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Gil F, Padilla N, Soria-Pastor S, Setoain X, Boget T, Rumiá J, Roldán P, Reyes D, Bargalló N, Conde E, Pintor L, Vernet O, Manzanares I, Ådén U, Carreño M, Donaire A. Beyond the Epileptic Focus: Functional Epileptic Networks in Focal Epilepsy. Cereb Cortex 2019; 30:2338-2357. [DOI: 10.1093/cercor/bhz243] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Abstract
Focal epilepsy can be conceptualized as a network disorder, and the functional epileptic network can be described as a complex system of multiple brain areas that interact dynamically to generate epileptic activity. However, we still do not fully understand the functional architecture of epileptic networks. We studied a cohort of 21 patients with extratemporal focal epilepsy. We used independent component analysis of functional magnetic resonance imaging (fMRI) data. In order to identify the epilepsy-related components, we examined the general linear model-derived electroencephalography-fMRI (EEG–fMRI) time courses associated with interictal epileptic activity as intrinsic hemodynamic epileptic biomarkers. Independent component analysis revealed components related to the epileptic time courses in all 21 patients. Each epilepsy-related component described a network of spatially distributed brain areas that corresponded to the specific epileptic network in each patient. We also provided evidence for the interaction between the epileptic activity generated at the epileptic network and the physiological resting state networks. Our findings suggest that independent component analysis, guided by EEG–fMRI epileptic time courses, have the potential to define the functional architecture of the epileptic network in a noninvasive way. These data could be useful in planning invasive EEG electrode placement, guiding surgical resections, and more effective therapeutic interventions.
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Affiliation(s)
- Francisco Gil
- Epilepsy Program, Department of Neurology, Hospital Clínic, Neuroscience Institute, CP 08036, Barcelona, Spain
| | - Nelly Padilla
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Sara Soria-Pastor
- Department of Psychiatry, Consorci Sanitari del Maresme, Hospital of Mataro, CP 08304, Mataro, Spain
| | - Xavier Setoain
- Epilepsy Program, Department of Nuclear Medicine, Hospital Clínic, CDIC, CP 08036, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Clinical and Experimental Neuroscience, Clinical Neurophysiology, CP 08036, Barcelona, Spain
- Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), University of Barcelona, CP 08036, Barcelona, Spain
| | - Teresa Boget
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Clinical and Experimental Neuroscience, Clinical Neurophysiology, CP 08036, Barcelona, Spain
- Epilepsy Program, Department of Neuropsychology, Hospital Clínic, Neuroscience Institute, CP 08036, Barcelona, Spain
| | - Jordi Rumiá
- Epilepsy Program, Department of Neurosurgery, Hospital Clínic, Neuroscience Institute, CP 08036, Barcelona, Spain
| | - Pedro Roldán
- Epilepsy Program, Department of Neurosurgery, Hospital Clínic, Neuroscience Institute, CP 08036, Barcelona, Spain
| | - David Reyes
- Epilepsy Program, Department of Neurology, Hospital Clínic, Neuroscience Institute, CP 08036, Barcelona, Spain
| | - Núria Bargalló
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Clinical and Experimental Neuroscience, Clinical Neurophysiology, CP 08036, Barcelona, Spain
- Epilepsy Program, Department of Radiology, Hospital Clínic, CDIC, CP 08036, Barcelona, Spain
| | - Estefanía Conde
- Epilepsy Program, Department of Neurology, Hospital Clínic, Neuroscience Institute, CP 08036, Barcelona, Spain
| | - Luis Pintor
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Clinical and Experimental Neuroscience, Clinical Neurophysiology, CP 08036, Barcelona, Spain
- Epilepsy Program, Department of Psychiatry, Hospital Clínic, CDIC, CP 08036, Barcelona, Spain
| | - Oriol Vernet
- Epilepsy Program, Department of Neurology, Hospital Clínic, Neuroscience Institute, CP 08036, Barcelona, Spain
| | - Isabel Manzanares
- Epilepsy Program, Department of Neurology, Hospital Clínic, Neuroscience Institute, CP 08036, Barcelona, Spain
| | - Ulrika Ådén
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Mar Carreño
- Epilepsy Program, Department of Neurology, Hospital Clínic, Neuroscience Institute, CP 08036, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Clinical and Experimental Neuroscience, Clinical Neurophysiology, CP 08036, Barcelona, Spain
| | - Antonio Donaire
- Epilepsy Program, Department of Neurology, Hospital Clínic, Neuroscience Institute, CP 08036, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Clinical and Experimental Neuroscience, Clinical Neurophysiology, CP 08036, Barcelona, Spain
- Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), University of Barcelona, CP 08036, Barcelona, Spain
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