Campinas, SP, Brazil.
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Elmalı AD, Ur Özçelik E, Bebek N, Baykan B. Let there be light: Inhibitory effect of photic stimulation on spike frequency in patients with mesial temporal lobe epilepsy with hippocampal sclerosis. Epilepsy Res 2021; 176:106734. [PMID: 34371448 DOI: 10.1016/j.eplepsyres.2021.106734] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 04/30/2021] [Accepted: 07/23/2021] [Indexed: 11/18/2022]
Abstract
Inhibition of epileptic discharges and seizures by sensory stimuli is an interesting phenomenon, but highly understudied. Here, we aimed to investigate the modulation of epileptiform discharges in patients with mesial temporal lobe epilepsy associated with hippocampal sclerosis (MTLE-HS) via photic stimulation (PS), based on a hypothesis that light stimulation may activate thalamocortical networks limiting the propagation of interictal epileptiform discharges. In order to do so, all EEGs performed in patients diagnosed with MTLE-HS were reviewed to include available recordings with definite epileptiform abnormalities. These were reevaluated by two clinical neurophysiologists independently, and spikes were counted in a blinded manner to calculate spike index (SI) (spikes per minute-pm) for baseline EEG, hyperventilation (HV), and PS periods. Our final study group consisted of 30 MTLE-HS patients with a mean age of 34.5 (±12.5) years. Mean seizure frequency was 38.1 per year (±46.6), and the mean disease duration was 16.2 years (±12.1). Mean SI during baseline was calculated as 1.17 pm (±1.4), during HV 2.1 pm (±2.8) and during PS 0.8 pm (±2.5). As a result, SI was significantly lower during PS compared to baseline (p = 0.001). Our findings suggest that PS has a remarkable inhibitory effect on epileptiform discharges in MTLE-HS patients, indicating the need for further prospective investigations for clinical translation.
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Affiliation(s)
- Ayşe Deniz Elmalı
- Istanbul University, Istanbul Faculty of Medicine, Neurology - Clinical Neurophysiology Department, Istanbul, Turkey.
| | - Emel Ur Özçelik
- Istanbul University, Istanbul Faculty of Medicine, Neurology - Clinical Neurophysiology Department, Istanbul, Turkey; University of Health Sciences, Istanbul Bakirkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatry, Neurology, Neurosurgery, Clinic of Neurology, Istanbul, Turkey
| | - Nerses Bebek
- Istanbul University, Istanbul Faculty of Medicine, Neurology - Clinical Neurophysiology Department, Istanbul, Turkey
| | - Betül Baykan
- Istanbul University, Istanbul Faculty of Medicine, Neurology - Clinical Neurophysiology Department, Istanbul, Turkey
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Magalhães TNC, Gerbelli CLB, Pimentel-Silva LR, de Campos BM, de Rezende TJR, Rizzi L, Joaquim HPG, Talib LL, Forlenza OV, Cendes F, Balthazar MLF. Differences in structural and functional default mode network connectivity in amyloid positive mild cognitive impairment: a longitudinal study. Neuroradiology 2021; 64:141-150. [PMID: 34278511 DOI: 10.1007/s00234-021-02760-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 06/28/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE Default mode network (DMN) has emerged as a potential biomarker of Alzheimer's disease (AD); however, it is not clear whether it can differentiate amnestic mild cognitive impairment with altered amyloid (aMCI-Aβ +) who will evolve to AD. We evaluated if structural and functional connectivity (FC), hippocampal volumes (HV), and cerebrospinal fluid biomarkers (CSF-Aβ42, p-Tau, and t-Tau) can differentiate aMCI-Aβ + converters from non-converters. METHODS Forty-eight individuals (18 normal controls and 30 aMCI subjects in the AD continuum - with altered Aβ42 in the CSF) were followed up for an average of 13 months. We used MultiAtlas, UF2C, and Freesurfer software to evaluate diffusion tensor imaging, FC, and HV, respectively, INNOTEST® kits to measure CSF proteins, and neuropsychological tests. Besides, we performed different MANOVAs with further univariate analyses to differentiate groups. RESULTS During follow-up, 8/30 aMCI-Aβ + converted (26.6%) to AD dementia. There were no differences in multivariate analysis between groups in CSF biomarkers (p = 0.092) or at DMN functional connectivity (p = 0.814). aMCI-Aβ + converters had smaller right HV than controls (p = 0.013), and greater right cingulum parahippocampal bundle radial diffusivity than controls (p < 0.001) and non-converters (p = 0.036). CONCLUSION In this exploratory study, structural, but not functional, DMN connectivity alterations may differentiate aMCI-Aβ + subjects who converted to AD dementia.
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Affiliation(s)
- Thamires Naela Cardoso Magalhães
- Laboratory of Neuroimaging, Department of Neurology - Medical Sciences School, University of Campinas (UNICAMP), Rua Tessália Vieira de Camargo 126, Campinas, SP, 13083-887, Brazil.
| | - Christian Luiz Baptista Gerbelli
- Laboratory of Neuroimaging, Department of Neurology - Medical Sciences School, University of Campinas (UNICAMP), Rua Tessália Vieira de Camargo 126, Campinas, SP, 13083-887, Brazil
| | - Luciana Ramalho Pimentel-Silva
- Laboratory of Neuroimaging, Department of Neurology - Medical Sciences School, University of Campinas (UNICAMP), Rua Tessália Vieira de Camargo 126, Campinas, SP, 13083-887, Brazil
| | - Brunno Machado de Campos
- Laboratory of Neuroimaging, Department of Neurology - Medical Sciences School, University of Campinas (UNICAMP), Rua Tessália Vieira de Camargo 126, Campinas, SP, 13083-887, Brazil
| | - Thiago Junqueira Ribeiro de Rezende
- Laboratory of Neuroimaging, Department of Neurology - Medical Sciences School, University of Campinas (UNICAMP), Rua Tessália Vieira de Camargo 126, Campinas, SP, 13083-887, Brazil
| | - Liara Rizzi
- Laboratory of Neuroimaging, Department of Neurology - Medical Sciences School, University of Campinas (UNICAMP), Rua Tessália Vieira de Camargo 126, Campinas, SP, 13083-887, Brazil
| | | | - Leda Leme Talib
- Laboratory of Neurosciences, (LIM 27), Department and Institute of Psychiatry, University of São Paulo (USP), São Paulo, Brazil
| | - Orestes Vicente Forlenza
- Laboratory of Neurosciences, (LIM 27), Department and Institute of Psychiatry, University of São Paulo (USP), São Paulo, Brazil
| | - Fernando Cendes
- Laboratory of Neuroimaging, Department of Neurology - Medical Sciences School, University of Campinas (UNICAMP), Rua Tessália Vieira de Camargo 126, Campinas, SP, 13083-887, Brazil
| | - Marcio Luiz Figueredo Balthazar
- Laboratory of Neuroimaging, Department of Neurology - Medical Sciences School, University of Campinas (UNICAMP), Rua Tessália Vieira de Camargo 126, Campinas, SP, 13083-887, Brazil
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Morita-Sherman M, Li M, Joseph B, Yasuda C, Vegh D, De Campos BM, Alvim MKM, Louis S, Bingaman W, Najm I, Jones S, Wang X, Blümcke I, Brinkmann BH, Worrell G, Cendes F, Jehi L. Incorporation of quantitative MRI in a model to predict temporal lobe epilepsy surgery outcome. Brain Commun 2021; 3:fcab164. [PMID: 34396113 PMCID: PMC8361423 DOI: 10.1093/braincomms/fcab164] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2021] [Indexed: 11/23/2022] Open
Abstract
Quantitative volumetric brain MRI measurement is important in research applications, but translating it into patient care is challenging. We explore the incorporation of clinical automated quantitative MRI measurements in statistical models predicting outcomes of surgery for temporal lobe epilepsy. Four hundred and thirty-five patients with drug-resistant epilepsy who underwent temporal lobe surgery at Cleveland Clinic, Mayo Clinic and University of Campinas were studied. We obtained volumetric measurements from the pre-operative T1-weighted MRI using NeuroQuant, a Food and Drug Administration approved software package. We created sets of statistical models to predict the probability of complete seizure-freedom or an Engel score of I at the last follow-up. The cohort was randomly split into training and testing sets, with a ratio of 7:3. Model discrimination was assessed using the concordance statistic (C-statistic). We compared four sets of models and selected the one with the highest concordance index. Volumetric differences in pre-surgical MRI located predominantly in the frontocentral and temporal regions were associated with poorer outcomes. The addition of volumetric measurements to the model with clinical variables alone increased the model’s C-statistic from 0.58 to 0.70 (right-sided surgery) and from 0.61 to 0.66 (left-sided surgery) for complete seizure freedom and from 0.62 to 0.67 (right-sided surgery) and from 0.68 to 0.73 (left-sided surgery) for an Engel I outcome score. 57% of patients with extra-temporal abnormalities were seizure-free at last follow-up, compared to 68% of those with no such abnormalities (P-value = 0.02). Adding quantitative MRI data increases the performance of a model developed to predict post-operative seizure outcomes. The distribution of the regions of interest included in the final model supports the notion that focal epilepsies are network disorders and that subtle cortical volume loss outside the surgical site influences seizure outcome.
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Affiliation(s)
| | - Manshi Li
- Department of Quantitative Health Sciences, Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - Boney Joseph
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Clarissa Yasuda
- Department of Neurology, University of Campinas, Campinas, Brazil
| | - Deborah Vegh
- Department of Neurology, Epilepsy Center, Cleveland Clinic, Cleveland, OH, USA
| | | | - Marina K M Alvim
- Department of Neurology, University of Campinas, Campinas, Brazil
| | - Shreya Louis
- Department of Neurology, Epilepsy Center, Cleveland Clinic, Cleveland, OH, USA
| | - William Bingaman
- Department of Neurology, Epilepsy Center, Cleveland Clinic, Cleveland, OH, USA
| | - Imad Najm
- Department of Neurology, Epilepsy Center, Cleveland Clinic, Cleveland, OH, USA
| | - Stephen Jones
- Department of Neurology, Epilepsy Center, Cleveland Clinic, Cleveland, OH, USA
| | - Xiaofeng Wang
- Department of Quantitative Health Sciences, Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - Ingmar Blümcke
- Department of Neuropathology, University Hospitals, Erlangen, Germany
| | | | | | - Fernando Cendes
- Department of Neurology, University of Campinas, Campinas, Brazil
| | - Lara Jehi
- Department of Neurology, Epilepsy Center, Cleveland Clinic, Cleveland, OH, USA
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Silva DS, Caseli BG, de Campos BM, Avelar WM, Lino APBL, Balthazar MLF, Figueiredo MJO, Cendes F, Pegoraro LFL, Coan AC. Cerebral Structure and Function in Stroke-free Patients with Atrial Fibrillation. J Stroke Cerebrovasc Dis 2021; 30:105887. [PMID: 34102554 DOI: 10.1016/j.jstrokecerebrovasdis.2021.105887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/27/2021] [Accepted: 05/08/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Atrial fibrillation (AF) is associated with high risk of dementia and brain atrophy in stroke-free patients, but the mechanisms underlying this association remain unclear. We aimed to examine the brain volume and connectivity of paramount cognitive brain networks in stroke-free patients with AF without dementia. MATERIALS AND METHODS Twenty-six stroke-free patients with AF and 26 age and sex-matched subjects without AF were submitted to a 3-tesla brain structural and functional MRI. An extensive clinical evaluation excluded stroke, dementia, low cardiac output, carotid stenosis and metabolic diseases without optimal therapy. We used CHA2DS2-VASc score to classify the cardiovascular risk factor burden and a broad neuropsychological battery to assess the cognitive performance. Voxel based morphometry analysis of. structural MRI defined whole-brain gray and white matter volumes. Finally, we used eco-plannar MRI images to compare the differences of functional connectivity of 7 large-scale resting-state networks between AF patients and controls. RESULTS Taking into account the history of hypertension and heart failure, AF was associated to volume decrease of the right basal frontal lobe and right inferior cerebellum. Decreased connectivity of the ventral Default Mode Network (vDMN) was observed in the AF group. No disruption of connectivity was observed in the executive, visuospatial and salience networks. CONCLUSION Individuals with AF without stroke or dementia have subtle reduction of gray and white matter, restricted to frontal areas and cerebellum. These patients show decreased vDMN connectivity, without other large-scale brain network disruption.
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Affiliation(s)
- Danilo S Silva
- Neurovascular Group, Department of Neurology, University of Campinas, UNICAMP, Campinas, SP, Brazil; Brazilian Institute of Neuroscience and Neurotechnology, BRAINN, at UNICAMP, Campinas, SP, Brazil
| | - Bruna G Caseli
- Neurovascular Group, Department of Neurology, University of Campinas, UNICAMP, Campinas, SP, Brazil; Department of Cardiology, University of Campinas, UNICAMP, Campinas, SP, Brazil; Neuroimaging Laboratory, Department of Neurology, University of Campinas, UNICAMP, Campinas, SP, Brazil; Brazilian Institute of Neuroscience and Neurotechnology, BRAINN, at UNICAMP, Campinas, SP, Brazil; Department of Medical Psychology and Psychiatry, University of Campinas, UNICAMP, Campinas, SP, Brazil
| | - Brunno M de Campos
- Neuroimaging Laboratory, Department of Neurology, University of Campinas, UNICAMP, Campinas, SP, Brazil; Brazilian Institute of Neuroscience and Neurotechnology, BRAINN, at UNICAMP, Campinas, SP, Brazil
| | - Wagner M Avelar
- Neurovascular Group, Department of Neurology, University of Campinas, UNICAMP, Campinas, SP, Brazil; Brazilian Institute of Neuroscience and Neurotechnology, BRAINN, at UNICAMP, Campinas, SP, Brazil
| | - Ana Paula B L Lino
- Department of Cardiology, University of Campinas, UNICAMP, Campinas, SP, Brazil
| | - Marcio L F Balthazar
- Neuroimaging Laboratory, Department of Neurology, University of Campinas, UNICAMP, Campinas, SP, Brazil; Brazilian Institute of Neuroscience and Neurotechnology, BRAINN, at UNICAMP, Campinas, SP, Brazil
| | | | - Fernando Cendes
- Neuroimaging Laboratory, Department of Neurology, University of Campinas, UNICAMP, Campinas, SP, Brazil; Brazilian Institute of Neuroscience and Neurotechnology, BRAINN, at UNICAMP, Campinas, SP, Brazil
| | - Luiz Fernando L Pegoraro
- Department of Medical Psychology and Psychiatry, University of Campinas, UNICAMP, Campinas, SP, Brazil
| | - Ana Carolina Coan
- Neuroimaging Laboratory, Department of Neurology, University of Campinas, UNICAMP, Campinas, SP, Brazil; Brazilian Institute of Neuroscience and Neurotechnology, BRAINN, at UNICAMP, Campinas, SP, Brazil.
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Banjac S, Roger E, Pichat C, Cousin E, Mosca C, Lamalle L, Krainik A, Kahane P, Baciu M. Reconfiguration dynamics of a language-and-memory network in healthy participants and patients with temporal lobe epilepsy. Neuroimage Clin 2021; 31:102702. [PMID: 34090125 PMCID: PMC8186554 DOI: 10.1016/j.nicl.2021.102702] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 04/21/2021] [Accepted: 05/14/2021] [Indexed: 12/03/2022]
Abstract
Current theoretical frameworks suggest that human behaviors are based on strong and complex interactions between cognitive processes such as those underlying language and memory functions in normal and neurological populations. We were interested in assessing the dynamic cerebral substrate of such interaction between language and declarative memory, as the composite function, in healthy controls (HC, N = 19) and patients with temporal lobe epilepsy (TLE, N = 16). Our assumption was that the language and declarative memory integration is based on a language-and-memory network (LMN) that is dynamic and reconfigures according to task demands and brain status. Therefore, we explored two types of LMN dynamics, a state reconfiguration (intrinsic resting-state compared to extrinsic state assessed with a sentence recall task) and a reorganization of state reconfiguration (TLE compared to HC). The dynamics was evaluated in terms of segregation (community or module detection) and integration (connector hubs). In HC, the level of segregation was the same in both states and the mechanism of LMN state reconfiguration was shown through module change of key language and declarative memory regions with integrative roles. In TLE patients, the reorganization of LMN state reconfiguration was reflected in segregation increase and extrinsic modules that were based on shorter-distance connections. While lateral and mesial temporal regions enabled state reconfiguration in HC, these regions showed reduced flexibility in TLE. We discuss our results in a connectomic perspective and propose a dynamic model of language and declarative memory functioning. We claim that complex and interactive cognitive functions, such as language and declarative memory, should be investigated dynamically, considering the interaction between cognitive networks.
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Affiliation(s)
- Sonja Banjac
- Univ. Grenoble Alpes, CNRS LPNC UMR 5105, 38000 Grenoble, France
| | - Elise Roger
- Univ. Grenoble Alpes, CNRS LPNC UMR 5105, 38000 Grenoble, France
| | - Cédric Pichat
- Univ. Grenoble Alpes, CNRS LPNC UMR 5105, 38000 Grenoble, France
| | - Emilie Cousin
- Univ. Grenoble Alpes, CNRS LPNC UMR 5105, 38000 Grenoble, France; Univ. Grenoble Alpes, UMS IRMaGe CHU Grenoble, 38000 Grenoble, France
| | - Chrystèle Mosca
- Neurology Department, Grenoble Hospital, Univ. Grenoble Alpes, 38000 Grenoble, France
| | - Laurent Lamalle
- Univ. Grenoble Alpes, UMS IRMaGe CHU Grenoble, 38000 Grenoble, France
| | - Alexandre Krainik
- Univ. Grenoble Alpes, UMS IRMaGe CHU Grenoble, 38000 Grenoble, France
| | - Philippe Kahane
- Neurology Department, Grenoble Hospital, Univ. Grenoble Alpes, 38000 Grenoble, France
| | - Monica Baciu
- Univ. Grenoble Alpes, CNRS LPNC UMR 5105, 38000 Grenoble, France.
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Factors affecting interictal unilateral and bilateral discharges and ictal diffusion patterns of scalp electroencephalogram in temporal lobe epilepsy. Neurol Sci 2021; 43:507-515. [PMID: 33942172 DOI: 10.1007/s10072-021-05293-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 04/26/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND The interictal discharges of temporal lobe epilepsy (TLE) can be unilateral or bilateral. In addition, the ictal electroencephalogram (EEG) showed the discharges also tend to spread to the contralateral brain in TLE. OBJECTIVE The factors influencing unilateral and bilateral interictal discharges in TLE as well as ictal diffusion patterns in scalp EEG during onset of seizure were evaluated in the present study. MATERIALS AND METHODS This was a retrospective analysis of 129 patients with TLE. Cases were classified into unilateral and bilateral discharge groups based on interictal discharge patterns in the EEG. Differences between the two groups in age, gender, disease duration, seizure frequency, magnetic resonance imaging (MRI) findings, origin of TLE, antiepileptic drug (AED) administration, and ictal diffusion patterns during seizures were statistically analyzed. In addition, the differences in ictal diffusion patterns between left and right TLE were statistically analyzed. RESULTS Statistically significant differences were not observed in gender, disease duration, seizure frequency, MRI findings, administration of AEDs, and ictal diffusion patterns between interictal unilateral and bilateral discharge groups but with statistically significant differences in age and side of origin of the TLE. In addition, whether the EEG-recorded diffusion pattern was confined to the same hemisphere or spread to both hemispheres was investigated and shown statistically significant differences between the left and right temporal lobes. CONCLUSIONS Age and side of origin of TLE affects the TLE interictal discharge patterns. Older patients are more prone to bilateral discharges. Bilateral discharges are more common in right TLE, and the onset of EEG more likely to bilateral diffusion in right TLE.
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Association of hypometabolic extension of 18F-FDG PET with diffusion tensor imaging indices in mesial temporal lobe epilepsy with hippocampal sclerosis. Seizure 2021; 88:130-137. [PMID: 33878604 DOI: 10.1016/j.seizure.2021.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 04/06/2021] [Accepted: 04/08/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To assess the association between hypometabolic extension of 18F-fluorodeoxyglucose positron emission tomography and diffusion tensor imaging indices, including mean diffusivity (MD) and fractional anisotropy (FA), in hippocampal sclerosis (HS). METHODS Thirty-six unilateral HS were retrospectively selected and stratified into two groups: broad and localized hypometabolic groups (hypometabolism beyond [n = 26] and within the temporal lobe [n = 10]). Forty-one pairs of gray matter (GM) regions of interest (ROIs) were segmented using FreeSurfer software. The GM ROIs were applied to MD maps, and median MD values within each ROI were compared between hemispheres ipsilateral and contralateral to HS using a mixed effect model. Tract-Based Spatial Statistics (TBSS) was used to evaluate FA of white matter (WM) tracts between hemispheres ipsilateral and contralateral to HS. Disease laterality was controlled for. RESULTS The MD values in the thalamus, caudate, hippocampus, amygdala, superior frontal gyrus, middle and inferior temporal gyrus, temporal pole, and isthmus cingulate gyrus were significantly higher in the HS side than the contralateral side for the broad hypometabolic group. Those in the amygdala and superior temporal sulcus were significantly higher in the HS side than the contralateral side for the localized group. The TBSS analyses showed significantly decreased FA in the WM tracts of the temporal and frontal lobes for the broad hypometabolic group, while no tracts showed significant differences for the localized group. CONCLUSION The hypometabolic extension for HS was associated with the abnormalities of MD and FA in GM and WM, respectively, with more widespread microstructural alterations for broad hypometabolic HS.
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Whitten A, Jacobs ML, Englot DJ, Rogers BP, Levine KK, González HFJ, Morgan VL. Resting-state hippocampal networks related to language processing reveal unique patterns in temporal lobe epilepsy. Epilepsy Behav 2021; 117:107834. [PMID: 33610102 PMCID: PMC8035309 DOI: 10.1016/j.yebeh.2021.107834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/22/2021] [Accepted: 01/26/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Patients with temporal lobe epilepsy (TLE) commonly experience a broad range of language impairments. These deficits are thought to arise from repeated seizure activity that damages language regions. However, connectivity between the seizure onset region in the hippocampus and regions related to language processing has rarely been studied, and could also have a strong impact on language function. The purpose of this study was to use resting-state functional connectivity (FC) measures to assess hippocampal network patterns and their relation to language abilities in patients with right TLE (RLTE), left TLE (LTLE), and healthy controls. METHODS Presurgical resting-state 3T functional MRI data were acquired from 40 patients with mesial TLE (27 RTLE, 13 LTLE) and 54 controls. The regions of interest were the anterior and posterior bilateral hippocampi and eleven regions grouped by frontal or temporo-parietal locations, including large areas of language-related cortex. FC values were computed with the right/left anterior and posterior hippocampi as the seeds and frontal and temporo-parietal regions as targets. Resting-state lateralization indices were also calculated (LI-Rest), and all FC measures were correlated to neuropsychological language scores and measures related to manifestation of epilepsy including age of onset, duration of disease, monthly seizure frequency, and hippocampal volume. RESULTS We found significant group differences between the anterior hippocampi and temporo-parietal regions closest to the seizure focus, in which RTLE and LTLE showed stronger connectivity to their contralateral hippocampus, while controls showed similar connectivity to both hippocampi. In addition, LI-Rest demonstrated significantly more right lateralization in LTLE compared to RTLE for temporo-parietal regions only. In LTLE, we found significant associations between stronger hippocampal network resting-state FC and later age of onset and decreased left anterior hippocampal volume. SIGNIFICANCE The results of our study indicate that the presence of TLE impacts hippocampal-temporo-parietal networks relevant to language processing.
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Affiliation(s)
- Allison Whitten
- Institute of Imaging Science, Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, USA
| | - Monica L Jacobs
- Department of Neurological Surgery, Vanderbilt University Medical Center, USA
| | - Dario J Englot
- Institute of Imaging Science, Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, USA; Department of Neurological Surgery, Vanderbilt University Medical Center, USA; Department of Biomedical Engineering, Vanderbilt University, USA
| | - Baxter P Rogers
- Institute of Imaging Science, Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, USA; Department of Biomedical Engineering, Vanderbilt University, USA
| | - Kaela K Levine
- Institute of Imaging Science, Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, USA
| | - Hernán F J González
- Institute of Imaging Science, Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, USA; Department of Biomedical Engineering, Vanderbilt University, USA
| | - Victoria L Morgan
- Institute of Imaging Science, Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, USA; Department of Neurological Surgery, Vanderbilt University Medical Center, USA; Department of Biomedical Engineering, Vanderbilt University, USA.
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Whiting AC, Morita-Sherman M, Li M, Vegh D, Machado de Campos B, Cendes F, Wang X, Bingaman W, Jehi LE. Automated analysis of cortical volume loss predicts seizure outcomes after frontal lobectomy. Epilepsia 2021; 62:1074-1084. [PMID: 33756031 DOI: 10.1111/epi.16877] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 03/03/2021] [Accepted: 03/03/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Patients undergoing frontal lobectomy demonstrate lower seizure-freedom rates than patients undergoing temporal lobectomy and several other resective interventions. We attempted to utilize automated preoperative quantitative analysis of focal and global cortical volume loss to develop predictive volumetric indicators of seizure outcome after frontal lobectomy. METHODS Ninety patients who underwent frontal lobectomy were stratified based on seizure freedom at a mean follow-up time of 3.5 (standard deviation [SD] 2.5) years. Automated quantitative analysis of cortical volume loss organized by distinct brain region and laterality was performed on preoperative T1-weighted magnetic resonance imaging (MRI) studies. Univariate statistical analysis was used to select potential predictors of seizure freedom. Backward variable selection and multivariate logistical regression were used to develop models to predict seizure freedom. RESULTS Forty-eight of 90 (53.3%) patients were seizure-free at the last follow-up. Several frontal and extrafrontal brain regions demonstrated statistically significant differences in both volumetric cortical volume loss and volumetric asymmetry between the left and right sides in the seizure-free and non-seizure-free cohorts. A final multivariate logistic model utilizing only preoperative quantitative MRI data to predict seizure outcome was developed with a c-statistic of 0.846. Using both preoperative quantitative MRI data and previously validated clinical predictors of seizure outcomes, we developed a model with a c-statistic of 0.897. SIGNIFICANCE This study demonstrates that preoperative cortical volume loss in both frontal and extrafrontal regions can be predictive of seizure outcome after frontal lobectomy, and models can be developed with excellent predictive capabilities using preoperative MRI data. Automated quantitative MRI analysis can be quickly and reliably performed in patients with frontal lobe epilepsy, and further studies may be developed for integration into preoperative risk stratification.
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Affiliation(s)
- Alexander C Whiting
- Cleveland Clinic Epilepsy Center, Cleveland Clinic Foundation, Cleveland, OH, USA
| | | | - Manshi Li
- Department of Quantitative Health Sciences, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Deborah Vegh
- Cleveland Clinic Epilepsy Center, Cleveland Clinic Foundation, Cleveland, OH, USA
| | | | - Fernando Cendes
- Department of Neurology, University of Campinas UNICAMP, Campinas, Brazil
| | - Xiaofeng Wang
- Department of Quantitative Health Sciences, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - William Bingaman
- Cleveland Clinic Epilepsy Center, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Lara E Jehi
- Cleveland Clinic Epilepsy Center, Cleveland Clinic Foundation, Cleveland, OH, USA
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Guo Z, Zhao B, Hu W, Zhang C, Wang X, Wang Y, Liu C, Mo J, Sang L, Ma Y, Shao X, Zhang J, Zhang K. Effective connectivity among the hippocampus, amygdala, and temporal neocortex in epilepsy patients: A cortico-cortical evoked potential study. Epilepsy Behav 2021; 115:107661. [PMID: 33434884 DOI: 10.1016/j.yebeh.2020.107661] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 08/08/2020] [Accepted: 11/21/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Mesial temporal lobe epilepsy (MTLE) is one of the most common types of intractable epilepsy. The hippocampus and amygdala are two crucial structures of the mesial temporal lobe and play important roles in the epileptogenic network of MTLE. This study aimed to explore the effective connectivity among the hippocampus, amygdala, and temporal neocortex and to determine whether differences in effective connectivity exist between MTLE patients and non-MTLE patients. METHODS This study recruited 20 patients from a large cohort of drug-resistant epilepsy patients, of whom 14 were MTLE patients. Single-pulse electrical stimulation (SPES) was performed to acquire cortico-cortical evoked potentials (CCEPs). The root mean square (RMS) was used as the metric of the magnitude of CCEP to represent the effective connectivity. We then conducted paired and independent sample t-tests to assess the directionality of the effective connectivity. RESULTS In both MTLE patients and non-MTLE patients, the directional connectivity from the amygdala to the hippocampus was stronger than that from the hippocampus to the amygdala (P < 0.01); the outward connectivity from the amygdala to the cortex was stronger than the inward connectivity from the cortex to the amygdala (P < 0.01); the amygdala had stronger connectivity to the neocortex than the hippocampus (P < 0.01). In MTLE patients, the neocortex had stronger connectivity to the hippocampus than to the amygdala (P < 0.01). No significant differences in directional connectivity were noted between the two groups. CONCLUSIONS A unique effective connectivity pattern among the hippocampus, amygdala, and temporal neocortex was identified through CCEPs analysis. This study may aid in our understanding of physiological and pathological networks in the brain and inspire neurostimulation protocols for neurological and psychiatric disorders.
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Affiliation(s)
- Zhihao Guo
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
| | - Baotian Zhao
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
| | - Wenhan Hu
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China; Stereotactic and Functional Neurosurgery Laboratory, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neurostimulation, Beijing, China
| | - Chao Zhang
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
| | - Xiu Wang
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
| | - Yao Wang
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
| | - Chang Liu
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
| | - Jiajie Mo
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
| | - Lin Sang
- Department of Neurosurgery, Beijing Fengtai Hospital, Beijing, China
| | - Yanshan Ma
- Department of Neurosurgery, Beijing Fengtai Hospital, Beijing, China
| | - Xiaoqiu Shao
- Department of Neurology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
| | - Jianguo Zhang
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China; Stereotactic and Functional Neurosurgery Laboratory, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neurostimulation, Beijing, China.
| | - Kai Zhang
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China; Stereotactic and Functional Neurosurgery Laboratory, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neurostimulation, Beijing, China.
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Vicentini JE, Weiler M, Casseb RF, Almeida SR, Valler L, de Campos BM, Li LM. Subacute functional connectivity correlates with cognitive recovery six months after stroke. NEUROIMAGE-CLINICAL 2020; 29:102538. [PMID: 33385880 PMCID: PMC7779317 DOI: 10.1016/j.nicl.2020.102538] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 11/19/2020] [Accepted: 12/15/2020] [Indexed: 12/27/2022]
Abstract
Stroke disrupts ipsilesional and inter-hemispheric functional connectivity of DMN. Subacute cognition correlated to inter-hemispheric and ipsilesional DMN connectivity. Subacute cognition correlated to weaker contralesional SN connectivity. Functional connectivity remapping was not observed after six months. Cognitive recovery correlated to DMN and SN connectivity from the subacute phase.
Background and purpose Cognitive impairment is a common consequence of stroke, and the rewiring of the surviving brain circuits might contribute to cognitive recovery. Studies investigating how the functional connectivity of networks change across time and whether their remapping relates to cognitive recovery in stroke patients are scarce. We aimed to investigate whether resting-state functional connectivity was associated with cognitive performance in stroke patients and if any alterations in these networks were correlated with cognitive recovery. Methods Using an fMRI ROI-ROI approach, we compared the ipsilesional, contralesional and interhemispheric functional connectivity of three resting-state networks involved in cognition – the Default Mode (DMN), Salience (SN) and Central Executive Networks (CEN), in subacute ischemic stroke patients (time 1, n = 37, stroke onset: 24.32 ± 7.44 days, NIHSS: 2.66 ± 3.45) with cognitively healthy controls (n = 20). Patients were reassessed six months after the stroke event (time 2, n = 20, stroke onset: 182.05 ± 8.17 days) to verify the subsequent reorganization of functional connections and whether such reorganization was associated with cognitive recovery. Results At time 1, patients had weaker interhemispheric connectivity in the DMN than controls; better cognitive performance at time 1 was associated with stronger interhemispheric and ipsilesional DMN connectivity, and weaker contralesional SN connectivity. At time 2, there were no changes in functional connectivity in stroke patients, compared to time 1. Better cognitive recovery measured at time 2 (time 2 – time 1) was associated with stronger functional connectivity in the DMN, and weaker interhemispheric subacute connectivity in the SN, both from time 1. Conclusions Stroke disrupts the functional connectivity of the DMN, not only at the lesioned hemisphere but also between hemispheres. Six months after the stroke event, we could not detect the remapping of networks. Cognitive recovery was associated with the connectivity of both the DMN and SN of time 1. Our findings may be helpful for facilitating further understanding of the potential mechanisms underlying post-stroke cognitive performance.
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Affiliation(s)
- Jéssica Elias Vicentini
- Brazilian Institute of Neuroscience and Neurotechnology - Brainn, Department of Neurology, Faculty of Medical Sciences - University of Campinas (UNICAMP), Brazil
| | - Marina Weiler
- Neurocognitive Aging Section, Laboratory of Behavioral Neuroscience, National Institute on Aging, National Institutes of Health (NIA/NIH), Intramural Research Program, United States
| | | | - Sara Regina Almeida
- Brazilian Institute of Neuroscience and Neurotechnology - Brainn, Department of Neurology, Faculty of Medical Sciences - University of Campinas (UNICAMP), Brazil
| | - Lenise Valler
- Brazilian Institute of Neuroscience and Neurotechnology - Brainn, Department of Neurology, Faculty of Medical Sciences - University of Campinas (UNICAMP), Brazil
| | - Brunno Machado de Campos
- Brazilian Institute of Neuroscience and Neurotechnology - Brainn, Department of Neurology, Faculty of Medical Sciences - University of Campinas (UNICAMP), Brazil
| | - Li Min Li
- Brazilian Institute of Neuroscience and Neurotechnology - Brainn, Department of Neurology, Faculty of Medical Sciences - University of Campinas (UNICAMP), Brazil.
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Zhang Y, Dou W, Zuo Z, You H, Lv Y, Hou B, Shi L, Feng F. Brain volume and perfusion asymmetry in temporal lobe epilepsy with and without hippocampal sclerosis. Neurol Res 2020; 43:299-306. [PMID: 33320070 DOI: 10.1080/01616412.2020.1853988] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objectives: To detect and compare the features of interictal perfusion and volume asymmetry between temporal lobe epilepsy (TLE) patients with and without hippocampal sclerosis (HS).Methods: Sixty-one TLE patients (mean age 28.4 ± 9.3 years; 28 female/33 male) with unilateral signs of HS (TLE-HS+) and 25 TLE patients (mean age 29.8 ± 8.0 years; 17 female/8 male) without HS (TLE-HS-) were included. Thirty healthy volunteers served as controls (mean age 26.0 ± 8.7 years; 22 female/8 male). Brain segmentation and volume calculation were performed. Quantitative cerebral blood flow (CBF) values were measured based on arterial spin labeling (ASL). The asymmetry indices (AIs) of volume and perfusion were calculated.Results: TLE-HS+ (adjusted P = 0.001) and TLE-HS- patients (adjusted P = 0.006) had significantly higher hippocampal perfusion AIs than controls. TLE-HS+ and TLE-HS- had similar hippocampal perfusion AIs (adjusted P = 1.00). TLE-HS+ had higher hippocampal volume AIs than TLE-HS- and controls (adjusted P < 0.001). TLE-HS- and controls had similar hippocampal volume AIs (adjusted P = 1.00). All (100%) TLE-HS+ patients had positive hippocampal perfusion or volume AIs. No significant correlation between the AIs of hippocampal perfusion and volume was found in both TLE-HS+(P = 0.894) and TLE-HS- (P = 0.106) patients. TLE-HS+ patients demonstrated more extensive whole-brain asymmetry of both perfusion and volume than TLE-HS- patients.Conclusion: TLE-HS+ and TLE-HS- patients have different patterns of whole-brain perfusion and volume asymmetry. Hippocampal perfusion asymmetry was revealed in both TLE-HS+ and TLE-HS- patients.
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Affiliation(s)
- Yiwei Zhang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wanchen Dou
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Zhentao Zuo
- Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
| | - Hui You
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuelei Lv
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bo Hou
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lin Shi
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China.,BrainNow Medical Technology Limited, Hong Kong Science and Technology Park, Hong Kong, China
| | - Feng Feng
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Shu T, Xiao X, Long Z, Zhang R. Reduced structural covariance connectivity of defaut mode network and salience network in MRI-normal focal epilepsy. Neuroreport 2020; 31:1289-1295. [PMID: 33165193 DOI: 10.1097/wnr.0000000000001541] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Neuroimaging studies have found altered functional connectivity of default mode network (DMN) and salience network (SN) in patients with focal epilepsy (FE). However, the structural basis underlying the functional connectivity disturbance in the patients is still unclear. Sixteen MRI-normal FE and 22 healthy controls were included in the current study. The T1 structural image of each participant was obtained. Seed-based structural covariance connectivity was employed to investigate changes of structural covariance connectivity of DMN and SN in FE patients. We further evaluated gray matter volume changes of brain areas showing altered structural connectivity in the patients. We found that patients with FE showed reduced connectivity of posterior cingulate cortex and left medial prefrontal cortex, hippocampus and orbitofrontal cortex, and reduced connectivity of right fronto-insula cortex with left insula, orbitofrontal cortex, opercum part of inferior frontal cortex and right medial prefrontal cortex compared with healthy controls. Moreover, those brain areas showing significant reduced structural covariance connectivity in patients with FE also had a loss of gray matter volume, indicating that reduced structural connectivity of DMN and SN might be associated with gray matter atrophy in the patients. Those results highlight the crucial role of DMN and SN in the pathology of patients with FE, and provided structural basis for the functional disturbance of the two networks in this disease.
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Affiliation(s)
- Ting Shu
- Medical Imaging Center, Second Affiliated Hospital of Nanchang University, Nanchang
| | - Xinlan Xiao
- Medical Imaging Center, Second Affiliated Hospital of Nanchang University, Nanchang
| | - Zhiliang Long
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, China
| | - Ran Zhang
- Medical Imaging Center, Second Affiliated Hospital of Nanchang University, Nanchang
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Gonen OM, Kwan P, O'Brien TJ, Lui E, Desmond PM. Resting-state functional MRI of the default mode network in epilepsy. Epilepsy Behav 2020; 111:107308. [PMID: 32698105 DOI: 10.1016/j.yebeh.2020.107308] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 06/28/2020] [Accepted: 06/28/2020] [Indexed: 02/09/2023]
Abstract
The default mode network (DMN) is a major neuronal network that deactivates during goal-directed tasks. Recent advances in neuroimaging have shed light on its structure and function. Alterations in the DMN are increasingly recognized in a range of neurological and psychiatric conditions including epilepsy. This review first describes the current understanding of the DMN in health, normal aging, and disease as it is acquired via resting-state functional magnetic resonance imaging (MRI), before focusing on how it is affected in various types of focal and generalized epilepsy. These findings support the potential use of DMN parameters as future biomarkers in epilepsy research, diagnosis, and management.
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Affiliation(s)
- Ofer M Gonen
- The Royal Melbourne Hospital, VIC, Australia; The University of Melbourne, VIC, Australia; The Alfred Hospital, VIC, Australia.
| | - Patrick Kwan
- The Royal Melbourne Hospital, VIC, Australia; The University of Melbourne, VIC, Australia; The Alfred Hospital, VIC, Australia; Monash University, VIC, Australia
| | - Terence J O'Brien
- The Royal Melbourne Hospital, VIC, Australia; The University of Melbourne, VIC, Australia; The Alfred Hospital, VIC, Australia; Monash University, VIC, Australia
| | - Elaine Lui
- The Royal Melbourne Hospital, VIC, Australia; The University of Melbourne, VIC, Australia
| | - Patricia M Desmond
- The Royal Melbourne Hospital, VIC, Australia; The University of Melbourne, VIC, Australia
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Carboni M, De Stefano P, Vorderwülbecke BJ, Tourbier S, Mullier E, Rubega M, Momjian S, Schaller K, Hagmann P, Seeck M, Michel CM, van Mierlo P, Vulliemoz S. Abnormal directed connectivity of resting state networks in focal epilepsy. NEUROIMAGE-CLINICAL 2020; 27:102336. [PMID: 32679553 PMCID: PMC7363703 DOI: 10.1016/j.nicl.2020.102336] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 06/30/2020] [Accepted: 07/01/2020] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Epilepsy diagnosis can be difficult in the absence of interictal epileptic discharges (IED) on scalp EEG. We used high-density EEG to measure connectivity in large-scale functional networks of patients with focal epilepsy (Temporal and Extratemporal Lobe Epilepsy, TLE and ETLE) and tested for network alterations during resting wakefulness without IEDs, compared to healthy controls. We measured global efficiency as a marker of integration within networks. METHODS We analysed 49 adult patients with focal epilepsy and 16 healthy subjects who underwent high-density-EEG and structural MRI. We estimated cortical activity using electric source analysis in 82 atlas-based cortical regions based on the individual MRI. We applied directed connectivity analysis (Partial Directed Coherence) on these sources and performed graph analysis: we computed the Global Efficiency on the whole brain and on each resting state network. We tested these features in different group of patients. RESULTS Compared to controls, efficiency was increased in both TLE and ETLE (p < 0.05). The somato-motor-network, the ventral-attention-network and the default-mode-network had a significantly increased efficiency (p < 0.05) in both TLE and ETLE as well as TLE with hippocampal sclerosis. SIGNIFICANCE During interictal scalp EEG epochs without IED, patients with focal epilepsy show brain functional connectivity alterations in the whole brain and in specific resting-state-networks. This higher integration reflects a chronic effect of pathological activity within these structures and complement previous work on altered information outflow. These findings could increase the diagnostic sensitivity of scalp EEG to identify epileptic activity in the absence of IED.
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Affiliation(s)
- Margherita Carboni
- EEG and Epilepsy Unit, Clinical Neuroscience Department, University Hospital and Faculty of Medicine of Geneva, Geneva, Switzerland; Functional Brain Mapping Lab, Department of Fundamental Neurosciences, University of Geneva, Geneva, Switzerland.
| | - Pia De Stefano
- EEG and Epilepsy Unit, Clinical Neuroscience Department, University Hospital and Faculty of Medicine of Geneva, Geneva, Switzerland
| | - Bernd J Vorderwülbecke
- EEG and Epilepsy Unit, Clinical Neuroscience Department, University Hospital and Faculty of Medicine of Geneva, Geneva, Switzerland; Epilepsy-Center Berlin-Brandenburg, Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Sebastien Tourbier
- Connectomics Lab, Department of Radiology, University Hospital of Lausanne, Lausanne, Switzerland
| | - Emeline Mullier
- Connectomics Lab, Department of Radiology, University Hospital of Lausanne, Lausanne, Switzerland
| | - Maria Rubega
- Functional Brain Mapping Lab, Department of Fundamental Neurosciences, University of Geneva, Geneva, Switzerland; Department of Neurosciences, University of Padova, Padova, Italy
| | - Shahan Momjian
- Department of Neurosurgery, University Hospital and Faculty of Medicine of Geneva, Geneva, Switzerland
| | - Karl Schaller
- Department of Neurosurgery, University Hospital and Faculty of Medicine of Geneva, Geneva, Switzerland
| | - Patric Hagmann
- Connectomics Lab, Department of Radiology, University Hospital of Lausanne, Lausanne, Switzerland
| | - Margitta Seeck
- EEG and Epilepsy Unit, Clinical Neuroscience Department, University Hospital and Faculty of Medicine of Geneva, Geneva, Switzerland
| | - Christoph M Michel
- Functional Brain Mapping Lab, Department of Fundamental Neurosciences, University of Geneva, Geneva, Switzerland
| | - Pieter van Mierlo
- Medical Image and Signal Processing Group, Department of Electronics and Information Systems, Ghent University, Ghent, Belgium
| | - Serge Vulliemoz
- EEG and Epilepsy Unit, Clinical Neuroscience Department, University Hospital and Faculty of Medicine of Geneva, Geneva, Switzerland
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48
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Abstract
The episodic nature of both epilepsy and psychiatric illnesses suggests that the brain switches between healthy and pathological states. The most obvious example of transitions between network states related to epilepsy is the manifestation of ictal events. In addition to seizures, there are more subtle changes in network communication within and between brain regions, which we propose may contribute to psychiatric illnesses associated with the epilepsies. This review will highlight evidence supporting aberrant network activity associated with epilepsy and the contribution to cognitive impairments and comorbid psychiatric illnesses. Further, we discuss potential mechanisms mediating the network dysfunction associated with comorbidities in epilepsy, including interneuron loss and hypothalamic–pituitary–adrenal axis dysfunction. Conceptually, it is necessary to think beyond ictal activity to appreciate the breadth of network dysfunction contributing to the spectrum of symptoms associated with epilepsy, including psychiatric comorbidities.
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Affiliation(s)
- Phillip L W Colmers
- Neuroscience Department, Tufts University School of Medicine, Boston, MA, USA
| | - Jamie Maguire
- Neuroscience Department, Tufts University School of Medicine, Boston, MA, USA
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49
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Dumlu SN, Ademoğlu A, Sun W. Investigation of functional variability and connectivity in temporal lobe epilepsy: A resting state fMRI study. Neurosci Lett 2020; 733:135076. [PMID: 32446775 DOI: 10.1016/j.neulet.2020.135076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 04/12/2020] [Accepted: 05/19/2020] [Indexed: 10/24/2022]
Abstract
It is crucial to reveal the variability between patients with epilepsy and healthy subjects to elucidate the underpinnings of the disease pathology. Herein, we assessed the inter-subject variability between patients with temporal lobe epilepsy (TLE) and healthy subjects in terms of estimating the functional connectivity using resting-state functional magnetic resonance (rs-fMRI) scans. According to inter-subject variability results between healthy and TLE population, the latter showed more variability mainly in frontoparietal control, default mode, dorsal/ventral attention, visual and somatomotor networks in line with the broad seizure onset and propagation pathway. As a result of 17-Network parcellation, a significant attenuation is observed in functional connectivity, mostly in bilateral frontoparietal control, somatomotor, default mode and ventral attention networks associated with the functional impairment in attention, long/short term memory, executive functioning. The results are in favor of the argument that the functional disruption in TLE spreads throughout the cortex beyond the temporal lobe with an implication of greater diversity in the TLE population.
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Affiliation(s)
- Seda Nilgün Dumlu
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA; Institute of Biomedical Engineering, Bogazici University, Istanbul 34684, Turkey
| | - Ahmet Ademoğlu
- Institute of Biomedical Engineering, Bogazici University, Istanbul 34684, Turkey
| | - Wei Sun
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
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50
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Pimentel-Silva LR, Casseb RF, Cordeiro MM, Campos BAG, Alvim MKM, Rogerio F, Yasuda CL, Cendes F. Interactions between in vivo neuronal-glial markers, side of hippocampal sclerosis, and pharmacoresponse in temporal lobe epilepsy. Epilepsia 2020; 61:1008-1018. [PMID: 32347553 DOI: 10.1111/epi.16509] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 03/01/2020] [Accepted: 03/29/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To evaluate the interactions of metabolic neuronal-glial changes with the presence and hemispheric-side of hippocampal sclerosis (HS) and its potential role in predicting pharmacoresistance in temporal lobe epilepsy (TLE). METHODS We included structural magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy (1 H-MRS) metabolic data for 91 patients with unilateral TLE and 50 healthy controls. We measured the values of total N-acetyl aspartate/total creatine (tNAA/tCr), glutamate/tCr (Glu/tCr), and myo-inositol/tCr (mIns/tCr). To assess the influence of the pharmacoresponse and hemispheric-side of HS on metabolic data, the relationship between clinical and MRI data, and the predictive value of NAA/Cr, we used analysis of variance/covariance and built a logistic regression model. We used bootstrap simulations to evaluate reproducibility. RESULTS Bilateral tNAA/tCr reduction was associated with pharmacoresistance and with left HS, a decrease of Glu/tCr ipsilateral to the seizure focus was associated with pharmacoresistance, and ipsilateral mIns/tCr increase was related to pharmacoresistance and the presence of left HS. The logistic regression model containing clinical and 1 H-MRS data discriminated pharmacoresistance (area under the curve [AUC] = 0.78). However, the reduction of tNAA/tCr was the main predictor, with the odds 2.48 greater for pharmacoresistance. SIGNIFICANCE Our study revealed a spectrum of neuronal-glial changes in TLE, which was associated with pharmacoresistance, being more severe in left-sided HS and less severe in MRI-negative TLE. These noninvasive, in vivo biomarkers provide valuable additional information about the interhemispheric differences in metabolic dysfunction, seizure burden, and HS, and may help to predict pharmacoresistance.
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Affiliation(s)
| | - Raphael F Casseb
- Department of Neurology, University of Campinas, Campinas, Brazil
| | | | - Bruno A G Campos
- Department of Neurology, University of Campinas, Campinas, Brazil
| | - Marina K M Alvim
- Department of Neurology, University of Campinas, Campinas, Brazil
| | - Fábio Rogerio
- Department of Pathology, University of Campinas, Campinas, Brazil
| | | | - Fernando Cendes
- Department of Neurology, University of Campinas, Campinas, Brazil
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