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Huang H, Huang D, Luo C, Qiu Z, Zheng J. Abnormalities of regional brain activity and executive function in patients with temporal lobe epilepsy: A cross-sectional and longitudinal resting-state functional MRI study. Neuroradiology 2024; 66:1093-1104. [PMID: 38668803 DOI: 10.1007/s00234-024-03368-1] [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: 01/15/2024] [Accepted: 04/22/2024] [Indexed: 06/05/2024]
Abstract
PURPOSE We decided to track changes in regional brain activity and executive function in temporal lobe epilepsy (TLE) patients based on cross-sectional and longitudinal designs and sought potential imaging features for follow-up observation. METHODS Thirty-two TLE patients and thirty-three healthy controls (HCs) were recruited to detect changes in fractional amplitude of low-frequency fluctuation (fALFF) and regional homogeneity (ReHo) and to evaluate executive function both at baseline and at two-year (23.3 ± 8.3 months) follow-up. Moreover, multivariate pattern analysis (MVPA) was used for follow-up observation. RESULTS TLE patients displayed lower fALFF values in the right superior frontal gyrus (SFG) and higher ReHo values in the left putamen (PUT) relative to the HCs. Longitudinal analysis revealed that TLE patients at follow-up exhibited higher fALFF values in the left postcentral gyrus (PoCG), higher ReHo values in the left PoCG and the right middle frontal gyrus (MFG), lower ReHo values in the bilateral PUT and the right fusiform gyrus (FFG) compared with these patients at baseline. The executive function was impaired in TLE patients but didn't deteriorate over time. No correlations were discovered between regional brain activity and executive function. The MVPA based on ReHo performed well in differentiating the follow-up group from the baseline group. CONCLUSION We revealed the abnormalities in regional brain activity and executive function as well as their longitudinal trends in TLE patients. The ReHo might be a good imaging feature for follow-up observation.
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Affiliation(s)
- Huachun Huang
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Dongying Huang
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Cuimi Luo
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Zhuoyan Qiu
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jinou Zheng
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China.
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Merlet I, Guillery M, Weyl L, Hammal M, Maliia M, Maliia S, Biraben A, Ricordeau C, Drapier D, Nica A. EEG changes induced by meditative practices: State and trait effects in healthy subjects and in patients with epilepsy. Rev Neurol (Paris) 2024; 180:326-347. [PMID: 38503588 DOI: 10.1016/j.neurol.2024.02.387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 02/28/2024] [Accepted: 02/28/2024] [Indexed: 03/21/2024]
Abstract
The effect of meditation on brain activity has been the topic of many studies in healthy subjects and in patients suffering from chronic diseases. These effects are either explored during meditation practice (state effects) or as a longer-term result of meditation training during the resting-state (trait). The topic of this article is to first review these findings by focusing on electroencephalography (EEG) changes in healthy subjects with or without experience in meditation. Modifications in EEG baseline rhythms, functional connectivity and advanced nonlinear parameters are discussed in regard to feasibility in clinical applications. Secondly, we provide a state-of-the-art of studies that proposed meditative practices as a complementary therapy in patients with epilepsy, in whom anxiety and depressive symptoms are prevalent. In these studies, the effects of standardized meditation programs including elements of traditional meditation practices such as mindfulness, loving-kindness and compassion are explored both at the level of psychological functioning and on the occurrence of seizures. Lastly, preliminary results are given regarding our ongoing study, the aim of which is to quantify the effects of a mindfulness self-compassion (MSC) practice on interictal and ictal epileptic activity. Feasibility, difficulties, and prospects of this study are discussed.
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Affiliation(s)
- I Merlet
- Universitiy of Rennes, INSERM, LTSI - UMR 1099, F-35000 Rennes, France.
| | - M Guillery
- Centre Hospitalier Guillaume-Regnier (CHGR), University of Rennes, 35000 Rennes, France.
| | - L Weyl
- Centre Hospitalier Guillaume-Regnier (CHGR), University of Rennes, 35000 Rennes, France.
| | - M Hammal
- Centre Hospitalier Guillaume-Regnier (CHGR), University of Rennes, 35000 Rennes, France.
| | - M Maliia
- Universitiy of Rennes, INSERM, LTSI - UMR 1099, F-35000 Rennes, France; Epilepsy Unit, Reference Center for Rare Epilepsies, Neurology Department, Rennes University Hospital, Rennes, France; Center for Clinical Investigation CIC-P INSERM 1414, F-35000 Rennes, France.
| | - S Maliia
- Centre Hospitalier Guillaume-Regnier (CHGR), University of Rennes, 35000 Rennes, France.
| | - A Biraben
- Universitiy of Rennes, INSERM, LTSI - UMR 1099, F-35000 Rennes, France; Epilepsy Unit, Reference Center for Rare Epilepsies, Neurology Department, Rennes University Hospital, Rennes, France; Center for Clinical Investigation CIC-P INSERM 1414, F-35000 Rennes, France.
| | - C Ricordeau
- Epilepsy Resource Team, 54, rue Saint-Helier, 35000 Rennes, France.
| | - D Drapier
- Centre Hospitalier Guillaume-Regnier (CHGR), University of Rennes, 35000 Rennes, France.
| | - A Nica
- Universitiy of Rennes, INSERM, LTSI - UMR 1099, F-35000 Rennes, France; Epilepsy Unit, Reference Center for Rare Epilepsies, Neurology Department, Rennes University Hospital, Rennes, France; Center for Clinical Investigation CIC-P INSERM 1414, F-35000 Rennes, France.
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Boot EM, Omes QPM, Maaijwee N, Schaapsmeerders P, Arntz RM, Rutten-Jacobs LCA, Kessels RPC, de Leeuw FE, Tuladhar AM. Functional brain connectivity in young adults with post-stroke epilepsy. Brain Commun 2023; 5:fcad277. [PMID: 37953839 PMCID: PMC10639092 DOI: 10.1093/braincomms/fcad277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/07/2023] [Accepted: 10/17/2023] [Indexed: 11/14/2023] Open
Abstract
Approximately 1 in 10 young stroke patients (18-50 years) will develop post-stroke epilepsy, which is associated with cognitive impairment. While previous studies have shown altered brain connectivity in patients with epilepsy, little is however known about the changes in functional brain connectivity in young stroke patients with post-stroke epilepsy and their relationship with cognitive impairment. Therefore, we aimed to investigate whether young ischaemic stroke patients have altered functional networks and whether this alteration is related to cognitive impairment. We included 164 participants with a first-ever cerebral infarction at young age (18-50 years), along with 77 age- and sex-matched controls, from the Follow-Up of Transient Ischemic Attack and Stroke patients and Unelucidated Risk Factor Evaluation study. All participants underwent neuropsychological testing and resting-state functional MRI to generate functional connectivity networks. At follow-up (10.5 years after the index event), 23 participants developed post-stroke epilepsy. Graph theoretical analysis revealed functional network reorganization in participants with post-stroke epilepsy, in whom a weaker (i.e. network strength), less-integrated (i.e. global efficiency) and less-segregated (i.e. clustering coefficient and local efficiency) functional network was observed compared with the participants without post-stroke epilepsy group and the controls (P < 0.05). Regional analysis showed a trend towards decreased clustering coefficient, local efficiency and nodal efficiency in contralesional brain regions, including the caudal anterior cingulate cortex, posterior cingulate cortex, precuneus, superior frontal gyrus and insula in participants with post-stroke epilepsy compared with those without post-stroke epilepsy. Furthermore, participants with post-stroke epilepsy more often had impairment in the processing speed domain than the group without post-stroke epilepsy, in whom the network properties of the precuneus were positively associated with processing speed performance. Our findings suggest that post-stroke epilepsy is associated with functional reorganization of the brain network after stroke that is characterized by a weaker, less-integrated and less-segregated brain network in young ischaemic stroke patients compared with patients without post-stroke epilepsy. The contralesional brain regions, which are mostly considered as hub regions, might be particularly involved in the altered functional network and may contribute to cognitive impairment in post-stroke epilepsy patients. Overall, our findings provide additional evidence for a potential role of disrupted functional network as underlying pathophysiological mechanism for cognitive impairment in patients with post-stroke epilepsy.
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Affiliation(s)
- Esther M Boot
- Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Radboud University Medical Centre, Nijmegen 6525GA, The Netherlands
| | - Quinty P M Omes
- Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Radboud University Medical Centre, Nijmegen 6525GA, The Netherlands
| | - Noortje Maaijwee
- Department of Neurology and Neurorehabilitation, Luzerner Kantonsspital Neurocentre, Luzern 16, Switzerland
| | | | - Renate M Arntz
- Department of Neurology, Medisch Spectrum Twente, Enschede 7500 KA, The Netherlands
| | | | - Roy P C Kessels
- Donders Institute for Brain, Cognition and Behaviour, Department of Psychology, Radboud University, Nijmegen 6525 GD, The Netherlands
- Department of Medical Psychology and Radboudumc Alzheimer Centre, Radboud University Medical Centre, Nijmegen 6525 GA, The Netherlands
- Vincent van Gogh Institute for Psychiatry, Venray 5803 AC, The Netherlands
| | - Frank-Erik de Leeuw
- Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Radboud University Medical Centre, Nijmegen 6525GA, The Netherlands
| | - Anil M Tuladhar
- Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Radboud University Medical Centre, Nijmegen 6525GA, The Netherlands
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Yuan S, Huang H, Cai B, Li J, Zhang M, Luo J. Altered metabolic-functional coupling in the epileptogenic network could predict surgical outcomes of mesial temporal lobe epilepsy. Front Neurosci 2023; 17:1165982. [PMID: 37360171 PMCID: PMC10286900 DOI: 10.3389/fnins.2023.1165982] [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: 02/14/2023] [Accepted: 05/09/2023] [Indexed: 06/28/2023] Open
Abstract
Objective To investigate the relationship between glucose metabolism and functional activity in the epileptogenic network of patients with mesial temporal lobe epilepsy (MTLE) and to determine whether this relationship is associated with surgical outcomes. Methods 18F-FDG PET and resting-state functional MRI (rs-fMRI) scans were performed on a hybrid PET/MR scanner in 38 MTLE patients with hippocampal sclerosis (MR-HS), 35 MR-negative patients and 34 healthy controls (HC). Glucose metabolism was measured using 18F-FDG PET standardized uptake value ratio (SUVR) relative to cerebellum; Functional activity was obtained by fractional amplitude of low-frequency fluctuation (fALFF). The betweenness centrality (BC) of metabolic covariance network and functional network were calculated using graph theoretical analysis. Differences in SUVR, fALFF, BC and the spatial voxel-wise SUVR-fALFF couplings of the epileptogenic network, consisting of default mode network (DMN) and thalamus, were evaluated by Mann-Whitney U test (using the false discovery rate [FDR] for multiple comparison correction). The top ten SUVR-fALFF couplings were selected by Fisher score to predict surgical outcomes using logistic regression model. Results The results showed decreased SUVR-fALFF coupling in the bilateral middle frontal gyrus (PFDR = 0.0230, PFDR = 0.0296) in MR-HS patients compared to healthy controls. Coupling in the ipsilateral hippocampus was marginally increased (PFDR = 0.0802) in MR-HS patients along with decreased BC of metabolic covariance network and functional network (PFDR = 0.0152; PFDR = 0.0429). With Fisher score ranking, the top ten SUVR-fALFF couplings in regions from DMN and thalamic subnuclei could predict surgical outcomes with the best performance being a combination of ten SUVR-fALFF couplings with an AUC of 0.914. Conclusion These findings suggest that the altered neuroenergetic coupling in the epileptogenic network is associated with surgical outcomes of MTLE patients, which may provide insight into their pathogenesis and help with preoperative evaluation.
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Affiliation(s)
- Siyu Yuan
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Hui Huang
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Bingyang Cai
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Jiwei Li
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Miao Zhang
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jie Luo
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
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Ma K, Zhang X, Song C, Han S, Li W, Wang K, Mao X, Zhang Y, Cheng J. Altered topological properties and their relationship to cognitive functions in unilateral temporal lobe epilepsy. Epilepsy Behav 2023; 144:109247. [PMID: 37267843 DOI: 10.1016/j.yebeh.2023.109247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 04/24/2023] [Accepted: 04/27/2023] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To investigate abnormalities in topological properties in unilateral temporal lobe epilepsy (TLE) with hippocampal sclerosis and their correlations with cognitive functions. METHODS Thirty-eight patients with TLE and 19 age- and sex-matched healthy controls (HCs) were enrolled in this research and underwent resting-state functional magnetic resonance imaging (fMRI) examinations. Whole-brain functional networks of participants were constructed based on the fMRI data. Topological characteristics of the functional network were compared between patients with left and right TLE and HCs. Correlations between altered topological properties and cognitive measurements were explored. RESULTS Compared with the HCs, patients with left TLE showed decreased clustering coefficient, global efficiency, and local efficiency (Eloc), and patients with right TLE showed decreased Eloc. We found altered nodal centralities in six regions related to the basal ganglia (BG) network or default mode network (DMN) in patients with left TLE and those in three regions related to reward/emotion network or ventral attention network in patients with right TLE. Patients with right TLE showed higher integration (reduced nodal shortest path length) in four regions related to the DMN and lower segregation (reduced nodal local efficiency and nodal clustering coefficient) in the right middle temporal gyrus. When comparing left TLE with right TLE, no significant differences were detected in global parameters, but the nodal centralities in the left parahippocampal gyrus and the left pallidum were decreased in left TLE. The Eloc and several nodal parameters were significantly correlated with memory functions, duration, national hospital seizure severity scale (NHS3), or antiseizure medications (ASMs) in patients with TLE. CONCLUSIONS The topological properties of whole-brain functional networks were disrupted in TLE. Networks of left TLE were characterized by lower efficiency; right TLE was preserved in global efficiency but disrupted in fault tolerance. Several nodes with abnormal topological centrality in the basal ganglia network beyond the epileptogenic focus in the left TLE were not found in the right TLE. Right TLE had some nodes with reduced shortest path length in regions of the DMN as compensation. These findings provide new insights into the effect of lateralization on TLE and help us to understand the cognitive impairment of patients with TLE.
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Affiliation(s)
- Keran Ma
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China; Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China; Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China; Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China; Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China; Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China.
| | - Xiaonan Zhang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China; Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China; Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China; Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China; Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China; Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China.
| | - Chengru Song
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China; Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China; Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China; Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China; Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China; Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China.
| | - Shaoqiang Han
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China; Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China; Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China; Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China; Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China; Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China.
| | - Wenbin Li
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China; Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China; Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China; Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China; Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China; Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China.
| | - Kefan Wang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China; Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China; Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China; Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China; Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China; Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China.
| | - Xinyue Mao
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China; Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China; Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China; Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China; Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China; Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China.
| | - Yong Zhang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China; Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China; Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China; Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China; Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China; Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China.
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China; Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China; Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China; Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China; Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China; Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China.
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Liu Y, Li Q, Yi D, Duan J, Zhang Q, Huang Y, He H, Liao Y, Song Z, Deng L, Wang W, Liu D. Topological abnormality of structural covariance network in MRI-negative frontal lobe epilepsy. Front Neurosci 2023; 17:1136110. [PMID: 37214387 PMCID: PMC10196002 DOI: 10.3389/fnins.2023.1136110] [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: 01/02/2023] [Accepted: 04/11/2023] [Indexed: 05/24/2023] Open
Abstract
Background Frontal lobe epilepsy (FLE) is the second most common type of focal epilepsy, however, imaging studies of FLE have been far less than Temporal lobe epilepsy (TLE) and the structural findings were not consistent in previous literature. Object Investigate the changes in cortical thickness in patients with FLE and the alteration of the structural covariance networks (SCNs) of cortical thickness with graph-theory. Method Thirty patients with FLE (18 males/12 females; 28.33 ± 11.81 years) and 27 demographically matched controls (15 males/12 females; 29.22 ± 9.73 years) were included in this study with high-resolution structural brain MRI scans. The cortical thickness was calculated, and structural covariance network (SCN) of cortical thickness were reconstructed using 68 × 68 matrix and analyzed with graph-theory approach. Result Cortical thickness was not significantly different between two groups, but path length and node betweenness were significantly increased in patients with FLE, and the regional network alterations were significantly changed in right precentral gyrus and right temporal pole (FDR corrected, p < 0.05). Comparing to HC group, network hubs were decreased and shifted away from frontal lobe. Conclusion The topological properties of cortical thickness covariance network were significantly altered in patients with FLE, even without obvious surface-based morphological damage. Graph-theory based SCN analysis may provide sensitive neuroanatomical biomarkers for FLE.
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Affiliation(s)
- Yin Liu
- Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Quanji Li
- Department of Neurology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Dali Yi
- Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Junhong Duan
- Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Qingxia Zhang
- Department of Neurology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Yunchen Huang
- Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Haibo He
- Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Yunjie Liao
- Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Zhi Song
- Department of Neurology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Lingling Deng
- Department of Radiology, The Second Affiliated Hospital, University of South China, Hengyang, China
| | - Wei Wang
- Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Ding Liu
- Department of Neurology, The Third Xiangya Hospital, Central South University, Changsha, China
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Wang X, Lin D, Zhao C, Li H, Fu L, Huang Z, Xu S. Abnormal metabolic connectivity in default mode network of right temporal lobe epilepsy. Front Neurosci 2023; 17:1011283. [PMID: 37034164 PMCID: PMC10076532 DOI: 10.3389/fnins.2023.1011283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 03/06/2023] [Indexed: 04/11/2023] Open
Abstract
Aims Temporal lobe epilepsy (TLE) is a common neurological disorder associated with the dysfunction of the default mode network (DMN). Metabolic connectivity measured by 18F-fluorodeoxyglucose Positron Emission Computed Tomography (18F-FDG PET) has been widely used to assess cumulative energy consumption and provide valuable insights into the pathophysiology of TLE. However, the metabolic connectivity mechanism of DMN in TLE is far from fully elucidated. The present study investigated the metabolic connectivity mechanism of DMN in TLE using 18F-FDG PET. Method Participants included 40 TLE patients and 41 health controls (HC) who were age- and gender-matched. A weighted undirected metabolic network of each group was constructed based on 14 primary volumes of interest (VOIs) in the DMN, in which Pearson's correlation coefficients between each pair-wise of the VOIs were calculated in an inter-subject manner. Graph theoretic analysis was then performed to analyze both global (global efficiency and the characteristic path length) and regional (nodal efficiency and degree centrality) network properties. Results Metabolic connectivity in DMN showed that regionally networks changed in the TLE group, including bilateral posterior cingulate gyrus, right inferior parietal gyrus, right angular gyrus, and left precuneus. Besides, significantly decreased (P < 0.05, FDR corrected) metabolic connections of DMN in the TLE group were revealed, containing bilateral hippocampus, bilateral posterior cingulate gyrus, bilateral angular gyrus, right medial of superior frontal gyrus, and left inferior parietal gyrus. Conclusion Taken together, the present study demonstrated the abnormal metabolic connectivity in DMN of TLE, which might provide further insights into the understanding the dysfunction mechanism and promote the treatment for TLE patients.
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Affiliation(s)
- Xiaoyang Wang
- Department of Medical Imaging, The 900th Hospital of Joint Logistic Support Force, PLA, Fuzhou, Fujian, China
- Department of Medical Imaging, Affiliated Dongfang Hospital, Xiamen University, Fuzhou, Fujian, China
| | - Dandan Lin
- Department of Clinical Medicine, Fujian Health College, Fuzhou, Fujian, China
| | - Chunlei Zhao
- Department of Medical Imaging, The 900th Hospital of Joint Logistic Support Force, PLA, Fuzhou, Fujian, China
- Department of Medical Imaging, Affiliated Dongfang Hospital, Xiamen University, Fuzhou, Fujian, China
| | - Hui Li
- Department of Medical Imaging, The 900th Hospital of Joint Logistic Support Force, PLA, Fuzhou, Fujian, China
| | - Liyuan Fu
- Department of Medical Imaging, The 900th Hospital of Joint Logistic Support Force, PLA, Fuzhou, Fujian, China
- Department of Medical Imaging, Affiliated Dongfang Hospital, Xiamen University, Fuzhou, Fujian, China
| | - Zhifeng Huang
- Department of Medical Imaging, The 900th Hospital of Joint Logistic Support Force, PLA, Fuzhou, Fujian, China
- Department of Medical Imaging, Affiliated Dongfang Hospital, Xiamen University, Fuzhou, Fujian, China
| | - Shangwen Xu
- Department of Medical Imaging, The 900th Hospital of Joint Logistic Support Force, PLA, Fuzhou, Fujian, China
- Department of Medical Imaging, Affiliated Dongfang Hospital, Xiamen University, Fuzhou, Fujian, China
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Sarrias-Arrabal E, Izquierdo-Ayuso G, Vázquez-Marrufo M. Attentional networks in neurodegenerative diseases: anatomical and functional evidence from the Attention Network Test. NEUROLOGÍA (ENGLISH EDITION) 2022; 38:206-217. [PMID: 35256319 DOI: 10.1016/j.nrleng.2020.05.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 05/11/2020] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Understanding alterations to brain anatomy and cognitive function associated with neurodegenerative diseases remains a challenge for neuroscience today. In experimental neuroscience, several computerised tests have been developed to contribute to our understanding of neural networks involved in cognition. The Attention Network Test (ANT) enables us to measure the activity of 3 attentional networks (alertness, orienting, and executive function). OBJECTIVES The main aim of this review is to describe all the anatomical and functional alterations found in diverse neurological diseases using the ANT. MATERIAL AND METHODS We collected studies published since 2010 in the PubMed database that employed the ANT in different neurological diseases. Thirty-two articles were obtained, addressing multiple sclerosis, epilepsy, and Parkinson's disease, among other disorders. CONCLUSIONS Some of the anatomical structures proposed in the 3 attentional networks model were confirmed. The most relevant structures in the alertness network are the prefrontal cortex, parietal region, thalamus, and cerebellum. The thalamus is also relevant in the orienting network, together with posterior parietal regions. The executive network does not depend exclusively on the prefrontal cortex and anterior cingulate cortex, but also involves such subcortical structures as the basal ganglia and cerebellum and their projections towards the entire cortex.
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Bakhtiari A, Bjørke AB, Larsson PG, Olsen KB, Nævra MCJ, Taubøll E, Heuser K, Østby Y. Episodic Memory Dysfunction and Effective Connectivity in Adult Patients With Newly Diagnosed Nonlesional Temporal Lobe Epilepsy. Front Neurol 2022; 13:774532. [PMID: 35222242 PMCID: PMC8866246 DOI: 10.3389/fneur.2022.774532] [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: 09/12/2021] [Accepted: 01/06/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Epilepsy is associated with both changes in brain connectivity and memory function, usually studied in the chronic patients. The aim of this study was to explore the presence of connectivity alterations measured by EEG in the parietofrontal network in patients with temporal lobe epilepsy (TLE), and to examine episodic memory, at the time point of diagnosis. Methods The parietofrontal network of newly diagnosed patients with TLE (N = 21) was assessed through electroencephalography (EEG) effective connectivity and compared with that of matched controls (N = 21). Furthermore, we assessed phenomenological aspects of episodic memory in both groups. Association between effective connectivity and episodic memory were assessed through correlation. Results Patients with TLE displayed decreased episodic (p ≤ 0.001, t = −5.18) memory scores compared with controls at the time point of diagnosis. The patients showed a decreased right parietofrontal connectivity (p = 0.03, F = 4.94) compared with controls, and significantly weaker connectivity in their right compared with their left hemisphere (p = 0.008, t = −2.93). There were no significant associations between effective connectivity and episodic memory scores. Conclusions We found changes in both memory function and connectivity at the time point of diagnosis, supporting the notion that TLE involves complex memory functions and brain networks beyond the seizure focus to strongly interconnected brain regions, already early in the disease course. Whether the observed connectivity changes can be interpreted as functionally important to the alterations in memory function, it remains speculative.
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Affiliation(s)
- Aftab Bakhtiari
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | - Agnes Balint Bjørke
- Division of Clinical Neuroscience, Department of Neurology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
- Division of Neurology, Rheumatology and Habilitation, Department of Neurology, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Pål Gunnar Larsson
- Section of Clinical Neurophysiology, Division of Clinical Neuroscience, Department of Neurosurgery, Oslo University Hospital–Rikshospitalet, Oslo, Norway
| | - Ketil Berg Olsen
- Section of Clinical Neurophysiology, Division of Clinical Neuroscience, Department of Neurosurgery, Oslo University Hospital–Rikshospitalet, Oslo, Norway
| | - Marianne C. Johansen Nævra
- Section of Clinical Neurophysiology, Division of Clinical Neuroscience, Department of Neurosurgery, Oslo University Hospital–Rikshospitalet, Oslo, Norway
| | - Erik Taubøll
- Division of Clinical Neuroscience, Department of Neurology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
- Division of Neurology, Rheumatology and Habilitation, Department of Neurology, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway
| | - Kjell Heuser
- Division of Clinical Neuroscience, Department of Neurology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
- *Correspondence: Kjell Heuser
| | - Ylva Østby
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
- Ylva Østby
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10
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Nie L, Jiang Y, Lv Z, Pang X, Liang X, Chang W, Zheng J. A study of brain functional network and alertness changes in temporal lobe epilepsy with and without focal to bilateral tonic-clonic seizures. BMC Neurol 2022; 22:14. [PMID: 34996377 PMCID: PMC8740350 DOI: 10.1186/s12883-021-02525-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 12/13/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Temporal lobe epilepsy (TLE) is commonly refractory. Epilepsy surgery is an effective treatment strategy for refractory epilepsy, but patients with a history of focal to bilateral tonic-clonic seizures (FBTCS) have poor outcomes. Previous network studies on epilepsy have found that TLE and idiopathic generalized epilepsy with generalized tonic-clonic seizures (IGE-GTCS) showed altered global and nodal topological properties. Alertness deficits also were found in TLE. However, FBTCS is a common type of seizure in TLE, and the implications for alertness as well as the topological rearrangements associated with this seizure type are not well understood. METHODS We obtained rs-fMRI data and collected the neuropsychological assessment data from 21 TLE patients with FBTCS (TLE- FBTCS), 18 TLE patients without FBTCS (TLE-non- FBTCS) and 22 controls, and constructed their respective functional brain networks. The topological properties were analyzed using the graph theoretical approach and correlations between altered topological properties and alertness were analyzed. RESULTS We found that TLE-FBTCS patients showed more serious impairment in alertness effect, intrinsic alertness and phasic alertness than the patients with TLE-non-FBTCS. They also showed significantly higher small-worldness, normalized clustering coefficient (γ) and a trend of higher global network efficiency (gE) compared to TLE-non-FBTCS patients. The gE showed a significant negative correlation with intrinsic alertness for TLE-non-FBTCS patients. CONCLUSION Our findings show different impairments in brain network information integration, segregation and alertness between the patients with TLE-FBTCS and TLE-non-FBTCS, demonstrating that impairments of the brain network may underlie the disruptions in alertness functions.
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Affiliation(s)
- Liluo Nie
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, No.6, Shuangyong Road, Nanning, 530021, China
| | - Yanchun Jiang
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, No.6, Shuangyong Road, Nanning, 530021, China
| | - Zongxia Lv
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, No.6, Shuangyong Road, Nanning, 530021, China
| | - Xiaomin Pang
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, No.6, Shuangyong Road, Nanning, 530021, China
| | - Xiulin Liang
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, No.6, Shuangyong Road, Nanning, 530021, China
| | - Weiwei Chang
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, No.6, Shuangyong Road, Nanning, 530021, China
| | - Jinou Zheng
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, No.6, Shuangyong Road, Nanning, 530021, China.
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11
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Fan B, Pang L, Li S, Zhou X, Lv Z, Chen Z, Zheng J. Correlation Between the Functional Connectivity of Basal Forebrain Subregions and Vigilance Dysfunction in Temporal Lobe Epilepsy With and Without Focal to Bilateral Tonic-Clonic Seizure. Front Psychiatry 2022; 13:888150. [PMID: 35722568 PMCID: PMC9201520 DOI: 10.3389/fpsyt.2022.888150] [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] [Received: 03/02/2022] [Accepted: 05/12/2022] [Indexed: 12/02/2022] Open
Abstract
PURPOSE Previous research has shown that subcortical brain regions are related to vigilance in temporal lobe epilepsy (TLE). However, it is unknown whether alterations in the function and structure of basal forebrain (BF) subregions are associated with vigilance impairment in distinct kinds of TLE. We aimed to investigate changes in the structure and function BF subregions in TLE patients with and without focal to bilateral tonic-clonic seizures (FBTCS) and associated clinical features. METHODS A total of 50 TLE patients (25 without and 25 with FBTCS) and 25 healthy controls (HCs) were enrolled in this study. The structural and functional alterations of BF subregions in TLE were investigated using voxel-based morphometry (VBM) and resting-state functional connectivity (rsFC) analysis. Correlation analyses were utilized to investigate correlations between substantially altered imaging characteristics and clinical data from patients. RESULTS FBTCS patients had a lower rsFC between Ch1-3 and the bilateral striatum as well as the left cerebellum posterior lobe than non-FBTCS patients. In comparison to non-FBTCS patients, the rsFC between Ch4 and the bilateral amygdala was also lower in FBTCS patients. Compared to HCs, the TLE patients had reduced rsFC between the BF subregions and the cerebellum, striatum, default mode network, frontal lobe, and occipital lobes. In the FBTCS group, the rsFC between the left Ch1-3 and striatum was positive correlated with the vigilance measures. In the non-FBTCS group, the rsFC between the left Ch4 and striatum was significantly negative correlated with the alertness measure. CONCLUSION These results extend current understanding of the pathophysiology of impaired vigilance in TLE and imply that the BF subregions may serve as critical nodes for developing and categorizing TLE biomarkers.
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Affiliation(s)
- Binglin Fan
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Linlin Pang
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Siyi Li
- Department of Neurology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Xia Zhou
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Zongxia Lv
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Zexiang Chen
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jinou Zheng
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
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12
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High prevalence of pathological alertness and wakefulness on maintenance of wakefulness test in adults with focal-onset epilepsy. Epilepsy Behav 2021; 125:108400. [PMID: 34800802 DOI: 10.1016/j.yebeh.2021.108400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 10/19/2021] [Accepted: 10/21/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Excessive daytime sleepiness (EDS) is a common complaint in adults with epilepsy (AWE), but objective evaluation is lacking. We used the maintenance of wakefulness test (MWT) to objectively measure the ability of adults with focal-onset epilepsy to maintain wakefulness in soporific conditions. METHODS Adults with epilepsy participating in a study investigating the effects of lacosamide on sleep and wakefulness underwent baseline ambulatory polysomnography (PSG)/EEG followed by MWT. Mean sleep latency (MSL) and mean percent sleep time (MST, mean percentage of non-wake EEG scored in 3-sec bins from lights out to sleep onset averaged over the 4 MWT trials) were quantified. Subjective sleepiness was assessed by the Epworth Sleepiness Scale (ESS). Spearman correlation and linear regression assessed relationships between MWT parameters, ESS and relevant sleep and epilepsy-related variables. RESULTS Maintenance of wakefulness test MSL in 51 AWE (mean age 43.5 ± 13 years, 69% female, mean BMI 24.6 ± 11.2 kg/m2) was 21.7 ± 11.9 min; 45.1% had an abnormally short MSL <19.4 min and 15.7% <8 min. MST was 9.3% [3.3, 19.1]. Mean ESS score was 8.8 ± 5.7; 39% had elevated ESS (>10). No correlation between subjective ESS and objective MSL (p = 0.67) or MST (p = 0.61) was found. MSL was significantly shorter in subjects with focal to bilateral tonic-clonic seizures (FBTCS; 7.9 min [13.6, 22.3]) compared to those without (27.4 min [21.2, 33.6], p = 0.013). Younger subjects had shorter MSL; MSL increased 3.2 min for every 10-year increase in age. CONCLUSION We found a high prevalence of objective sleepiness/difficulty maintaining wakefulness on the MWT and subjective sleepiness using the ESS in AWE without a correlation between the two. More severe objective sleepiness was found in subjects with a history of FBTCS and younger age. Further research is needed to determine mechanistic underpinnings and optimal measurements of pathological sleepiness in people with epilepsy given the burden of it on quality of life.
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13
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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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14
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Hatlestad-Hall C, Bruña R, Erichsen A, Andersson V, Syvertsen MR, Skogan AH, Renvall H, Marra C, Maestú F, Heuser K, Taubøll E, Solbakk AK, Haraldsen IH. The organization of functional neurocognitive networks in focal epilepsy correlates with domain-specific cognitive performance. J Neurosci Res 2021; 99:2669-2687. [PMID: 34173259 DOI: 10.1002/jnr.24896] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 04/28/2021] [Accepted: 05/15/2021] [Indexed: 11/10/2022]
Abstract
Understanding and diagnosing cognitive impairment in epilepsy remains a prominent challenge. New etiological models suggest that cognitive difficulties might not be directly linked to seizure activity, but are rather a manifestation of a broader brain pathology. Consequently, treating seizures is not sufficient to alleviate cognitive symptoms, highlighting the need for novel diagnostic tools. Here, we investigated whether the organization of three intrinsic, resting-state functional connectivity networks was correlated with domain-specific cognitive test performance. Using individualized EEG source reconstruction and graph theory, we examined the association between network small worldness and cognitive test performance in 23 patients with focal epilepsy and 17 healthy controls, who underwent a series of standardized pencil-and-paper and digital cognitive tests. We observed that the specific networks robustly correlated with test performance in distinct cognitive domains. Specifically, correlations were evident between the default mode network and memory in patients, the central-executive network and executive functioning in controls, and the salience network and social cognition in both groups. Interestingly, the correlations were evident in both groups, but in different domains, suggesting an alteration in these functional neurocognitive networks in focal epilepsy. The present findings highlight the potential clinical relevance of functional brain network dysfunction in cognitive impairment.
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Affiliation(s)
| | - Ricardo Bruña
- Center for Biomedical Technology, Technical University of Madrid, Pozuelo de Alarcón, Spain.,Department of Experimental Psychology, Complutense University of Madrid, Pozuelo de Alarcón, Spain.,Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - Aksel Erichsen
- Department of Neurology, Oslo University Hospital, Oslo, Norway.,Department of Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | | | - Marte Roa Syvertsen
- Department of Neurology, Drammen Hospital, Vestre Viken Health Care Trust, Drammen, Norway
| | - Annette Holth Skogan
- Division of Clinical Neuroscience, National Centre for Epilepsy, Oslo University Hospital, Oslo, Norway
| | - Hanna Renvall
- Department of Neuroscience and Biomedical Engineering, Aalto University, Helsinki, Finland.,BioMag Laboratory, HUS Diagnostic Center, Helsinki University Hospital, University of Helsinki and Aalto, Helsinki, Finland
| | - Camillo Marra
- Department of Neuroscience, Fondazione Policlinico Agostino Gemelli, Rome, Italy
| | - Fernando Maestú
- Center for Biomedical Technology, Technical University of Madrid, Pozuelo de Alarcón, Spain.,Department of Experimental Psychology, Complutense University of Madrid, Pozuelo de Alarcón, Spain.,Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - Kjell Heuser
- Department of Neurology, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Erik Taubøll
- Department of Neurology, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Anne-Kristin Solbakk
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway.,RITMO Centre for Interdisciplinary Studies in Rhythm, Time and Motion, University of Oslo, Oslo, Norway.,Department of Neurosurgery, Oslo University Hospital, Oslo, Norway.,Department of Neuropsychology, Helgeland Hospital, Mosjøen, Norway
| | - Ira H Haraldsen
- Department of Neurology, Oslo University Hospital, Oslo, Norway
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15
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Li C, Pang X, Shi K, Long Q, Liu J, Zheng J. The Insula Is a Hub for Functional Brain Network in Patients With Anti- N-Methyl-D-Aspartate Receptor Encephalitis. Front Neurosci 2021; 15:642390. [PMID: 33790737 PMCID: PMC8005702 DOI: 10.3389/fnins.2021.642390] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 01/29/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND In recent years, imaging technologies have been rapidly evolving, with an emphasis on the characterization of brain structure changes and functional imaging in patients with autoimmune encephalitis. However, the neural basis of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis and its linked cognitive decline is unclear. Our research aimed to assess changes in the functional brain network in patients with anti-NMDAR encephalitis and whether these changes lead to cognitive impairment. METHODS Twenty-one anti-NMDAR encephalitis patients and 22 age-, gender-, and education status-matched healthy controls were assessed using resting functional magnetic resonance imaging (fMRI) scanning and neuropsychological tests, including the Hamilton Depression Scale (HAMD24), the Montreal Cognitive Assessment (MoCA), and the Hamilton Anxiety Scale (HAMA). A functional brain network was constructed using fMRI, and the topology of the network parameters was analyzed using graph theory. Next, we extracted the aberrant topological parameters of the functional network as seeds and compared causal connectivity with the whole brain. Lastly, we explored the correlation of aberrant topological structures with deficits in cognitive performance. RESULTS Relative to healthy controls, anti-NMDAR encephalitis patients exhibited decreased MoCA scores and increased HAMA and HAMD24 scores (p < 0.05). The nodal clustering coefficient and nodal local efficiency of the left insula (Insula_L) were significantly decreased in anti-NMDAR encephalitis patients (p < 0.05 following Bonferroni correction). Moreover, anti-NMDAR encephalitis patients showed a weakened causal connectivity from the left insula to the left inferior parietal lobe (Parietal_Inf_L) compared to healthy controls. Conversely, the left superior parietal lobe (Parietal_sup_L) exhibited an enhanced causal connectivity to the left insula in anti-NMDAR encephalitis patients compared to controls. Unexpectedly, these alterations were not correlated with any neuropsychological test scores. CONCLUSION This research describes topological abnormalities in the functional brain network in anti-NMDAR encephalitis. These results will be conducive to understand the structure and function of the brain network of patients with anti-NMDAR encephalitis and further explore the neuropathophysiological mechanisms.
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Affiliation(s)
- Chunyan Li
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xiaomin Pang
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Ke Shi
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Qijia Long
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jinping Liu
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jinou Zheng
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
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16
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Disrupted alertness and related functional connectivity in patients with focal impaired awareness seizures in temporal lobe epilepsy. Epilepsy Behav 2020; 112:107369. [PMID: 32858367 DOI: 10.1016/j.yebeh.2020.107369] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/21/2020] [Accepted: 07/22/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Focal impaired awareness seizures are common in temporal lobe epilepsy (TLE). The cognitive impairment associated with this type of seizure is unclear. Alertness is a fundamental aspect of cognition. The locus coeruleus (LC) is closely related to alertness. We aimed to assess the impairment in alertness and LC-related alertness network in patients with focal impaired awareness seizures. METHODS Patients with unilateral TLE were grouped into the only focal impaired awareness seizure group (focal group, n = 19) and the focal impaired awareness seizure with focal to bilateral tonic-clonic seizure (FBTCS) group (FBTCS group, n = 19) and compared with matched healthy controls (HC, n = 19). Alertness was assessed with the attention network test. Functional magnetic resonance imaging (fMRI) was used to construct an alertness-related LC-based functional connectivity (FC) network. RESULTS The focal group exhibited impaired tonic and phasic alertness and exhibited a decreased trend of LC-based FC to the left superior frontal gyrus (SFG). The FBTCS group exhibited impaired tonic alertness, phasic alertness, and alertness efficiency. No significant difference or trend in LC-based FC was found in the FBTCS group. SIGNIFICANCE This study reveals disrupted alertness and alertness-related LC-based FC in patients with focal impaired awareness seizures. Our results further demonstrate that the patterns of impaired alertness and of changed LC-based FC were not significantly different between focal impaired awareness seizures and FBTCS.
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17
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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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18
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Sarrias-Arrabal E, Izquierdo-Ayuso G, Vázquez-Marrufo M. Attentional networks in neurodegenerative diseases: anatomical and functional evidence from the Attention Network Test. Neurologia 2020; 38:S0213-4853(20)30218-8. [PMID: 32962808 DOI: 10.1016/j.nrl.2020.05.015] [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: 12/04/2019] [Revised: 04/29/2020] [Accepted: 05/11/2020] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Understanding alterations to brain anatomy and cognitive function associated with neurodegenerative diseases remains a challenge for neuroscience today. In experimental neuroscience, several computerised tests have been developed to contribute to our understanding of neural networks involved in cognition. The Attention Network Test (ANT) enables us to measure the activity of 3 attentional networks (alertness, orienting, and executive function). OBJECTIVES The main aim of this review is to describe all the anatomical and functional alterations found in diverse neurological diseases using the ANT. MATERIAL AND METHODS We collected studies published since 2010 in the PubMed database that employed the ANT in different neurological diseases. Thirty-two articles were obtained, addressing multiple sclerosis, epilepsy, and Parkinson's disease, among other disorders. CONCLUSIONS Some of the anatomical structures proposed in the 3 attentional networks model were confirmed. The most relevant structures in the alertness network are the prefrontal cortex, parietal region, thalamus, and cerebellum. The thalamus is also relevant in the orienting network, together with posterior parietal regions. The executive network does not depend exclusively on the prefrontal cortex and anterior cingulate cortex, but also involves such subcortical structures as the basal ganglia and cerebellum and their projections towards the entire cortex.
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Affiliation(s)
- E Sarrias-Arrabal
- Departamento de Psicología Experimental, Facultad de Psicología, Universidad de Sevilla, Sevilla, España.
| | | | - M Vázquez-Marrufo
- Departamento de Psicología Experimental, Facultad de Psicología, Universidad de Sevilla, Sevilla, España
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19
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Zhang M, Liu W, Huang P, Lin X, Huang X, Meng H, Wang J, Hu K, Li J, Lin M, Sun B, Zhan S, Li B. Utility of hybrid PET/MRI multiparametric imaging in navigating SEEG placement in refractory epilepsy. Seizure 2020; 81:295-303. [PMID: 32932134 DOI: 10.1016/j.seizure.2020.08.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 08/09/2020] [Accepted: 08/25/2020] [Indexed: 02/07/2023] Open
Abstract
PURPOSE Stereo-electroencephalography (SEEG) implantation before epilepsy surgery is critical for precise localization and complete resection of the seizure onset zone (SOZ). Combined metabolic and morphological imaging using hybrid PET/MRI may provide supportive information for the optimization of the SEEG coverage of brain structures. In this study, we originally imported PET/MRI images into the SEEG positioning system to evaluate the application of PET/MRI in guiding SEEG implantation in refractory epilepsy patients. MATERIALS Forty-two patients undergoing simultaneous PET/MRI examinations were recruited. All the patients underwent SEEG implantation guided by hybrid PET/MRI and surgical resection or ablation of epileptic lesion. Surgery outcome was assessed using a modified Engel classification one year (13.60 ± 2.49 months) after surgery. Areas of SOZ were identified using hybrid PET/MRI and concordance with SEEG was evaluated. Logistic regression analysis was used to predict the presence of a favorable outcome with the coherence of concordance of PET/MRI and SEEG. RESULTS Hybrid PET/MRI (including visual PET, MRI, plus MI Neuro) identified SOZ lesions in 38 epilepsy patients (90.47 %). PET/MRI showed the same SOZ localization with SEEG in 29 patients (69.05 %), which was considered to be concordant. The concordance between the PET/MRI and SEEG findings was significantly predictive of a successful surgery outcome (odds ratio = 20.41; 95 % CI = 2.75-151.4, P = 0.003**). CONCLUSION Hybrid PET/MRI combined visual PET, multiple sequences MRI and SPM PET helps identify epilepsy lesions particularly in subtle hypometabolic areas. Patients with concordant epileptic lesion localization on PET/MRI and SEEG demonstrated a more favorable outcome than those with inconsistent localization between modalities.
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Affiliation(s)
- Miao Zhang
- Department of Nuclear Medicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Wei Liu
- Department of Neurosurgery, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Peng Huang
- Department of Neurosurgery, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Xiaozhu Lin
- Department of Nuclear Medicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Xinyun Huang
- Department of Nuclear Medicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Hongping Meng
- Department of Nuclear Medicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Jin Wang
- Department of Nuclear Medicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Kejia Hu
- Department of Neurosurgery, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Jian Li
- Clinical Research Center, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Mu Lin
- MR Collaborations, Siemens Healthcare Ltd., Shanghai, China
| | - Bomin Sun
- Department of Neurosurgery, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Shikun Zhan
- Department of Neurosurgery, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Biao Li
- Department of Nuclear Medicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
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Zhang Z, Zhou X, Liu J, Qin L, Ye W, Zheng J. Aberrant functional connectivity of the cingulate subregions in right-sided temporal lobe epilepsy. Exp Ther Med 2020; 19:2901-2912. [PMID: 32256775 PMCID: PMC7086282 DOI: 10.3892/etm.2020.8551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 12/09/2019] [Indexed: 11/17/2022] Open
Abstract
Patients with temporal lobe epilepsy (TLE) have been indicated to exhibit abnormal resting-state functional connectivity (rsFC) of the cingulate cortex. However, it has remained elusive whether cingulate subregions show different connectivity patterns in TLE. The present study aimed to investigate the differences in rsFC of each cingulate subregion between patients with right-sided TLE (rTLE) and healthy controls (HCs), as well as their association with executive control performance in rTLE. A total of 27 patients with rTLE and 20 age-, sex- and education-matched healthy controls were recruited and all participants underwent resting-state functional MRI and an attention network test for the assessment executive control function. In each hemisphere, the cingulate gyrus (CG) was divided into CG-1 (dorsal area 23; A23d), CG-2 (rostroventral area 24; A24rv), CG-3 (pregenual area 32; A32p), CG-4 (ventral area 23; A23v), CG-5 (caudodorsal area 24; A24cd), CG-6 (caudal area 24; A23c) and CG-7 (subgenual area 32; A32sg). Pearson's correlation analysis was performed to assess the correlation between the altered FCs of the cingulate subregions and clinical variables. In patients with rTLE, the majority of the cingulate subregions exhibited decreased rsFC; this was primarily restricted to the right CG-2, the bilateral CG-6 and the bilateral CG-7. Increased rsFC was only detected in rTLE restricted to the left CG-1. Impairments in executive control efficiency were identified in patients with rTLE in comparison with the HCs. Significant alterations in rsFC between the cingulate subregion and the brain regions were mostly decreased (and some slightly increased), suggesting that FC may potentially have a left-side advantage in patients with rTLE. FC variations of the cingulate subregions were indicated to be specific to rTLE. In addition, increased connectivity in the left CG-1 and left superior frontal gyrus were negatively correlated with executive control performance, suggesting a compensatory mechanism on executive control deficits in pathological conditions. This information on differentially altered FC patterns of the cingulate subregions may provide a deeper understanding of the complex neurological mechanisms and executive control dysfunctions underlying rTLE.
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Affiliation(s)
- Zhao Zhang
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Xia Zhou
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Jinping Liu
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Lu Qin
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Wei Ye
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Jinou Zheng
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
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Zhang Z, Zhou X, Liu J, Qin L, Yu L, Pang X, Ye W, Zheng J. Longitudinal assessment of resting-state fMRI in temporal lobe epilepsy: A two-year follow-up study. Epilepsy Behav 2020; 103:106858. [PMID: 31899164 DOI: 10.1016/j.yebeh.2019.106858] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 12/07/2019] [Accepted: 12/13/2019] [Indexed: 12/27/2022]
Abstract
In this study, we aimed to detect longitudinal alterations in local spontaneous brain activity and functional connectivity (FC) of the default mode network (DMN) in patients with temporal lobe epilepsy (TLE) over a two-year follow-up. We used amplitude of low-frequency fluctuation (ALFF) analysis and independent component analysis (ICA) to explore differences in local spontaneous brain activity and FC strength. In total, 33 participants (16 patients with TLE and 17 age- and gender-matched healthy controls (HCs)) were recruited in this study. All participants performed the Attention Network Test (ANT) for evaluation of the executive control function. Compared with healthy patients at baseline, patients with TLE at follow-up exhibited increased ALFF values in the left medial frontal gyrus, as well as reduced FC values in the left inferior parietal gyrus (IPG) within the DMN. Patients with TLE revealed executive dysfunction, but no progressive deterioration was observed during follow-up. This study revealed the abnormal distribution of ALFF values and Rs-FC changes over a two-year follow-up period in TLE, both of which demonstrated different reorganization trajectories and loss of efficiency.
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Affiliation(s)
- Zhao Zhang
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xia Zhou
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jinping Liu
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Lu Qin
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Lu Yu
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xiaomin Pang
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Wei Ye
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jinou Zheng
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
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