Impaired hippocampal functional connectivity in patients with drug resistant, generalized tonic-clonic seizures

Wang, Zhengge; Wang, Xiaoyun; Rong, Rong; Xu, Yun; Zhang, Bing; Wang, Zhongyuan

doi:10.1097/wnr.0000000000001262

Cited by 15 publications

(16 citation statements)

References 29 publications

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“…In the present study, it is worth noting that the average VMHC values in the bilateral HF and LTC were significantly correlated with the epilepsy duration. Previous studies have confirmed that epilepsy duration is one of the main clinical factors affecting a patient’s functional organization ( Wang et al, 2011 , 2018 , 2019b ; Liu et al, 2017 ). In these previous studies, the FC between the regions within the DMN or between the DMN and other subnetworks of the brain showed negative correlations with the epilepsy duration.…”

Section: Discussionmentioning

confidence: 84%

“…In the past few years, investigating the functional interactions between regions has become a powerful tool to explore the human brain. In a resting state fMRI study, the disruption of FC networks in GTCS has been reported ( Wang et al, 2011 , 2019b ; Liu et al, 2017 ; Parsons et al, 2020 ). Connectivity changes in a number of brain regions involved the HP, thalamus, insula, temporal cortex, cerebellum, precuneus, and medial prefrontal cortex.…”

Section: Discussionmentioning

confidence: 98%

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Impaired Functional Homotopy and Topological Properties Within the Default Mode Network of Children With Generalized Tonic-Clonic Seizures: A Resting-State fMRI Study

Qin²,

Chen³

et al. 2022

Front. Neurosci.

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IntroductionThe aim of the present study was to examine interhemispheric functional connectivity (FC) and topological organization within the default-mode network (DMN) in children with generalized tonic-clonic seizures (GTCS).MethodsResting-state functional MRI was collected in 24 children with GTCS and 34 age-matched typically developing children (TDC). Between-group differences in interhemispheric FC were examined by an automated voxel-mirrored homotopic connectivity (VMHC) method. The topological properties within the DMN were also analyzed using graph theoretical approaches. Consistent results were detected and the VMHC values were extracted as features in machine learning for subject classification.ResultsChildren with GTCS showed a significant decrease in VMHC in the DMN, including the hippocampal formation (HF), lateral temporal cortex (LTC), and angular and middle frontal gyrus. Although the patients exhibited efficient small-world properties of the DMN similar to the TDC, significant changes in regional topological organization were found in the patients, involving the areas of the bilateral temporal parietal junction, bilateral LTC, left temporal pole, and HF. Within the DMN, disrupted interhemispheric FC was found between the bilateral HF and LTC, which was consistent with the VMHC results. The VMHC values in bilateral HF and LTC were significantly correlated with clinical information in patients. Support vector machine analysis using average VMHC information in the bilateral HF and LTC as features achieved a correct classification rate of 89.34% for the classification.ConclusionThese results indicate that decreased homotopic coordination in the DMN can be used as an effective biomarker to reflect seizure effects and to distinguish children with GTCSs from TDC.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 98%

Impaired Functional Homotopy and Topological Properties Within the Default Mode Network of Children With Generalized Tonic-Clonic Seizures: A Resting-State fMRI Study

Qin²,

Chen³

et al. 2022

Front. Neurosci.

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“…The same group found significantly reduced default mode network connectivity and cerebellar resting‐state functional connectivity among patients with valproate‐resistant IGE 88,89 . Hippocampal functional connectivity was found to be impaired and negatively correlated with epilepsy duration in drug‐resistant generalized tonic–clonic seizures in IGE, whereas drug‐responsive patients demonstrated compensatory improvement in hippocampal functional connectivity on follow‐up 90 . However, a recent study using the graph theory on resting state fMRI data did not find significant differences in network topology between drug‐resistant and responsive IGE 91 …”

Section: Exploring Functional Connectivity and Epileptic Networkmentioning

confidence: 87%

Brainwaves beyond diagnosis: Wider applications of electroencephalography in idiopathic generalized epilepsy

2021

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Despite the advent of many technologically advanced investigations, electroencephalography (EEG) remains one of the most widely used tools playing a critical role in the diagnosis of epilepsy. In particular, EEG abnormalities are vital in the classification of epilepsies into focal and generalized subgroups.Given typically normal structural neuroimaging, EEG is particularly valuable in establishing the diagnosis of idiopathic generalized epilepsy (IGE), which accounts for 15%-20% of all epilepsies across all age groups. 1 The generalized spike-wave complex, first described by Gibbs in 1935, is the electrographic signature of IGE. 2 Generalized polyspikes, polyspike-wave discharges, paroxysmal fast rhythm, photoparoxysmal response (PPR), eye-closure sensitivity, fixation-off sensitivity, epileptiform K-complexes, and occipital intermittent rhythmic delta activity are other EEG abnormalities described in IGE. 3,4 Furthermore, these changes typically emerge from a normal background.With advances in epilepsy surgery, EEG has wide applications beyond establishing the diagnosis of focal epilepsy. Both surface and intracranial EEGs are indispensable for the localization of the epileptogenic zone in the presurgical workup. EEG source localization is a technique for epileptogenic

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“…Some studies have found no significant difference in the subcortical structure volume of IGE-GTCS patients compared with that of normal controls (NCs) ( Bernasconi et al, 2003 ; Natsume et al, 2003 ; Seeck et al, 2004 ; Ozturk et al, 2020 ). Some functional MRI studies complemented these findings, indicating connectome anomalies in the thalamus and hippocampus ( Wang et al, 2019a , b ). Despite the contribution of these findings to localizing anomalies in this disease, there is limited insight into the specific clinical value of the abnormality of subcortical nuclei.…”

Section: Introductionmentioning

confidence: 77%

Atrophy in the Left Amygdala Predicted Drug Responses in Idiopathic Generalized Epilepsy Patients With Tonic–Clonic Seizures

Wang

Chen

et al. 2021

Front. Neurosci.

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We aimed to determine the alterations in the subcortical structures of patients with idiopathic generalized epilepsy with tonic–clonic seizures (IGE-GTCS) via MRI volumetry and vertex-based shape analysis and to evaluate the relationships between MRI measures and drug responses. In a follow-up sample of 48 patients with IGE-GTCS and 48 matched normal controls (NCs), high-resolution 3D T1WI was performed at baseline. After 1 year of follow-up, 31 patients were classified as seizure free (SF) and 17 as drug resistant (DR). The volumes of subcortical structures were extracted, and vertex-based shape analysis was performed using FSL-Integrated Registration and Segmentation Toolbox (FSL-FIRST). Comparisons among groups were calculated adjusting for covariates [age, sex, and intracranial volume (ICV)]. Analysis of the relationships among imaging biomarkers along with frequency and duration was assessed using partial correlations. The differential imaging indicators were used as features in a linear support vector machine (LSVM). The DR group displayed significant regional atrophy in the volume of the left amygdala compared with NCs (p = 0.004, false discovery rate corrected) and SF patients (p = 0.029, uncorrected). Meanwhile, vertex-based shape analysis showed focal inward deformation in the basolateral subregion of the left amygdala in DR compared with the results for SF and NC (p < 0.05, FWE corrected). There were significant correlations between the volume changes and seizure frequency (r = −0.324, p = 0.030) and between shape (r = −0.438, p = 0.003) changes and seizure frequency. Moreover, the volume of the left thalamus in the DR group was significantly correlated with seizure frequency (r = −0.689, p = 0.006). The SVM results revealed areas under the receiver operating characteristic curve of 0.82, 0.68, and 0.88 for the classification between SF and DR, between SF and NC, and between DR and NC, respectively. This study indicates the presence of focal atrophy in the basolateral region of the left amygdala in patients with IGE drug resistance; this finding may help predict drug responses and suggests a potential therapeutic target.

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Impaired hippocampal functional connectivity in patients with drug resistant, generalized tonic-clonic seizures

Abstract: Supplemental Digital Content is available in the text.

Cited by 15 publications

References 29 publications

Impaired Functional Homotopy and Topological Properties Within the Default Mode Network of Children With Generalized Tonic-Clonic Seizures: A Resting-State fMRI Study

Impaired Functional Homotopy and Topological Properties Within the Default Mode Network of Children With Generalized Tonic-Clonic Seizures: A Resting-State fMRI Study

Brainwaves beyond diagnosis: Wider applications of electroencephalography in idiopathic generalized epilepsy

Atrophy in the Left Amygdala Predicted Drug Responses in Idiopathic Generalized Epilepsy Patients With Tonic–Clonic Seizures

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