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Sheehan J, Trifiletti D, Keole S. Unlocking the Power of Connectomes for Image-Guided Cranial Interventions. Int J Radiat Oncol Biol Phys 2024; 119:1133-1136. [PMID: 38925767 DOI: 10.1016/j.ijrobp.2023.12.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/15/2023] [Accepted: 12/31/2023] [Indexed: 06/28/2024]
Affiliation(s)
- Jason Sheehan
- Department of Neurosurgery, University of Virginia, Charlottesville, Virginia.
| | - Daniel Trifiletti
- Department of Radiation Oncology, Mayo Clinic Florida, Jacksonville, Florida
| | - Sameer Keole
- Department of Radiation Oncology, Mayo Clinic Arizona, Phoenix, Arizona
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2
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Tang Y, Zhu H, Xiao L, Li R, Han H, Tang W, Liu D, Zhou C, Liu D, Yang Z, Zhou L, Xiao B, Rominger A, Shi K, Hu S, Feng L. Individual cerebellar metabolic connectome in patients with MTLE and NTLE associated with surgical prognosis. Eur J Nucl Med Mol Imaging 2024:10.1007/s00259-024-06762-2. [PMID: 38805089 DOI: 10.1007/s00259-024-06762-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 05/12/2024] [Indexed: 05/29/2024]
Abstract
PURPOSE This study aimed to comprehensively explore the different metabolic connectivity topological changes in MTLE and NTLE, as well as their association with surgical outcomes. METHODS This study enrolled a cohort of patients with intractable MTLE and NTLE. Each individual's metabolic connectome, as determined by Kullback-Leibler divergence similarity estimation for the [18F]FDG PET image, was employed to conduct a comprehensive analysis of the cerebral metabolic network. Alterations in network connectivity were assessed by extracting and evaluating the strength of edge and weighted connectivity. By utilizing these two connectivity strength metrics with the cerebellum, we explored the network properties of connectivity and its association with prognosis in surgical patients. RESULTS Both MTLE and NTLE patients exhibited substantial alterations in the connectivity of the metabolic network at the edge and nodal levels (p < 0.01, FDR corrected). The key disparity between MTLE and NTLE was observed in the cerebellum. In MTLE, there was a predominance of increased connectivity strength in the cerebellum. Whereas, a decrease in cerebellar connectivity was identified in NTLE. It was found that in MTLE, higher edge connectivity and weighted connectivity strength in the contralateral cerebellar hemisphere correlated with improved surgical outcomes. Conversely, in NTLE, a higher edge metabolic connectivity strength in the ipsilateral cerebellar hemisphere suggested a worse surgical prognosis. CONCLUSION The cerebellum exhibits distinct topological characteristics in the metabolic networks between MTLE and NTLE. The hyper- or hypo-metabolic connectivity in the cerebellum may be a prognostic biomarker of surgical prognosis, which might aid in therapeutic decision-making for TLE individuals.
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Affiliation(s)
- Yongxiang Tang
- Department of Nuclear Medicine, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China
- Department of Nuclear Medicine, Inselspital, University Hospital Bern, Bern, Switzerland
| | - Haoyue Zhu
- Department of Neurology, Xiangya Hospital, Central South University, 87 Xiangya Rd, Changsha, 410008, PR China
| | - Ling Xiao
- Department of Nuclear Medicine, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China
| | - Rong Li
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
- MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, China
| | - Honghao Han
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
- MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, China
| | - Weiting Tang
- Department of Neurology, Xiangya Hospital, Central South University, 87 Xiangya Rd, Changsha, 410008, PR China
| | - Ding Liu
- Department of Neurology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Chunyao Zhou
- Department of Neurosurgery, Xiangya Hospital, Central Southern University, Changsha, China
| | - Dingyang Liu
- Department of Neurosurgery, Xiangya Hospital, Central Southern University, Changsha, China
| | - Zhiquan Yang
- Department of Neurosurgery, Xiangya Hospital, Central Southern University, Changsha, China
| | - Luo Zhou
- Department of Neurology, Xiangya Hospital, Central South University, 87 Xiangya Rd, Changsha, 410008, PR China
| | - Bo Xiao
- Department of Neurology, Xiangya Hospital, Central South University, 87 Xiangya Rd, Changsha, 410008, PR China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Axel Rominger
- Department of Nuclear Medicine, Inselspital, University Hospital Bern, Bern, Switzerland
| | - Kuangyu Shi
- Department of Nuclear Medicine, Inselspital, University Hospital Bern, Bern, Switzerland
- Department of Informatics, Technische Universität München, Munich, Germany
| | - Shuo Hu
- Department of Nuclear Medicine, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
- Key Laboratory of Biological Nanotechnology of National Health Commission, Xiangya Hospital, Central South University, Changsha, Hunan, China.
| | - Li Feng
- Department of Neurology, Xiangya Hospital, Central South University, 87 Xiangya Rd, Changsha, 410008, PR China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
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3
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Leiberg K, de Tisi J, Duncan JS, Little B, Taylor PN, Vos SB, Winston GP, Mota B, Wang Y. Effects of anterior temporal lobe resection on cortical morphology. Cortex 2023; 166:233-242. [PMID: 37399617 DOI: 10.1016/j.cortex.2023.04.018] [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: 01/19/2023] [Revised: 04/11/2023] [Accepted: 04/16/2023] [Indexed: 07/05/2023]
Abstract
Neuroimaging can capture brain restructuring after anterior temporal lobe resection (ATLR), a surgical procedure to treat drug-resistant temporal lobe epilepsy (TLE). Here, we examine the effects of this surgery on brain morphology measured in recently-proposed independent variables. We studied 101 individuals with TLE (55 left, 46 right onset) who underwent ATLR. For each individual we considered one pre-surgical MRI and one follow-up MRI 2-13 months after surgery. We used a surface-based method to locally compute traditional morphological variables, and the independent measures K, I, and S, where K measures white matter tension, I captures isometric scaling, and S contains the remaining information about cortical shape. A normative model trained on data from 924 healthy controls was used to debias the data and account for healthy ageing effects occurring during scans. A SurfStat random field theory clustering approach assessed changes across the cortex caused by ATLR. Compared to preoperative data, surgery had marked effects on all morphological measures. Ipsilateral effects were located in the orbitofrontal and inferior frontal gyri, the pre- and postcentral gyri and supramarginal gyrus, and the lateral occipital gyrus and lingual cortex. Contralateral effects were in the lateral occipital gyrus, and inferior frontal gyrus and frontal pole. The restructuring following ATLR is reflected in widespread morphological changes, mainly in regions near the resection, but also remotely in regions that are structurally connected to the anterior temporal lobe. The causes could include mechanical effects, Wallerian degeneration, or compensatory plasticity. The study of independent measures revealed additional effects compared to traditional measures.
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Affiliation(s)
- Karoline Leiberg
- CNNP Lab (www.cnnp-lab.com), Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle Upon Tyne, UK.
| | - Jane de Tisi
- Department of Clinical & Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
| | - John S Duncan
- Department of Clinical & Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK; Chalfont Centre for Epilepsy, Chalfont St Peter, UK
| | - Bethany Little
- CNNP Lab (www.cnnp-lab.com), Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle Upon Tyne, UK; Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Peter N Taylor
- CNNP Lab (www.cnnp-lab.com), Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle Upon Tyne, UK; Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, United Kingdom; Queen Square Institute of Neurology, University College London, Queen Square, London, UK
| | - Sjoerd B Vos
- Queen Square Institute of Neurology, University College London, Queen Square, London, UK; Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL, UK; Centre for Medical Image Computing, University College London, London, UK; Centre for Microscopy, Characterisation, And Analysis, The University of Western Australia, Nedlands, Australia
| | - Gavin P Winston
- Department of Clinical & Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK; MRI Unit, Epilepsy Society, Buckinghamshire, UK; Division of Neurology, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Bruno Mota
- MetaBIO Lab, Instituto de Física, Universidade Federal Do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Yujiang Wang
- CNNP Lab (www.cnnp-lab.com), Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle Upon Tyne, UK; Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, United Kingdom; Queen Square Institute of Neurology, University College London, Queen Square, London, UK.
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de Bézenac CE, Adan G, Weber B, Keller SS. Association of Epilepsy Surgery With Changes in Imaging-Defined Brain Age. Neurology 2021; 97:e554-e563. [PMID: 34261787 PMCID: PMC8424496 DOI: 10.1212/wnl.0000000000012289] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 05/03/2021] [Indexed: 11/15/2022] Open
Abstract
Objective To determine whether surgery in patients with mesial temporal lobe epilepsy (mTLE) is associated with reduced brain-predicted age as a neural marker overall brain health, we compared brain-predicted and chronologic age difference (brain age gap estimation [BrainAGE]) in patients before and after surgery with healthy controls. Methods We acquired 3D T1-weighted MRI scans for 48 patients with mTLE before and after temporal lobe surgery to estimate brain age using a gaussian processes regression model. We examined BrainAGE before and after surgery controlling for brain volume change, comparing patients to 37 age- and sex-matched controls. Results Preoperatively, patients showed an increased BrainAGE of more than 7 years compared to controls. However, surgery was associated with a mean BrainAGE reduction of 5 years irrespective of whether or not surgery resulted in complete seizure freedom. We observed a lateralization effect as patients with left mTLE had BrainAGE values that more closely resembled control group values following surgery. Conclusions Our findings suggest that while morphologic brain alterations linked to accelerated aging have been observed in mTLE, surgery may be associated with changes that reverse such alterations in some patients. This work highlights the advantages of resective surgery on overall brain health in patients with refractory focal epilepsy.
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Affiliation(s)
- Christophe E de Bézenac
- From the Department of Pharmacology and Therapeutics (C.E.d.B., G.A., S.S.K.), Institute of Systems, Molecular and Integrative Biology, University of Liverpool; The Walton Centre NHS Foundation Trust (C.E.d.B., G.A., S.S.K.), Liverpool, UK; and Institute of Experimental Epileptology and Cognition Research (B.W.), University of Bonn, Germany.
| | - Guleed Adan
- From the Department of Pharmacology and Therapeutics (C.E.d.B., G.A., S.S.K.), Institute of Systems, Molecular and Integrative Biology, University of Liverpool; The Walton Centre NHS Foundation Trust (C.E.d.B., G.A., S.S.K.), Liverpool, UK; and Institute of Experimental Epileptology and Cognition Research (B.W.), University of Bonn, Germany
| | - Bernd Weber
- From the Department of Pharmacology and Therapeutics (C.E.d.B., G.A., S.S.K.), Institute of Systems, Molecular and Integrative Biology, University of Liverpool; The Walton Centre NHS Foundation Trust (C.E.d.B., G.A., S.S.K.), Liverpool, UK; and Institute of Experimental Epileptology and Cognition Research (B.W.), University of Bonn, Germany
| | - Simon S Keller
- From the Department of Pharmacology and Therapeutics (C.E.d.B., G.A., S.S.K.), Institute of Systems, Molecular and Integrative Biology, University of Liverpool; The Walton Centre NHS Foundation Trust (C.E.d.B., G.A., S.S.K.), Liverpool, UK; and Institute of Experimental Epileptology and Cognition Research (B.W.), University of Bonn, Germany
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5
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Wang R, Beg U, Padmanaban V, Abel TJ, Lipsman N, Ibrahim GM, Mansouri A. A Systematic Review of Minimally Invasive Procedures for Mesial Temporal Lobe Epilepsy: Too Minimal, Too Fast? Neurosurgery 2021; 89:164-176. [PMID: 33862622 DOI: 10.1093/neuros/nyab125] [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: 10/07/2020] [Accepted: 02/13/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Cortico-amygdalohippocampectomy (CAH) is effective for mesial temporal lobe epilepsy (mTLE). Concerns regarding surgical morbidity have generated enthusiasm for more minimally invasive interventions. A careful analysis of current data is warranted before widespread adoption of these techniques. OBJECTIVE To systematically review the use of laser interstitial thermal therapy (LITT), stereotactic radiosurgery (SRS), radiofrequency thermocoagulation (RF-TC), and focused ultrasound for mTLE. METHODS Major online databases were searched for prospective observational studies, randomized clinical trials, and retrospective studies (>50 patients), including mTLE patients. Outcomes of interest were seizure freedom (Engel I), complications and re-operation rates, and neuropsychological and quality-of-life (QoL) data. RESULTS Nineteen publications were identified. At ≥6 mo postoperatively, LITT (9/19) Engel I outcomes ranged from 52% to 80%. SRS (3/19) has a latency period (52%-67%, 24-36 mo postoperatively) and the radiosurgery vs. open surgery for epilepsy (ROSE) trial reported inferiority of SRS compared to CAH. RF-TC (7/19) demonstrated variable seizure freedom rates (0%-79%) and high re-operation rates (0%-90%). Twelve studies reported neuropsychological outcomes but QoL (4/19) was not widely reported, and few studies (3/19) assessed both. Study quality ranged from fair to good. CONCLUSION Based on nonrandomized data, LITT has compelling evidence of efficacy; however, comparisons to surgical resection are lacking. SRS has a latency period and is inferior to CAH (ROSE trial). RF-TC is a less resource-intensive alternative to LITT; however, comparisons of efficacy are limited. Additional studies are needed before minimally invasive procedures can supplant standard surgery.
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Affiliation(s)
- Ryan Wang
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Usman Beg
- Midwestern University Arizona College of Osteopathic Medicine, Glendale, Arizona, USA
| | - Varun Padmanaban
- Department of Neurosurgery, Penn State Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Taylor J Abel
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Bioengineering, University of Pittsburgh, Pennsylvania, USA
| | - Nir Lipsman
- Division of Neurosurgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Harquail Centre for Neuromodulation, Sunnybrook Research Institute, Hurvitz Brain Sciences Program, Toronto, Ontario, Canada
| | - George M Ibrahim
- Division of Neurosurgery, The Hospital for Sick Children, Toronto, Ontario, Canada.,Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
| | - Alireza Mansouri
- Department of Neurosurgery, Penn State Hershey Medical Center, Hershey, Pennsylvania, USA.,Penn State Cancer Institute, Hershey, Pennsylvania, USA
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6
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Abstract
Human neuroimaging has had a major impact on the biological understanding of epilepsy and the relationship between pathophysiology, seizure management, and outcomes. This review highlights notable recent advancements in hardware, sequences, methods, analyses, and applications of human neuroimaging techniques utilized to assess epilepsy. These structural, functional, and metabolic assessments include magnetic resonance imaging (MRI), positron emission tomography (PET), and magnetoencephalography (MEG). Advancements that highlight non-invasive neuroimaging techniques used to study the whole brain are emphasized due to the advantages these provide in clinical and research applications. Thus, topics range across presurgical evaluations, understanding of epilepsy as a network disorder, and the interactions between epilepsy and comorbidities. New techniques and approaches are discussed which are expected to emerge into the mainstream within the next decade and impact our understanding of epilepsies. Further, an increasing breadth of investigations includes the interplay between epilepsy, mental health comorbidities, and aberrant brain networks. In the final section of this review, we focus on neuroimaging studies that assess bidirectional relationships between mental health comorbidities and epilepsy as a model for better understanding of the commonalities between both conditions.
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Affiliation(s)
- Adam M. Goodman
- Department of Neurology, UAB Epilepsy Center, University of Alabama At Birmingham, 312 Civitan International Research Center, Birmingham, AL 35294 USA
| | - Jerzy P. Szaflarski
- Department of Neurology, UAB Epilepsy Center, University of Alabama At Birmingham, 312 Civitan International Research Center, Birmingham, AL 35294 USA
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7
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Li W, Jiang Y, Qin Y, Zhou B, Lei D, Luo C, Zhang H, Gong Q, Zhou D, An D. Dynamic gray matter and intrinsic activity changes after epilepsy surgery. Acta Neurol Scand 2021; 143:261-270. [PMID: 33058145 DOI: 10.1111/ane.13361] [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: 07/12/2020] [Revised: 09/20/2020] [Accepted: 10/05/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVES To explore the dynamic changes of gray matter volume and intrinsic brain activity following anterior temporal lobectomy (ATL) in patients with unilateral mesial temporal lobe epilepsy (mTLE) who achieved seizure-free for 2 years. MATERIALS AND METHODS High-resolution T1-weighted MRI and resting-state functional MRI data were obtained in ten mTLE patients at five serial timepoints: before surgery, 3, 6, 12, and 24 months after surgery. The gray matter volume (GMV) and amplitude of low-frequency fluctuations (ALFF) were compared among the five scans to depict the dynamic changes after ATL. RESULTS After successful ATL, GMV decreased in several ipsilateral brain regions: ipsilateral insula, thalamus, and putamen showed gradual gray matter atrophy from 3 to 24 months, while ipsilateral superior temporal gyrus, middle temporal gyrus, inferior temporal gyrus, middle occipital gyrus, inferior occipital gyrus, caudate nucleus, lingual gyrus, and fusiform gyrus showed significant GMV decrease at 3 months follow-up, without further changes. Ipsilateral insula showed gradual ALFF decrease from 3 to 24 months after surgery. Ipsilateral superior temporal gyrus showed ALFF decrease at 3 months follow-up, without further changes. Ipsilateral thalamus and cerebellar vermis showed obvious ALFF increase after surgery. CONCLUSIONS Surgical resection may lead to a short-term reduction of gray matter volume and intrinsic brain activity in neighboring regions, while the progressive gray matter atrophy may be due to possible intrinsic mechanism of mTLE. Dynamic ALFF changes provide evidence that disrupted focal spontaneous activities were reorganized after successful surgery.
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Affiliation(s)
- Wei Li
- Department of Neurology West China Hospital Sichuan University Chengdu China
| | - Yuchao Jiang
- The Clinical Hospital of Chengdu Brain Science Institute MOE Key Lab for Neuroinformation Center for Information in Medicine School of life Science and technology University of Electronic Science and Technology of China Chengdu China
| | - Yingjie Qin
- Department of Neurology West China Hospital Sichuan University Chengdu China
| | - Baiwan Zhou
- Department of Radiology Huaxi MR Research Center West China Hospital Sichuan University Chengdu China
| | - Du Lei
- Department of Radiology Huaxi MR Research Center West China Hospital Sichuan University Chengdu China
| | - Cheng Luo
- The Clinical Hospital of Chengdu Brain Science Institute MOE Key Lab for Neuroinformation Center for Information in Medicine School of life Science and technology University of Electronic Science and Technology of China Chengdu China
- Research Unit of NeuroInformation Chinese Academy of Medical Sciences Chengdu China
| | - Heng Zhang
- Department of Neurosurgery West China Hospital Sichuan University Chengdu China
| | - Qiyong Gong
- Department of Radiology Huaxi MR Research Center West China Hospital Sichuan University Chengdu China
| | - Dong Zhou
- Department of Neurology West China Hospital Sichuan University Chengdu China
| | - Dongmei An
- Department of Neurology West China Hospital Sichuan University Chengdu China
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8
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Nenning KH, Fösleitner O, Schwartz E, Schwarz M, Schmidbauer V, Geisl G, Widmann C, Pirker S, Baumgartner C, Prayer D, Pataraia E, Bartha-Doering L, Langs G, Kasprian G, Bonelli SB. The impact of hippocampal impairment on task-positive and task-negative language networks in temporal lobe epilepsy. Clin Neurophysiol 2021; 132:404-411. [PMID: 33450563 DOI: 10.1016/j.clinph.2020.10.031] [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: 06/24/2020] [Revised: 10/12/2020] [Accepted: 10/27/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To study hippocampal integration within task-positive and task-negative language networks and the impact of a diseased left and right hippocampus on the language connectome in temporal lobe epilepsy (TLE). METHODS We used functional magnetic resonance imaging (fMRI) to study a homogenous group of 32 patients with TLE (17 left) and 14 healthy controls during a verb-generation task. We performed functional connectivity analysis and quantified alterations within the language connectome and evaluated disruptions of the functional dissociation along the anterior-posterior axis of the hippocampi. RESULTS Connectivity analysis revealed significant differences between left and right TLE compared to healthy controls. Left TLE showed widespread impairment of task-positive language networks, while right TLE showed less pronounced alterations. Particularly right TLE showed altered connectivity for cortical regions that were part of the default mode network (DMN). Left TLE showed a disturbed functional dissociation pattern along the left hippocampus to left and right inferior frontal language regions, while left and right TLE revealed an altered dissociation pattern along the right hippocampus to regions associated with the DMN. CONCLUSIONS Our results showed an impaired hippocampal integration into active language and the default mode networks, which both may contribute to language impairment in TLE. SIGNIFICANCE Our results emphasize the direct role of the left hippocampus in language processing, and the potential role of the right hippocampus as a modulator between DMN and task-positive networks.
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Affiliation(s)
- Karl-Heinz Nenning
- Computational Imaging Research Lab, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Olivia Fösleitner
- Department of Biomedical Imaging and Image-guided Therapy, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Ernst Schwartz
- Computational Imaging Research Lab, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Michelle Schwarz
- Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Victor Schmidbauer
- Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Gudrun Geisl
- Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Christian Widmann
- Department of Biomedical Imaging and Image-guided Therapy, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Susanne Pirker
- Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology, Riedelgasse 5, 1130 Vienna, Austria; Department of Neurology, General Hospital Hietzing with Neurological Center Rosenhügel, Riedelgasse 5, 1130 Vienna, Austria
| | - Christoph Baumgartner
- Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology, Riedelgasse 5, 1130 Vienna, Austria; Department of Neurology, General Hospital Hietzing with Neurological Center Rosenhügel, Riedelgasse 5, 1130 Vienna, Austria
| | - Daniela Prayer
- Department of Biomedical Imaging and Image-guided Therapy, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Ekaterina Pataraia
- Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Lisa Bartha-Doering
- Department of Paediatrics and Adolescent Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Georg Langs
- Computational Imaging Research Lab, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Gregor Kasprian
- Department of Biomedical Imaging and Image-guided Therapy, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Silvia B Bonelli
- Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
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Maallo AMS, Granovetter MC, Freud E, Kastner S, Pinsk MA, Glen D, Patterson C, Behrmann M. Large-scale resculpting of cortical circuits in children after surgical resection. Sci Rep 2020; 10:21589. [PMID: 33299002 PMCID: PMC7725819 DOI: 10.1038/s41598-020-78394-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 11/24/2020] [Indexed: 11/09/2022] Open
Abstract
Despite the relative successes in the surgical treatment of pharmacoresistant epilepsy, there is rather little research on the neural (re)organization that potentially subserves behavioral compensation. Here, we examined the post-surgical functional connectivity (FC) in children and adolescents who have undergone unilateral cortical resection and, yet, display remarkably normal behavior. Conventionally, FC has been investigated in terms of the mean correlation of the BOLD time courses extracted from different brain regions. Here, we demonstrated the value of segregating the voxel-wise relationships into mutually exclusive populations that were either positively or negatively correlated. While, relative to controls, the positive correlations were largely normal, negative correlations among networks were increased. Together, our results point to reorganization in the contralesional hemisphere, possibly suggesting competition for cortical territory due to the demand for representation of function. Conceivably, the ubiquitous negative correlations enable the differentiation of function in the reduced cortical volume following a unilateral resection.
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Affiliation(s)
- Anne Margarette S Maallo
- Department of Psychology and Neuroscience Institute, Carnegie Mellon University, Pittsburgh, USA
| | - Michael C Granovetter
- Department of Psychology and Neuroscience Institute, Carnegie Mellon University, Pittsburgh, USA.,School of Medicine, University of Pittsburgh, Pittsburgh, USA
| | - Erez Freud
- Department of Psychology, The Centre for Vision Research, York University, Toronto, Canada
| | - Sabine Kastner
- Princeton Neuroscience Institute, Princeton University, Princeton, USA.,Department of Psychology, Princeton University, Princeton, USA
| | - Mark A Pinsk
- Princeton Neuroscience Institute, Princeton University, Princeton, USA
| | - Daniel Glen
- Scientific and Statistical Computing Core, National Institute of Mental Health, Bethesda, USA
| | | | - Marlene Behrmann
- Department of Psychology and Neuroscience Institute, Carnegie Mellon University, Pittsburgh, USA.
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10
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Yang S, Zhang Z, Chen H, Meng Y, Li J, Li Z, Xu Q, Zhang Q, Fan YS, Lu G, Liao W. Temporal variability profiling of the default mode across epilepsy subtypes. Epilepsia 2020; 62:61-73. [PMID: 33236791 DOI: 10.1111/epi.16759] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 10/21/2020] [Accepted: 10/21/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Epilepsies are a group of neurological disorders sharing certain core features, but also demonstrate remarkable pathogenic and symptomatic heterogeneities. Various subtypes of epilepsy have been identified with abnormal shift in the brain default mode network (DMN). This study aims to evaluate the fine details of shared and distinct alterations in the DMN among epileptic subtypes. METHODS We collected resting-state functional magnetic resonance imaging (MRI) data from a large epilepsy sample (n = 371) at a single center, including temporal lobe epilepsy (TLE), frontal lobe epilepsy (FLE), and genetic generalized epilepsy with generalized tonic-clonic seizures (GGE-GTCS), as well as healthy controls (HC, n = 150). We analyzed temporal dynamics profiling of the DMN, including edge-wise and node-wise temporal variabilities, and recurrent dynamic states of functional connectivity, to identify abnormalities common to epilepsies as well as those specific to each subtype. RESULTS The analyses revealed that hypervariable edges within the specific DMN subsystem were shared by all subtypes (all PNBS < .005), and deficits in node-wise temporal variability were prominent in TLE (all t(243) ≤ 2.51, PFDR < .05) and FLE (all t(302) ≤ -2.65, PFDR < .05) but relatively weak in GGE-GTCS. Moreover, dynamic states were generally less stable in patients than controls (all P's < .001). SIGNIFICANCE Collectively, these findings demonstrated general DMN abnormalities common to different epilepsies as well as distinct dysfunctions to subtypes, and provided insights into understanding the relationship of pathophysiological mechanisms and brain connectivity.
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Affiliation(s)
- Siqi Yang
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China.,MOE Key Lab for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, China
| | - Zhiqiang Zhang
- Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Huafu Chen
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China.,MOE Key Lab for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, China
| | - Yao Meng
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China.,MOE Key Lab for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, China
| | - Jiao Li
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China.,MOE Key Lab for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, China
| | - Zehan Li
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China.,MOE Key Lab for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, China
| | - Qiang Xu
- Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Qirui Zhang
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China.,MOE Key Lab for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, China
| | - Yun-Shuang Fan
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China.,MOE Key Lab for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, China
| | - Guangming Lu
- Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Wei Liao
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China.,MOE Key Lab for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, China
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11
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Dynamic functional connectivity in temporal lobe epilepsy: a graph theoretical and machine learning approach. Neurol Sci 2020; 42:2379-2390. [PMID: 33052576 DOI: 10.1007/s10072-020-04759-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 09/23/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE Functional magnetic resonance imaging (fMRI) in resting state can be used to evaluate the functional organization of the human brain in the absence of any task or stimulus. The functional connectivity (FC) has non-stationary nature and consented to be varying over time. By considering the dynamic characteristics of the FC and using graph theoretical analysis and a machine learning approach, we aim to identify the laterality in cases of temporal lobe epilepsy (TLE). METHODS Six global graph measures are extracted from static and dynamic functional connectivity matrices using fMRI data of 35 unilateral TLE subjects. Alterations in the time trend of the graph measures are quantified. The random forest (RF) method is used for the determination of feature importance and selection of dynamic graph features including mean, variance, skewness, kurtosis, and Shannon entropy. The selected features are used in the support vector machine (SVM) classifier to identify the left and right epileptogenic sides in patients with TLE. RESULTS Our results for the performance of SVM demonstrate that the utility of dynamic features improves the classification outcome in terms of accuracy (88.5% for dynamic features compared with 82% for static features). Selecting the best dynamic features also elevates the accuracy to 91.5%. CONCLUSION Accounting for the non-stationary characteristics of functional connectivity, dynamic connectivity analysis of graph measures along with machine learning approach can identify the temporal trend of some specific network features. These network features may be used as potential imaging markers in determining the epileptogenic hemisphere in patients with TLE.
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12
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Zhu J, Wang J, Xu C, Zhang X, Qiao L, Wang X, Zhang X, Yan X, Ni D, Yu T, Zhang G, Li Y. The functional connectivity study on the brainstem-cortical/subcortical structures in responders following cervical vagus nerve stimulation. Int J Dev Neurosci 2020; 80:679-686. [PMID: 32931055 DOI: 10.1002/jdn.10064] [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] [Received: 06/26/2020] [Revised: 08/14/2020] [Accepted: 09/01/2020] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Cervical vagus nerve stimulation (VNS) is an effective neuromodulation therapy for patients with drug-resistant epilepsy (DRE). The previous studies reported that VNS may reduce seizures by regulating the functional connectivity (FC) between cortical and subcortical regions. However, no studies on brainstem have been done in responders who achieved ≥50% seizure reduction following VNS. METHODS Eight healthy controls and eight patients who became responders after 3 months of operation were enrolled in this study. Resting-state functional MRI (rs-fMRI) was performed, and two sample and paired sample t test were, respectively, used to detect altered FC between brainstem and cortical/subcortical regions between controls and patients, between preoperative and postoperative patients. RESULTS In the control group, regions with highest FC to brainstem included bilateral anterior cingulate gyri, left basal ganglia, left insula, left cuneus, right precuneus, and bilateral cerebellum. In preoperative patients, right frontal middle gyrus, bilateral basal ganglia, and right cerebellum were showed highest FC to brainstem. Compared with the controls, preoperative patients exhibited increased FC in bilateral inferior frontal gyri, right temporal cortex, while decreased FC in left insula, left postcentral gyrus, right posterior cingulate gyrus, right precuneus, and left superior parietal gyrus. In postoperative patients, regions with increased FC to brainstem were left insula, left precuneus and left cuneus, and those with decreased FC were right inferior occipital gyrus and right cerebellum. CONCLUSIONS Recurrent seizures caused disturbances in brainstem-cortical/subcortical FC, especially in motor executive function related regions and default mode network. VNS could reorganize the altered FC between brainstem and insula, precuneus, and cerebellum in responders.
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Affiliation(s)
- Jin Zhu
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jingjuan Wang
- Department of Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Cuiping Xu
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xi Zhang
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Liang Qiao
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xueyuan Wang
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xiaohua Zhang
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xiaoming Yan
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Duanyu Ni
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Tao Yu
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Guojun Zhang
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yongjie Li
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
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13
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González HFJ, Goodale SE, Jacobs ML, Haas KF, Landman BA, Morgan VL, Englot DJ. Brainstem Functional Connectivity Disturbances in Epilepsy may Recover After Successful Surgery. Neurosurgery 2020; 86:417-428. [PMID: 31093673 DOI: 10.1093/neuros/nyz128] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 12/20/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Focal seizures in temporal lobe epilepsy (TLE) are associated with widespread brain network perturbations and neurocognitive problems. OBJECTIVE To determine whether brainstem connectivity disturbances improve with successful epilepsy surgery, as recent work has demonstrated decreased brainstem connectivity in TLE that is related to disease severity and neurocognitive profile. METHODS We evaluated 15 adult TLE patients before and after (>1 yr; mean, 3.4 yr) surgery, and 15 matched control subjects using magnetic resonance imaging to measure functional and structural connectivity of ascending reticular activating system (ARAS) structures, including cuneiform/subcuneiform nuclei (CSC), pedunculopontine nucleus (PPN), and ventral tegmental area (VTA). RESULTS TLE patients who achieved long-term postoperative seizure freedom (10 of 15) demonstrated increases in functional connectivity between ARAS structures and fronto-parietal-insular neocortex compared to preoperative baseline (P = .01, Kruskal-Wallis), with postoperative connectivity patterns resembling controls' connectivity. No functional connectivity changes were detected in 5 patients with persistent seizures after surgery (P = .9, Kruskal-Wallis). Among seizure-free postoperative patients, larger increases in CSC, PPN, and VTA functional connectivity were observed in individuals with more frequent seizures before surgery (P < .05 for each, Spearman's rho). Larger postoperative increases in PPN functional connectivity were seen in patients with lower baseline verbal IQ (P = .03, Spearman's rho) or verbal memory (P = .04, Mann-Whitney U). No changes in ARAS structural connectivity were detected after successful surgery. CONCLUSION ARAS functional connectivity disturbances are present in TLE but may recover after successful epilepsy surgery. Larger increases in postoperative connectivity may be seen in individuals with more severe disease at baseline.
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Affiliation(s)
- Hernán F J González
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee.,Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical center, Nashville, Tennessee
| | - Sarah E Goodale
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee.,Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical center, Nashville, Tennessee.,Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Monica L Jacobs
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee.,Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Kevin F Haas
- Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Bennett A Landman
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical center, Nashville, Tennessee.,Department of Electrical Engineering, Vanderbilt University, Nashville, Tennessee.,Department of Computer Science, Vanderbilt University, Nashville, Tennessee.,Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Victoria L Morgan
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee.,Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical center, Nashville, Tennessee.,Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.,Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee.,Department of Electrical Engineering, Vanderbilt University, Nashville, Tennessee.,Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Dario J Englot
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee.,Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical center, Nashville, Tennessee.,Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.,Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
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14
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Mansouri AM, Germann J, Boutet A, Elias GJB, Mithani K, Chow CT, Karmur B, Ibrahim GM, McAndrews MP, Lozano AM, Zadeh G, Valiante TA. Identification of neural networks preferentially engaged by epileptogenic mass lesions through lesion network mapping analysis. Sci Rep 2020; 10:10989. [PMID: 32620922 PMCID: PMC7335039 DOI: 10.1038/s41598-020-67626-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 06/09/2020] [Indexed: 11/09/2022] Open
Abstract
Lesion network mapping (LNM) has been applied to true lesions (e.g., cerebrovascular lesions in stroke) to identify functionally connected brain networks. No previous studies have utilized LNM for analysis of intra-axial mass lesions. Here, we implemented LNM for identification of potentially vulnerable epileptogenic networks in mass lesions causing medically-refractory epilepsy (MRE). Intra-axial brain lesions were manually segmented in patients with MRE seen at our institution (EL_INST). These lesions were then normalized to standard space and used as seeds in a high-resolution normative resting state functional magnetic resonance imaging template. The resulting connectivity maps were first thresholded (pBonferroni_cor < 0.05) and binarized; the thresholded binarized connectivity maps were subsequently summed to produce overall group connectivity maps, which were compared with established resting-state networks to identify potential networks prone to epileptogenicity. To validate our data, this approach was also applied to an external dataset of epileptogenic lesions identified from the literature (EL_LIT). As an additional exploratory analysis, we also segmented and computed the connectivity of institutional non-epileptogenic lesions (NEL_INST), calculating voxel-wise odds ratios (VORs) to identify voxels more likely to be functionally-connected with EL_INST versus NEL_INST. To ensure connectivity results were not driven by anatomical overlap, the extent of lesion overlap between EL_INST, and EL_LIT and NEL_INST was assessed using the Dice Similarity Coefficient (DSC, lower index ~ less overlap). Twenty-eight patients from our institution were included (EL_INST: 17 patients, 17 lesions, 10 low-grade glioma, 3 cavernoma, 4 focal cortical dysplasia; NEL_INST: 11 patients, 33 lesions, all brain metastases). An additional 23 cases (25 lesions) with similar characteristics to the EL_INST data were identified from the literature (EL_LIT). Despite minimal anatomical overlap of lesions, both EL_INST and EL_LIT showed greatest functional connectivity overlap with structures in the Default Mode Network, Frontoparietal Network, Ventral Attention Network, and the Limbic Network-with percentage volume overlap of 19.5%, 19.1%, 19.1%, and 12.5%, respectively-suggesting them as networks consistently engaged by epileptogenic mass lesions. Our exploratory analysis moreover showed that the mesial frontal lobes, parahippocampal gyrus, and lateral temporal neocortex were at least twice as likely to be functionally connected with the EL_INST compared to the NEL_INST group (i.e. Peak VOR > 2.0); canonical resting-state networks preferentially engaged by EL_INSTs were the Limbic and the Frontoparietal Networks (Mean VOR > 1.5). In this proof of concept study, we demonstrate the feasibility of LNM for intra-axial mass lesions by showing that ELs have discrete functional connections and may preferentially engage in discrete resting-state networks. Thus, the underlying normative neural circuitry may, in part, explain the propensity of particular lesions toward the development of MRE. If prospectively validated, this has ramifications for patient counseling along with both approach and timing of surgery for lesions in locations prone to development of MRE.
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Affiliation(s)
| | | | - Alexandre Boutet
- University Health Network, Toronto, ON, USA.,Joint Department of Medical Imaging, University of Toronto, Toronto, ON, USA
| | | | - Karim Mithani
- Faculty of Medicine, University of Toronto, Toronto, ON, USA
| | | | - Brij Karmur
- Faculty of Medicine, University of Toronto, Toronto, ON, USA
| | - George M Ibrahim
- Program in Neuroscience and Mental Health, Sickkids Research Institute, Toronto, ON, USA.,Division of Neurosurgery, The Hospital for Sick Children, Toronto, ON, USA.,Department of Surgery, Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, USA
| | - Mary Pat McAndrews
- Department of Neuropsychology, University Health Network, Toronto, ON, USA
| | - Andres M Lozano
- Division of Neurosurgery, University Health Network, Toronto, ON, USA
| | - Gelareh Zadeh
- Division of Neurosurgery, University Health Network, Toronto, ON, USA
| | - Taufik A Valiante
- Division of Neurosurgery, University Health Network, Toronto, ON, USA
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15
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Foit NA, Bernasconi A, Bernasconi N. Functional Networks in Epilepsy Presurgical Evaluation. Neurosurg Clin N Am 2020; 31:395-405. [PMID: 32475488 DOI: 10.1016/j.nec.2020.03.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Continuing advancements in neuroimaging methodology allow for increasingly detailed in vivo characterization of structural and functional brain networks, leading to the recognition of epilepsy as a disorder of large-scale networks. In surgical candidates, analysis of functional networks has proved invaluable for the identification of eloquent brain areas, such as hemispherical language dominance. More recently, connectome-based biomarkers have demonstrated potential to further inform clinical decision making in drug-refractory epilepsy. This article summarizes current evidence on epilepsy as a network disorder, emphasizing potential benefits of network analysis techniques for preoperative assessments and resection planning.
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Affiliation(s)
- Niels Alexander Foit
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, 3801 Rue Université, Montreal, Quebec H3A 2B4, Canada
| | - Andrea Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, 3801 Rue Université, Montreal, Quebec H3A 2B4, Canada
| | - Neda Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, 3801 Rue Université, Montreal, Quebec H3A 2B4, Canada.
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16
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Neal EG, Maciver S, Schoenberg MR, Vale FL. Surgical disconnection of epilepsy network correlates with improved outcomes. Seizure 2020; 76:56-63. [PMID: 32014727 DOI: 10.1016/j.seizure.2020.01.018] [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: 07/21/2019] [Revised: 01/15/2020] [Accepted: 01/27/2020] [Indexed: 02/02/2023] Open
Abstract
PURPOSE A novel software algorithm combining non-invasive EEG and resting state functional MRI data to map networks of cortex correlated to epileptogenic tissue was used to map an epilepsy network non-invasively. The relationship between epilepsy network connectivity and outcomes after surgery was investigated using this non-invasive and non-concurrent modeling algorithm. METHOD Scalp EEG and resting state functional MRI were acquired for nineteen patients with temporal lobe epilepsy. The hypothetical irritative zone was mapped, and resting state functional MRI data was used to model regions functionally correlated with the irritative zone. Epilepsy network connectivity was measured in patient with temporal lobe epilepsy (n = 19) both pre- and post-operatively. Temporal networks were also mapped in healthy control participants (n = 6). RESULTS Thirteen of nineteen patients (68 %) were seizure free after 20.3 ± 4.8 months. Epilepsy network connectivity within the temporal lobe was significantly higher among patients with temporal lobe epilepsy compared to the healthy control patients (p < 0.05). Disconnection of the epilepsy network was significantly higher in patients who were seizure free. Using spearman rho analyses, neuropsychological function after surgery was found to be relatively better in patients with higher degree of epilepsy network disconnection. CONCLUSIONS The magnitude of network disconnection after surgery was strongly associated with increased rates of seizure freedom and relatively better neuropsychological measures of memory and naming function. It was shown that seizure-free outcomes and relatively improved neuropsychological function correlated with surgical disconnection of a highly synchronous epilepsy network.
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Affiliation(s)
- Elliot G Neal
- Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, FL, USA
| | - Stephanie Maciver
- Department of Neurology, University of South Florida, Tampa, FL, USA
| | - Mike R Schoenberg
- Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, FL, USA; Department of Neurology, University of South Florida, Tampa, FL, USA
| | - Fernando L Vale
- Department of Neurosurgery, Medical College of Georgia, Augusta University, Augusta, GA, USA.
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17
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Yrondi A, Valton L, Bouilleret V, Aghakhani N, Curot J, Birmes PJ. Post-traumatic Stress Disorder With Flashbacks of an Old Childhood Memory Triggered by Right Temporal Lobe Epilepsy Surgery in Adulthood. Front Psychiatry 2020; 11:351. [PMID: 32411032 PMCID: PMC7198875 DOI: 10.3389/fpsyt.2020.00351] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 04/06/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND A plethora of data show that the hippocampus and the amygdala are involved in post-traumatic stress disorder (PTSD). Neural dysfunctions leading to PTSD (e.g. how the amygdala and the hippocampus are altered) are only partially known. The unusual case of a patient presenting with refractory epilepsy and developing PTSD immediately after surgery is described. Such symptoms in epileptic patients may help to explore PTSD mechanisms. CASE REPORT A 41-year-old male suffering from partial refractory temporal lobe epilepsy was operated in May 2017. A right amygdala, hippocampus, and temporal pole selective resection was performed. He experienced intense PTSD symptoms 1 month after surgery. He complained about repetitive intrusive memories of abuse. The PTSD checklist score was equal to 62/80. He reported a history of childhood abuse: physical and emotional abuse as well as emotional negligence, assessed with the Childhood Trauma Questionnaire. No other medical history was recorded. He never complained about PTSD or any other psychiatric symptoms before surgery. CONCLUSION this case indicates that PTSD may occur after temporal lobe epilepsy surgery and may specifically stem, as in this context, from the excision of part of the medial temporal lobe structures. Although rarely reported, PTSD may be undiagnosed when not selectively detected via multi-disciplinary neurological and psychiatric management, in the preoperative period and the immediate and delayed postoperative period.
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Affiliation(s)
- Antoine Yrondi
- Service de Psychiatrie et de Psychologie Médicale, Centre Expert Dépression Résistante FondaMental, CHU de Toulouse, Hôpital Purpan, ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France
| | - Luc Valton
- Explorations Neurophysiologiques, Hôpital Pierre Paul Riquet, CHU Purpan, Toulouse, France.,Centre de Recherche Cerveau et Cognition, University of Toulouse, Centre National de la Recherche Scientifique CerCo, Toulouse, France
| | - Viviane Bouilleret
- Service de Neurophysiologie Clinique et D'épileptologie, Hôpitaux Universitaires Paris-Sud, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France
| | - Nozar Aghakhani
- Service de Neurochirurgie, Hôpitaux Universitaires Paris-Sud, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France
| | - Jonathan Curot
- Explorations Neurophysiologiques, Hôpital Pierre Paul Riquet, CHU Purpan, Toulouse, France.,Centre de Recherche Cerveau et Cognition, University of Toulouse, Centre National de la Recherche Scientifique CerCo, Toulouse, France
| | - Philippe Jean Birmes
- Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France
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18
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Mithani K, Boutet A, Germann J, Elias GJB, Weil AG, Shah A, Guillen M, Bernal B, Achua JK, Ragheb J, Donner E, Lozano AM, Widjaja E, Ibrahim GM. Lesion Network Localization of Seizure Freedom following MR-guided Laser Interstitial Thermal Ablation. Sci Rep 2019; 9:18598. [PMID: 31819108 PMCID: PMC6901556 DOI: 10.1038/s41598-019-55015-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 11/22/2019] [Indexed: 01/08/2023] Open
Abstract
Treatment-resistant epilepsy is a common and debilitating neurological condition, for which neurosurgical cure is possible. Despite undergoing nearly identical ablation procedures however, individuals with treatment-resistant epilepsy frequently exhibit heterogeneous outcomes. We hypothesized that treatment response may be related to the brain regions to which MR-guided laser ablation volumes are functionally connected. To test this, we mapped the resting-state functional connectivity of surgical ablations that either resulted in seizure freedom (N = 11) or did not result in seizure freedom (N = 16) in over 1,000 normative connectomes. There was no difference seizure outcome with respect to the anatomical location of the ablations, and very little overlap between ablation areas was identified using the Dice Index. Ablations that did not result in seizure-freedom were preferentially connected to a number of cortical and subcortical regions, as well as multiple canonical resting-state networks. In contrast, ablations that led to seizure-freedom were more functionally connected to prefrontal cortices. Here, we demonstrate that underlying normative neural circuitry may in part explain heterogenous outcomes following ablation procedures in different brain regions. These findings may ultimately inform target selection for ablative epilepsy surgery based on normative intrinsic connectivity of the targeted volume.
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Affiliation(s)
- Karim Mithani
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Alexandre Boutet
- University Health Network, Toronto, ON, Canada.,Joint Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | | | | | - Alexander G Weil
- Division of Neurosurgery, CHU-Ste Justine, Université de Montréal, Montréal, Canada
| | - Ashish Shah
- Division of Neurosurgery, Brain Institute, Nicklaus Children's Hospital, Miami, USA
| | - Magno Guillen
- Department of Radiology, Nicklaus Children's Hospital, Miami, USA
| | - Byron Bernal
- Department of Radiology, Nicklaus Children's Hospital, Miami, USA
| | - Justin K Achua
- Division of Neurosurgery, Brain Institute, Nicklaus Children's Hospital, Miami, USA
| | - John Ragheb
- Division of Neurosurgery, Brain Institute, Nicklaus Children's Hospital, Miami, USA
| | - Elizabeth Donner
- Division of Neurology, Hospital for Sick Children, Toronto, Canada
| | - Andres M Lozano
- Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Elysa Widjaja
- Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Canada
| | - George M Ibrahim
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada. .,Division of Neurosurgery, Hospital for Sick Children, Department of Surgery, University of Toronto, Toronto, Canada.
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19
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de Bézenac C, Garcia-Finana M, Baker G, Moore P, Leek N, Mohanraj R, Bonilha L, Richardson M, Marson AG, Keller S. Investigating imaging network markers of cognitive dysfunction and pharmacoresistance in newly diagnosed epilepsy: a protocol for an observational cohort study in the UK. BMJ Open 2019; 9:e034347. [PMID: 31619436 PMCID: PMC6797398 DOI: 10.1136/bmjopen-2019-034347] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Epilepsy is one of the most common serious brain disorders, characterised by seizures that severely affect a person's quality of life and, frequently, their cognitive and mental health. Although most existing work has examined chronic epilepsy, newly diagnosed patients present a unique opportunity to understand the underlying biology of epilepsy and predict effective treatment pathways. The objective of this prospective cohort study is to examine whether cognitive dysfunction is associated with measurable brain architectural and connectivity impairments at diagnosis and whether the outcome of antiepileptic drug treatment can be predicted using these measures. METHODS AND ANALYSIS 107 patients with newly diagnosed focal epilepsy from two National Health Service Trusts and 48 healthy controls (aged 16-65 years) will be recruited over a period of 30 months. Baseline assessments will include neuropsychological evaluation, structural and functional Magnetic Resonance Imaging (MRI), Electroencephalography (EEG), and a blood and saliva sample. Patients will be followed up every 6 months for a 24-month period to assess treatment outcomes. Connectivity- and network-based analyses of EEG and MRI data will be carried out and examined in relation to neuropsychological evaluation and patient treatment outcomes. Patient outcomes will also be investigated with respect to analysis of molecular isoforms of high mobility group box-1 from blood and saliva samples. ETHICS AND DISSEMINATION This study was approved by the North West, Liverpool East Research Ethics Committee (19/NW/0384) through the Integrated Research Application System (Project ID 260623). Health Research Authority (HRA) approval was provided on 22 August 2019. The project is sponsored by the UoL (UoL001449) and funded by a UK Medical Research Council (MRC) research grant (MR/S00355X/1). Findings will be presented at national and international meetings and conferences and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER IRAS Project ID 260623.
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Affiliation(s)
- Christophe de Bézenac
- Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | | | - Gus Baker
- Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Perry Moore
- Department of Neurology, Salford Royal NHS Foundation Trust, Salford, UK
| | - Nicola Leek
- Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Rajiv Mohanraj
- Department of Neurology, Salford Royal NHS Foundation Trust, Salford, UK
| | - Leonardo Bonilha
- Department of Neurology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Mark Richardson
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Anthony Guy Marson
- Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Simon Keller
- Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK
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20
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Boerwinkle VL, Cediel EG, Mirea L, Williams K, Kerrigan JF, Lam S, Raskin JS, Desai VR, Wilfong AA, Adelson PD, Curry DJ. Network-targeted approach and postoperative resting-state functional magnetic resonance imaging are associated with seizure outcome. Ann Neurol 2019; 86:344-356. [PMID: 31294865 DOI: 10.1002/ana.25547] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 07/08/2019] [Accepted: 07/09/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Postoperative resting-state functional magnetic resonance imaging (MRI) in children with intractable epilepsy has not been quantified in relation to seizure outcome. Therefore, its value as a biomarker for epileptogenic pathology is not well understood. METHODS In a sample of children with intractable epilepsy who underwent prospective resting-state seizure onset zone (SOZ)-targeted epilepsy surgery, postoperative resting-state functional MRI (rs-fMRI) was performed 6 to 12 months later. Graded normalization of the postoperative resting-state SOZ was compared to seizure outcomes, patient, surgery, and anatomical MRI characteristics. RESULTS A total of 64 cases were evaluated. Network-targeted surgery, followed by postoperative rs-fMRI normalization was significantly (p < 0.001) correlated with seizure reduction, with a Spearman rank correlation coefficient of 0.83. Of 39 cases with postoperative rs-fMRI SOZ normalization, 38 (97%) became completely seizure free. In contrast, of the 25 cases without complete rs-fMRI SOZ normalization, only 3 (5%) became seizure free. The accuracy of rs-fMRI as a biomarker predicting seizure freedom is 94%, with 96% sensitivity and 93% specificity. INTERPRETATION Among seizure localization techniques in pediatric epilepsy, network-targeted surgery, followed by postoperative rs-fMRI normalization, has high correlation with seizure freedom. This study shows that rs-fMRI SOZ can be used as a biomarker of the epileptogenic zone, and postoperative rs-fMRI normalization is a biomarker for SOZ quiescence. ANN NEUROL 2019;86:344-356.
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Affiliation(s)
- Varina L Boerwinkle
- Division of Pediatric Neurology, Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ
| | - Emilio G Cediel
- Division of Pediatric Neurosurgery, Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ
| | - Lucia Mirea
- Department of Research, Phoenix Children's Hospital, Phoenix, AZ
| | - Korwyn Williams
- Division of Pediatric Neurology, Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ
| | - John F Kerrigan
- Division of Pediatric Neurology, Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ
| | - Sandi Lam
- Section of Pediatric Neurosurgery, Riley Hospital for Children, Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, IN
| | - Jeffrey S Raskin
- Section of Pediatric Neurosurgery, Riley Hospital for Children, Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, IN
| | - Virendra R Desai
- Department of Neurosurgery, Houston Methodist Hospital, Houston, TX
| | - Angus A Wilfong
- Division of Pediatric Neurology, Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ
| | - P David Adelson
- Division of Pediatric Neurology, Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ.,Division of Pediatric Neurosurgery, Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ
| | - Daniel J Curry
- Department of Pediatric Neurosurgery, Texas Children's Hospital, Baylor College of Medicine, Houston, TX
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21
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Robinson PA. Neural field theory of effects of brain modifications and lesions on functional connectivity: Acute effects, short-term homeostasis, and long-term plasticity. Phys Rev E 2019; 99:042407. [PMID: 31108595 DOI: 10.1103/physreve.99.042407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Indexed: 11/07/2022]
Abstract
Neural field theory is used to predict the functional connectivity effects of lesions or other modifications to effective connectivity. Widespread initial changes are predicted after localized or diffuse changes to white or gray matter, consistent with observations, and enabling lesion severity indexes to be defined. It is shown how short-term homeostasis and longer-term plasticity can reduce perturbations while maintaining brain criticality under conditions where some connections remain fixed because of damage in the lesion core. The extent to which such effects can compensate for initial connectivity changes is then explored, showing that the strongest corrective changes are concentrated toward the edges of the perturbation if it is localized and its core is fixed. The results are applicable to inferring underlying connectivity changes and to interpreting and monitoring functional connectivity modifications after lesions, injury, surgery, drugs, or brain stimulation.
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Affiliation(s)
- P A Robinson
- School of Physics, University of Sydney, New South Wales 2006, Australia and Center for Integrative Brain Function, University of Sydney, New South Wales 2006, Australia
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22
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Jeong W, Lee H, Kim JS, Chung CK. Characterization of brain network supporting episodic memory in the absence of one medial temporal lobe. Hum Brain Mapp 2019; 40:2188-2199. [PMID: 30648325 PMCID: PMC6590340 DOI: 10.1002/hbm.24516] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 12/04/2018] [Accepted: 01/01/2019] [Indexed: 12/25/2022] Open
Abstract
How the brain supports normal episodic memory function without medial temporal lobe (MTL) structures has not been well characterized, which could provide clues for new therapeutic targets for people with MTL dysfunction‐related memory impairment. To characterize brain network supporting effective episodic memory function in the absence of unilateral MTL, we investigated the whole‐brain cortical interactions during functional magnetic resonance imaging memory encoding paradigms of words and figures in patients who showed a normal range of memory capacity following unilateral MTL resection and healthy controls (HC). Compared to the HC, the patients showed less activation in the left inferior frontal areas and right thalamus together with greater activation in the many cortical areas including the medial prefrontal cortex (mPFC). Task‐based functional connectivity (FC) analysis revealed that the mPFC showed stronger interactions with widespread brain areas in both patient groups, including the hippocampus contralateral to the resection. Moreover, the strength of the mPFC FC predicts the individual memory capacity of the patients. Our data suggest that hyperconnectivity of distributed brain areas, especially the mPFC, is a neural mechanism for memory function in the absence of one MTL.
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Affiliation(s)
- Woorim Jeong
- Neuroscience Research Institute, Seoul National University College of Medicine, Seoul, Korea.,Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea
| | - Hyeongrae Lee
- Department of Mental Health Research, National Center for Mental Health, Seoul, Korea
| | - June Sic Kim
- Research Institute of Basic Sciences, Seoul National University, Seoul, Korea
| | - Chun Kee Chung
- Neuroscience Research Institute, Seoul National University College of Medicine, Seoul, Korea.,Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea.,Department of Brain and Cognitive Sciences, Seoul National University, Seoul, Korea
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23
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Pang Y, Chen H, Chen Y, Cui Q, Wang Y, Zhang Z, Lu G, Chen H. Extraversion and Neuroticism Related to Topological Efficiency in White Matter Network: An Exploratory Study Using Diffusion Tensor Imaging Tractography. Brain Topogr 2018; 32:87-96. [PMID: 30046926 DOI: 10.1007/s10548-018-0665-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Accepted: 07/17/2018] [Indexed: 12/15/2022]
Affiliation(s)
- Yajing Pang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
- School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Heng Chen
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
- School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yuyan Chen
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
- School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Qian Cui
- School of Public Administration, University of Electronic Science and Technology of China, Chengdu, China.
| | - Yifeng Wang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
- School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Zhiqiang Zhang
- Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Guangming Lu
- Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Huafu Chen
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China.
- School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China.
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24
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Lee K, Khoo HM, Lina JM, Dubeau F, Gotman J, Grova C. Disruption, emergence and lateralization of brain network hubs in mesial temporal lobe epilepsy. NEUROIMAGE-CLINICAL 2018; 20:71-84. [PMID: 30094158 PMCID: PMC6070692 DOI: 10.1016/j.nicl.2018.06.029] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 05/26/2018] [Accepted: 06/27/2018] [Indexed: 01/05/2023]
Abstract
Hubs of brain networks are brain regions exhibiting denser connections than others, promoting long-range communication. Studies suggested the reorganization of hubs in epilepsy. The patterns of connector hub abnormalities specific to mesial temporal lobe epilepsy (mTLE) are unclear. We wish to quantify connector hub abnormalities in mTLE and identify epilepsy-related resting state networks involving abnormal connector hubs. A recently developed sparsity-based analysis of reliable k-hubness (SPARK) allowed us to address this question by using resting state functional MRI in 20 mTLE patients and 17 healthy controls. Handling the multicollinearity of functional networks, SPARK measures a new metric of hubness by counting the number (k) of networks involved in each voxel, and identifies which networks are actually associated to each connector hub. This measure provides new information about the network architecture involving connector hubs and a realistic range of k-hubness. We quantified the disruption and emergence of connector hubs in individual epileptic subjects and assessed the lateralization of networks involving connector hubs. In mTLE, we found pathological disruptions of normal connector hubs in the mTL and within the default mode network. Right mTLE had remarkably higher emergence of new connector hubs in the mTL than left mTLE. Different patterns of lateralization of the salience network involving the abnormal hippocampus were found in right versus left mTLE. The temporal, cerebellar, default mode, subcortical and motor networks also contributed to the lateralization of hippocampal networks. We finally observed an asymmetrical connector hub reorganization and overall regularization of epilepsy-related resting state networks in mTLE, characterized by the disruption of distant connections and the emergence of local connections. Individually reproducible brain network hubs in mesial Temporal Lobe Epilepsy (mTLE). We observed asymmetrical connector hub reorganization and network regularization in mTLE. We found connector hub disruptions within the mTL and default mode network. Emergence of new connector hubs in the mTL was prominent in right but not in left mTLE. Lateralization of hippocampal connectivity was associated with the salience network.
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Affiliation(s)
- Kangjoo Lee
- Multimodal Functional Imaging Lab, Department of Biomedical Engineering, McGill University, Duff Medical Building, 3775 Rue University, Montreal, QC H3A 2B4, Canada; Montreal Neurological Institute, McGill University, 3801 Rue University, Montreal, QC H3A 2B4, Canada.
| | - Hui Ming Khoo
- Montreal Neurological Institute, McGill University, 3801 Rue University, Montreal, QC H3A 2B4, Canada; Department of Neurosurgery, Osaka University, 2-2 Yamadaoka, Suita, Osaka Prefecture, 565-0871, Japan
| | - Jean-Marc Lina
- École de Technologie Supérieure, 1100 Rue Notre-Dame O, Montreal, QC H3C 1K3, Canada; Centre de Recherches Mathématiques, Université de Montréal, Pavillon André-Aisenstadt 2920 Chemin de la tour, Montreal, QC H3T 1J4, Canada
| | - François Dubeau
- Montreal Neurological Institute, McGill University, 3801 Rue University, Montreal, QC H3A 2B4, Canada
| | - Jean Gotman
- Montreal Neurological Institute, McGill University, 3801 Rue University, Montreal, QC H3A 2B4, Canada
| | - Christophe Grova
- Multimodal Functional Imaging Lab, Department of Biomedical Engineering, McGill University, Duff Medical Building, 3775 Rue University, Montreal, QC H3A 2B4, Canada; Montreal Neurological Institute, McGill University, 3801 Rue University, Montreal, QC H3A 2B4, Canada; Centre de Recherches Mathématiques, Université de Montréal, Pavillon André-Aisenstadt 2920 Chemin de la tour, Montreal, QC H3T 1J4, Canada; Department of Physics and PERFORM Centre, Concordia University, 7200 Rue Sherbrooke St. W, Montreal, QC H4B 1R6, Canada
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25
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Limotai C, McLachlan RS, Hayman-Abello S, Hayman-Abello B, Brown S, Bihari F, Mirsattari SM. Memory loss and memory reorganization patterns in temporal lobe epilepsy patients undergoing anterior temporal lobe resection, as demonstrated by pre-versus post-operative functional MRI. J Clin Neurosci 2018; 55:38-44. [PMID: 29934057 DOI: 10.1016/j.jocn.2018.06.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 02/28/2018] [Accepted: 06/04/2018] [Indexed: 11/29/2022]
Abstract
This study was aimed to longitudinally assess memory function and whole-brain memory circuit reorganization in patients with temporal lobe epilepsy (TLE) by comparing activation potentials before versus after anterior temporal lobe (ATL) resection. Nineteen patients with medically-intractable TLE (10 left TLE, 9 right TLE) and 15 healthy controls were enrolled. Group analyses were conducted pre- and post-ATL of a novelty complex scene-encoding paradigm comparing areas of blood oxygen-level-dependent (BOLD) signal activations on functional magnetic resonance imaging (fMRI). None of the pre-operative patient characteristics we studied predicted the extent of pre- to post-operative memory loss. On fMRI, extra-temporal activations were detected pre-operatively in both LTLE and RTLE, particularly in the frontal lobe. Greater activations also were noted in the contralateral hippocampus and parahippocampus in both groups. Performing within-subject comparisons, post-op relative to pre-op, pronounced ipsilateral activations were identified in the left parahippocampal gyrus in LTLE, versus the right middle temporal gyrus in RTLE patients. Memory function was impaired pre-operatively but declined after ATL resection in both RTLE and LTLE patients. Post-operative fMRI results indicate possible functional adaptations to ATL loss, primarily occurring within the left parahippocampal gyrus versus right middle temporal gyrus in LTLE versus RTLE patients, respectively.
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Affiliation(s)
- Chusak Limotai
- Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada; Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Chulalongkorn Comprehensive Epilepsy Center of Excellence (CCEC), King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand
| | - Richard S McLachlan
- Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | - Susan Hayman-Abello
- Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | - Brent Hayman-Abello
- Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | - Suzan Brown
- Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | - Frank Bihari
- Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | - Seyed M Mirsattari
- Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada; Department of Medical Imaging, Western University, London, Ontario, Canada; Department of Medical Biophysics, Western University, London, Ontario, Canada; Department of Psychology, Western University, London, Ontario, Canada.
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26
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Taylor PN, Sinha N, Wang Y, Vos SB, de Tisi J, Miserocchi A, McEvoy AW, Winston GP, Duncan JS. The impact of epilepsy surgery on the structural connectome and its relation to outcome. Neuroimage Clin 2018; 18:202-214. [PMID: 29876245 PMCID: PMC5987798 DOI: 10.1016/j.nicl.2018.01.028] [Citation(s) in RCA: 84] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 12/05/2017] [Accepted: 01/21/2018] [Indexed: 01/26/2023]
Abstract
Background Temporal lobe surgical resection brings seizure remission in up to 80% of patients, with long-term complete seizure freedom in 41%. However, it is unclear how surgery impacts on the structural white matter network, and how the network changes relate to seizure outcome. Methods We used white matter fibre tractography on preoperative diffusion MRI to generate a structural white matter network, and postoperative T1-weighted MRI to retrospectively infer the impact of surgical resection on this network. We then applied graph theory and machine learning to investigate the properties of change between the preoperative and predicted postoperative networks. Results Temporal lobe surgery had a modest impact on global network efficiency, despite the disruption caused. This was due to alternative shortest paths in the network leading to widespread increases in betweenness centrality post-surgery. Measurements of network change could retrospectively predict seizure outcomes with 79% accuracy and 65% specificity, which is twice as high as the empirical distribution. Fifteen connections which changed due to surgery were identified as useful for prediction of outcome, eight of which connected to the ipsilateral temporal pole. Conclusion Our results suggest that the use of network change metrics may have clinical value for predicting seizure outcome. This approach could be used to prospectively predict outcomes given a suggested resection mask using preoperative data only.
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Affiliation(s)
- Peter N Taylor
- Interdisciplinary Computing and Complex BioSystems Group, School of Computing Science, Newcastle University, UK; Institute of Neuroscience, Faculty of Medical Science, Newcastle University, UK; NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK.
| | - Nishant Sinha
- Interdisciplinary Computing and Complex BioSystems Group, School of Computing Science, Newcastle University, UK; Institute of Neuroscience, Faculty of Medical Science, Newcastle University, UK
| | - Yujiang Wang
- Interdisciplinary Computing and Complex BioSystems Group, School of Computing Science, Newcastle University, UK; Institute of Neuroscience, Faculty of Medical Science, Newcastle University, UK; NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Sjoerd B Vos
- Translational Imaging Group, Centre for Medical Image Computing, University College London, UK; Chalfont Centre for Epilepsy, Chalfont St Peter SL9 0LR, UK
| | - Jane de Tisi
- NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Anna Miserocchi
- NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Andrew W McEvoy
- NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Gavin P Winston
- NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK; Chalfont Centre for Epilepsy, Chalfont St Peter SL9 0LR, UK
| | - John S Duncan
- NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK; Chalfont Centre for Epilepsy, Chalfont St Peter SL9 0LR, UK
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27
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Zhang H, Chen X, Shi F, Li G, Kim M, Giannakopoulos P, Haller S, Shen D. Topographical Information-Based High-Order Functional Connectivity and Its Application in Abnormality Detection for Mild Cognitive Impairment. J Alzheimers Dis 2018; 54:1095-1112. [PMID: 27567817 DOI: 10.3233/jad-160092] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Temporal synchronization-based functional connectivity (FC) has long been used by the neuroscience community. However, topographical FC information may provide additional information to characterize the advanced relationship between two brain regions. Accordingly, we proposed a novel method, namely high-order functional connectivity (HOFC), to capture this second-level relationship using inter-regional resemblance of the FC topographical profiles. Specifically, HOFC first calculates an FC profile for each brain region, notably between the given brain region and other brain regions. Based on these FC profiles, a second layer of correlations is computed between all pairs of brain regions (i.e., correlation's correlation). On this basis, we generated an HOFC network, where "high-order" network properties were computed. We found that HOFC was discordant with the traditional FC in several links, indicating additional information being revealed by the new metrics. We applied HOFC to identify biomarkers for early detection of Alzheimer's disease by comparing 77 mild cognitive impairment patients with 89 healthy individuals (control group). Sensitivity in detection of group difference was consistently improved by ∼25% using HOFC compared to using FC. An HOFC network analysis also provided complementary information to an FC network analysis. For example, HOFC between olfactory and orbitofrontal cortices was found significantly reduced in patients, besides extensive alterations in HOFC network properties. In conclusion, our results showed promise in using HOFC to comprehensively map the human brain connectome.
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Affiliation(s)
- Han Zhang
- Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Xiaobo Chen
- Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Feng Shi
- Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Gang Li
- Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Minjeong Kim
- Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Sven Haller
- Affidea Centre de Diagnostique Radiologique de Carouge CDRC, Switzerland.,Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden.,Department of Neuroradiology, University Hospital Freiburg, Germany.,Faculty of Medicine of the University of Geneva, Switzerland
| | - Dinggang Shen
- Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Department of Brain and Cognitive Engineering, Korea University, Seoul, Republic of Korea
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28
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He X, Doucet GE, Pustina D, Sperling MR, Sharan AD, Tracy JI. Presurgical thalamic "hubness" predicts surgical outcome in temporal lobe epilepsy. Neurology 2017; 88:2285-2293. [PMID: 28515267 DOI: 10.1212/wnl.0000000000004035] [Citation(s) in RCA: 112] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 03/14/2017] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To characterize the presurgical brain functional architecture presented in patients with temporal lobe epilepsy (TLE) using graph theoretical measures of resting-state fMRI data and to test its association with surgical outcome. METHODS Fifty-six unilateral patients with TLE, who subsequently underwent anterior temporal lobectomy and were classified as obtaining a seizure-free (Engel class I, n = 35) vs not seizure-free (Engel classes II-IV, n = 21) outcome at 1 year after surgery, and 28 matched healthy controls were enrolled. On the basis of their presurgical resting-state functional connectivity, network properties, including nodal hubness (importance of a node to the network; degree, betweenness, and eigenvector centralities) and integration (global efficiency), were estimated and compared across our experimental groups. Cross-validations with support vector machine (SVM) were used to examine whether selective nodal hubness exceeded standard clinical characteristics in outcome prediction. RESULTS Compared to the seizure-free patients and healthy controls, the not seizure-free patients displayed a specific increase in nodal hubness (degree and eigenvector centralities) involving both the ipsilateral and contralateral thalami, contributed by an increase in the number of connections to regions distributed mostly in the contralateral hemisphere. Simulating removal of thalamus reduced network integration more dramatically in not seizure-free patients. Lastly, SVM models built on these thalamic hubness measures produced 76% prediction accuracy, while models built with standard clinical variables yielded only 58% accuracy (both were cross-validated). CONCLUSIONS A thalamic network associated with seizure recurrence may already be established presurgically. Thalamic hubness can serve as a potential biomarker of surgical outcome, outperforming the clinical characteristics commonly used in epilepsy surgery centers.
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Affiliation(s)
- Xiaosong He
- From the Departments of Neurology (X.H., M.R.S., J.I.T.) and Neurosurgery (A.D.S.), Thomas Jefferson University, Philadelphia, PA; Department of Psychiatry (G.E.D.), Icahn School of Medicine at Mount Sinai, New York, NY; and Departments of Neurology and Radiology (D.P.), University of Pennsylvania, Philadelphia
| | - Gaelle E Doucet
- From the Departments of Neurology (X.H., M.R.S., J.I.T.) and Neurosurgery (A.D.S.), Thomas Jefferson University, Philadelphia, PA; Department of Psychiatry (G.E.D.), Icahn School of Medicine at Mount Sinai, New York, NY; and Departments of Neurology and Radiology (D.P.), University of Pennsylvania, Philadelphia
| | - Dorian Pustina
- From the Departments of Neurology (X.H., M.R.S., J.I.T.) and Neurosurgery (A.D.S.), Thomas Jefferson University, Philadelphia, PA; Department of Psychiatry (G.E.D.), Icahn School of Medicine at Mount Sinai, New York, NY; and Departments of Neurology and Radiology (D.P.), University of Pennsylvania, Philadelphia
| | - Michael R Sperling
- From the Departments of Neurology (X.H., M.R.S., J.I.T.) and Neurosurgery (A.D.S.), Thomas Jefferson University, Philadelphia, PA; Department of Psychiatry (G.E.D.), Icahn School of Medicine at Mount Sinai, New York, NY; and Departments of Neurology and Radiology (D.P.), University of Pennsylvania, Philadelphia
| | - Ashwini D Sharan
- From the Departments of Neurology (X.H., M.R.S., J.I.T.) and Neurosurgery (A.D.S.), Thomas Jefferson University, Philadelphia, PA; Department of Psychiatry (G.E.D.), Icahn School of Medicine at Mount Sinai, New York, NY; and Departments of Neurology and Radiology (D.P.), University of Pennsylvania, Philadelphia
| | - Joseph I Tracy
- From the Departments of Neurology (X.H., M.R.S., J.I.T.) and Neurosurgery (A.D.S.), Thomas Jefferson University, Philadelphia, PA; Department of Psychiatry (G.E.D.), Icahn School of Medicine at Mount Sinai, New York, NY; and Departments of Neurology and Radiology (D.P.), University of Pennsylvania, Philadelphia.
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29
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Krámská L, Vojtěch Z, Lukavský J, Stará M, Malíková H. Five-Year Neuropsychological Outcome after Stereotactic Radiofrequency Amygdalohippocampectomy for Mesial Temporal Lobe Epilepsy: Longitudinal Study. Stereotact Funct Neurosurg 2017; 95:149-157. [DOI: 10.1159/000468527] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 03/02/2017] [Indexed: 11/19/2022]
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30
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Cano-López I, Vázquez JF, Campos A, Gutiérrez A, Garcés M, Gómez-Ibáñez A, Conde R, González-Bono E, Villanueva V. Age at surgery as a predictor of cognitive improvements in patients with drug-resistant temporal epilepsy. Epilepsy Behav 2017; 70:10-17. [PMID: 28407524 DOI: 10.1016/j.yebeh.2017.03.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 12/16/2016] [Accepted: 03/04/2017] [Indexed: 10/19/2022]
Abstract
Temporal lobe epilepsy (TLE) surgery is an effective procedure that can produce cognitive changes. However, the prognostic factors related with cognitive outcomes need to be better understood. The aim of the present study is to know if age at surgery is a reliable predictor of verbal memory competence and considering factors such as: hemisphere; type of surgery; pre-surgical seizure frequency; and epilepsy duration. Sixty-one typically dominant patients with drug-resistant TLE (34 with left TLE [L-TLE] and 27 with right TLE [R-TLE]) underwent a neuropsychological assessment before and a year after surgery. Results showed that R-TLE patients had better evolution in short- and long-term verbal memory and naming than L-TLE patients (for all, p >.04). L-TLE patients also more frequently showed a strong and reliable decline in these functions than R-TLE patients. No effects for gender or type of surgery were found. From a multivariate approach, patients with improvements in verbal competence underwent surgery at earlier ages and suffered epilepsy for less time (for all, p <0.4). The relevance of age at surgery was confirmed as a predictor of long-term verbal memory changes, although the frequency of partial seizures also explains, at least partially, these changes. In addition, the frequency of partial seizures explains short-term verbal memory changes. These results emphasize the importance of early intervention, independently of the resected hemisphere, in order to minimize the cognitive side-effects of epilepsy treatment, as well the need to consider cognitive functions as related processes and network dependent.
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Affiliation(s)
- Irene Cano-López
- Department of Psychobiology/IDOCAL, University of Valencia, Spain; Multidisciplinary Epilepsy Unit/Neurology Service, Hospital Universitario y Politécnico La Fe, Spain
| | - Juan Francisco Vázquez
- Multidisciplinary Epilepsy Unit/Neurology Service, Hospital Universitario y Politécnico La Fe, Spain
| | - Anabel Campos
- Multidisciplinary Epilepsy Unit/Neurology Service, Hospital Universitario y Politécnico La Fe, Spain
| | - Antonio Gutiérrez
- Multidisciplinary Epilepsy Unit/Neurology Service, Hospital Universitario y Politécnico La Fe, Spain
| | - Mercedes Garcés
- Multidisciplinary Epilepsy Unit/Neurology Service, Hospital Universitario y Politécnico La Fe, Spain
| | - Asier Gómez-Ibáñez
- Multidisciplinary Epilepsy Unit/Neurology Service, Hospital Universitario y Politécnico La Fe, Spain
| | - Rebeca Conde
- Multidisciplinary Epilepsy Unit/Neurology Service, Hospital Universitario y Politécnico La Fe, Spain
| | | | - Vicente Villanueva
- Multidisciplinary Epilepsy Unit/Neurology Service, Hospital Universitario y Politécnico La Fe, Spain.
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Ji GJ, Yu F, Liao W, Wang K. Dynamic aftereffects in supplementary motor network following inhibitory transcranial magnetic stimulation protocols. Neuroimage 2017; 149:285-294. [DOI: 10.1016/j.neuroimage.2017.01.035] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 12/24/2016] [Accepted: 01/15/2017] [Indexed: 12/20/2022] Open
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Tang Y, Xia W, Yu X, Zhou B, Luo C, Huang X, Chen Q, Gong Q, Zhou D. Short-term cerebral activity alterations after surgery in patients with unilateral mesial temporal lobe epilepsy associated with hippocampal sclerosis: A longitudinal resting-state fMRI study. Seizure 2017; 46:43-49. [DOI: 10.1016/j.seizure.2016.12.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 12/20/2016] [Accepted: 12/30/2016] [Indexed: 11/16/2022] Open
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Tanaka T, Ihara M. Post-stroke epilepsy. Neurochem Int 2017; 107:219-228. [PMID: 28202284 DOI: 10.1016/j.neuint.2017.02.002] [Citation(s) in RCA: 97] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 02/05/2017] [Accepted: 02/06/2017] [Indexed: 01/17/2023]
Abstract
Post-stroke epilepsy (PSE) is a common complication after stroke, yet treatment options remain limited. While many physicians prescribe antiepileptic drugs (AED) for secondary prevention of PSE, it is unclear which treatments are most effective in the prevention of recurrence of symptoms, or whether such therapy is needed for primary prevention. This review discusses the current understanding of epidemiology, diagnoses, mechanisms, risk factors, and treatments of PSE.
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Affiliation(s)
- Tomotaka Tanaka
- Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan.
| | - Masafumi Ihara
- Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan
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Tomlinson SB, Venkataraman A. Secondary generalization of focal-onset seizures: examining the relationship between seizure propagation and epilepsy surgery outcome. J Neurophysiol 2016; 117:1426-1430. [PMID: 27707815 DOI: 10.1152/jn.00739.2016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 10/03/2016] [Indexed: 11/22/2022] Open
Abstract
Surgical intervention often fails to achieve seizure-free results in patients with intractable epilepsy. Identifying features of the epileptic brain that dispose certain patients to unfavorable outcomes is critical for improving surgical candidacy assessments. Recent research by Martinet, Ahmad, Lepage, Cash, and Kramer (J Neurosci 35: 9477-9490, 2015) suggests that pathways of secondary seizure generalization distinguish patients with favorable (i.e., seizure free) vs. unfavorable (i.e., seizure persistent) surgical outcomes, lending insights into the network mechanisms of epilepsy surgery failure.
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Affiliation(s)
- Samuel B Tomlinson
- School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, New York
| | - Arun Venkataraman
- School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, New York
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Liu HH, Wang J, Chen XM, Li JP, Ye W, Zheng J. Reduced local diffusion homogeneity as a biomarker for temporal lobe epilepsy. Medicine (Baltimore) 2016; 95:e4032. [PMID: 27472676 PMCID: PMC5265813 DOI: 10.1097/md.0000000000004032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
In the present study, we adopted a novel method-local diffusion homogeneity (LDH)-to characterize the structure feature in mesial temporal lobe epilepsy (MTLE). Diffusion-weighted images were acquired from 11 left MTLE patients, 16 right MTLE patients, and 20 healthy controls from May 2014 to January 2015. Local diffusion homogeneity was compared among patient groups and controls by 2 sample t test. The discriminative value of LDH abnormalities was examined by receiver operating characteristic (ROC) curve analysis. Correlations with disease duration and onset age in both patient groups were assessed using Pearson's coefficient. Both patient groups exhibited lower LDH in the anterior corpus callosum (P < 0.05, corrected), and this regional anomaly exhibited excellent classification performance in left MTLE patients (sensitivity = 82%, specificity = 100%), right MTLE patients (sensitivity = 81%, specificity = 90%), and the entire patient cohort (sensitivity = 82%, specificity = 95%). In summary, left and right MTLE patients show common pathological changes in the anterior corpus callosum. This regional LDH abnormality is a potential quantitative biomarker for MTLE.
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Affiliation(s)
- Hui-hua Liu
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning
- Department of Neurology, the Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin
| | - Jun Wang
- Department of Neurology, the Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin
| | - Xue-mei Chen
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning
| | - Jian-ping Li
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning
| | - 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
- Correspondence: Jinou Zheng, Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China (e-mail: )
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Beyond the Arcuate Fasciculus: Damage to Ventral and Dorsal Language Pathways in Aphasia. Brain Topogr 2016; 30:249-256. [DOI: 10.1007/s10548-016-0503-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 06/13/2016] [Indexed: 12/16/2022]
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Gaba P, DeSimone CV, Henz BD, Friedman PA, Bruce CJ, Holmes DR, Madhavan M, Vasudevan K, Wahnschaffe D, Berhow S, Danielsen AJ, Ladewig DJ, Mikell SB, Johnson SB, Suddendorf SH, Kara T, Worrell GA, Asirvatham SJ. Novel Techniques in Epilepsy Management: Venous Pacing and Capture of Electrical Activity in the Primate Cortex. JOURNAL OF NEUROLOGY & NEUROPHYSIOLOGY 2016; 7:373. [PMID: 27453800 PMCID: PMC4946343 DOI: 10.4172/2155-9562.1000373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Pharmacotherapy for epilepsy is limited with 30% of patients refractory to this approach of suppressing seizures. Current surgical options are invasive and carry significant morbidities including infection, bleeding, and the potential for deleterious neurocognitive effects. As a result, there is a burgeoning need for innovation to develop safer and efficacious interventions. METHODS Four distinct catheters (2 existing: Cardima catheter, Standard EPT Blazer catheter; 2 new prototypes: balloon catheter, basket catheters) were tested in 12 baboons (21-30 kg, 100% male). For each, we assessed whether or not the catheter was able to be maneuvered safely in various locations of the cerebral venous system, provide adequate cortical tissue contact to record signals, detect these signals as normal or abnormal, successfully stimulate the cortex, and capture the cortical tissue. Locations trialed included the petrosal sinus, straight sinus, vein of Galen, and occipital vein. Pacing cycle length and pacing thresholds varied among experiments. RESULTS Successful mapping was conducted in all 12 baboons. The pacing cycle length varied from 75 ms to 650 ms depending on location of the cortex. Pacing threshold was recorded in 4/12 (33%) of the experiments; data is not available for the remaining 8/12 experiments. The threshold values ranged from 0.3 - 20 mAmps. Capture of cortical electrical activity was observed in 11/12 (91.7 %) experiments though the number of successful capture and stimulation attempts varied among experiments. The most reliable and consistent capture occurred with the use of our novel prototyped over-the-wire balloon catheter (9/12; 75%) and basket catheter (3/3; 100%). Necropsy and histology were performed post-experimentation, and only minimal complications were noted (Table 1). CONCLUSION New electrode design can be maneuvered safely in the venous system, provide adequate cortical tissue contact to record signals, detect these signals as normal or abnormal, successfully stimulate the cortex, and capture cortical tissue. These novel devices merit further study in chronic baboons to establish long-term efficacy of continuous seizure recording.
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Affiliation(s)
| | - Christopher V DeSimone
- Division of Cardiovascular Disease, Department of Internal Medicine, Mayo Clinic, Rochester, MN
| | | | - Paul A Friedman
- Division of Cardiovascular Disease, Department of Internal Medicine, Mayo Clinic, Rochester, MN
| | - Charles J Bruce
- Division of Cardiovascular Disease, Department of Internal Medicine, Mayo Clinic, Rochester, MN
| | - David R Holmes
- Division of Cardiovascular Disease, Department of Internal Medicine, Mayo Clinic, Rochester, MN
| | - Malini Madhavan
- Division of Cardiovascular Disease, Department of Internal Medicine, Mayo Clinic, Rochester, MN
| | | | | | | | | | | | | | - Susan B Johnson
- Division of Cardiovascular Disease, Department of Internal Medicine, Mayo Clinic, Rochester, MN
| | - Scott H Suddendorf
- Division of Cardiovascular Disease, Department of Internal Medicine, Mayo Clinic, Rochester, MN
| | - Tomas Kara
- Division of Cardiovascular Disease, Department of Internal Medicine, Mayo Clinic, Rochester, MN; ICRC - Department of Cardiovascular Diseases, St Anne's University Hospital, Brno, CZ
| | - Gregory A Worrell
- Division of Neurology, Department of Internal Medicine, Mayo Clinic, Rochester, MN
| | - Samuel J Asirvatham
- Division of Cardiovascular Disease, Department of Internal Medicine, Mayo Clinic, Rochester, MN; Department of Pediatrics and Adolescent Medicine Mayo Clinic, Rochester, MN
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