Insights into Intrinsic Brain Networks based on Graph Theory and PET in right- compared to left-sided Temporal Lobe Epilepsy

Vanicek, Thomas; Hahn, Andreas; Traub-Weidinger, Tatjana; Hilger, Eva; Spies, Marie; Wadsak, Wolfgang; Lanzenberger, Rupert; Pataraia, Ekaterina; Asenbaum-Nan, Susanne

doi:10.1038/srep28513

Cited by 27 publications

(30 citation statements)

References 61 publications

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“…[7][8][9][10][11] With the advances in electroencephalography (EEG) and imaging technologies, including multimodal coregistration techniques, the role of 18 FDG-PET in presurgical evaluation has been enhanced beyond being a useful diagnostic tool reserved for magnetic resonance imaging (MRI)-negative cases or clinical scenarios with discordant electroclinical and structural imaging findings. 19,20 It has also been suggested that hypometabolic changes affecting the contralateral (CTL) temporal lobe (TL) may impact on seizure outcomes in patients with drug-resistant MTLE. 17,18 Furthermore, the findings of recent 18 FDG-PET and functional connectivity studies have been convergent in demonstrating the role of 18 FDG-PET as a metabolic biomarker of the extent of the epileptic network dysfunction.…”

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confidence: 99%

“…19,20 It has also been suggested that hypometabolic changes affecting the contralateral (CTL) temporal lobe (TL) may impact on seizure outcomes in patients with drug-resistant MTLE. 20,[30][31][32][33] The higher rates of bitemporal hypometabolism have been observed in patients with unilateral right MTLE; 19 however, the effect of this distinct metabolic pattern on seizure outcomes following anterior TL resection (ATLR) has not been demonstrated. 28,29 Furthermore, the results of functional and metabolic connectivity studies have been suggestive of distinct functional connectivity patterns depending on the lateralization of MTLE, including higher rates of CTL TL involvement in patients with right MTLE.…”

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confidence: 99%

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Metabolic patterns and seizure outcomes following anterior temporal lobectomy

Cahill

Sinclair

Malpas

et al. 2019

Annals of Neurology

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Objective: We investigated the relationship between the interictal metabolic patterns, the extent of resection of 18 Ffluorodeoxyglucose positron emission tomography ( 18 FDG-PET) hypometabolism, and seizure outcomes in patients with unilateral drug-resistant mesial temporal lobe epilepsy (MTLE) following anterior temporal lobe (TL) resection. Methods: Eighty-two patients with hippocampal sclerosis or normal magnetic resonance imaging (MRI) findings, concordant 18 FDG-PET hypometabolism, and at least 2 years of postoperative follow-up were included in this 2-center study. The hypometabolic regions in each patient were identified with reference to 20 healthy controls (p < 0.005). The resected TL volume and the volume of resected TL PET hypometabolism (TLH) were calculated from the pre-and postoperative MRI scans coregistered with interictal 18 FDG-PET. Results: Striking differences in metabolic patterns were observed depending on the lateralization of the epileptogenic TL. The extent of the ipsilateral TLH was significantly greater in left MTLE patients (p < 0.001), whereas right MTLE patients had significantly higher rates of contralateral (CTL) TLH (p = 0.016). In right MTLE patients, CTL hypometabolism was the strongest predictor of an unfavorable seizure outcome, associated with a 5-fold increase in the likelihood of seizure recurrence (odds ratio [OR] = 4.90, 95% confidence interval [CI] = 1.07-22.39, p = 0.04). In left MTLE patients, greater extent of resection of ipsilateral TLH was associated with lower rates of seizure recurrence (p = 0.004) in univariate analysis; however, its predictive value did not reach statistical significance (OR = 0.96, 95% CI = 0.90-1.02, p = 0.19). Interpretation: The difference in metabolic patterns depending on the lateralization of MTLE may represent distinct epileptic networks in patients with right versus left MTLE, and can guide preoperative counseling and surgical planning.

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confidence: 99%

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confidence: 99%

Metabolic patterns and seizure outcomes following anterior temporal lobectomy

Cahill

Sinclair

Malpas

et al. 2019

Annals of Neurology

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“…Furthermore, in lean individuals, intranasal insulin increases the activity of memory‐related areas . We have demonstrated that this activation is part of a complex network based on metabolic, and not on functional, connectivity .…”

Section: Discussionmentioning

confidence: 82%

Inward Glucose Transfer Accounts for Insulin‐Dependent Increase in Brain Glucose Metabolism Associated with Diet‐Induced Obesity

Bahri

Horowitz

Malbert³

2018

Obesity

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Whole-body insulin sensitivity was reduced by more than 50% in the obesity group. During insulin stimulation, whole-brain insulin-induced increased glucose uptake was unaltered in lean animals but increased markedly in the animals with obesity. The increased glucose uptake reflected an increase in the inward transfer without changes in phosphorylation or outward brain transport. Connectivity was increased in the animals with obesity CONCLUSIONS: Diet-induced obesity is associated with an increase in insulin-stimulated brain glucose uptake as a consequence of a larger inward transfer. These changes occurred together with an increased connectivity in reference to regions associated with memory recollection.

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“…Furthermore, a growing body of evidence points to the fact that mTLE is not a focal but rather a network disease, which is characterized by abnormal epileptic networks between hippocampal sclerosis or mesial temporal structures and extra‐hippocampal epileptic‐related regions. Moreover, compared to the disrupted connectivity of the ipsilateral mesio‐temporal lobe with the epileptic zone, the contralateral hemisphere always shows a compensatory reorganization and striking reconfigurations of large‐scale networks . Thus, investigation of the networks’ property of hippocampal and extra‐hippocampal regions is crucial for understanding the concept of the epileptic network and the associated brain damage effects and is also critical for clinical medical treatment or presurgical evaluation of mTLE.…”

Section: Introductionmentioning

confidence: 99%

Metabolic covariance networks combining graph theory measuring aberrant topological patterns in mesial temporal lobe epilepsy

Wang

Liu

et al. 2018

CNS Neurosci Ther

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Summary Objective We aimed to study the networks’ mechanism of metabolic covariance networks in mesial temporal lobe epilepsy (mTLE), through examining the brain value of fluorine‐18‐fluorodeoxyglucose positron emission tomography (18F‐FDG‐PET). Methods 18F‐FDG‐PET images from 16 patients with mTLE were analyzed using local and global metabolic covariance network (MCN) approaches, including whole metabolic pattern analysis (WMPA), hippocampus‐based (h‐) MCN, whole brain (w‐) MCN, and edge‐based connectivity analysis (EBCA). Results WMPA showed a typical ipsilateral hypometabolism and contralateral hypermetabolism pattern to epileptic zones in mTLE. h‐MCN revealed decreased hippocampus‐based synchronization in contralateral regions. w‐MCN exhibited a disrupted metabolic network with globally increased small‐world properties and regionally decreased nodal metrics in the ipsilateral hemisphere. Hippocampus (h)‐EBCA and whole brain EBCA (w‐EBCA) both detected a reduced‐connectivity dominated metabolic covariant network. Moreover, the reduced interhemisphere connectivity seemingly played a major role in the aberrant epileptic topological pattern. Conclusion From a metabolic point of view, we demonstrated the damaging effects with reduced contralateral intranetwork metrics properties and the compensatory effects in contralateral intranetworks with increased network properties. However, the import role of significant reduced interhemisphere connection has rarely been reported in other mTLE studies. Taken together, 18F‐FDG‐PET MCN analysis provides new evidence that the mTLE is a system neurological disorder with disrupted networks.

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Insights into Intrinsic Brain Networks based on Graph Theory and PET in right- compared to left-sided Temporal Lobe Epilepsy

Cited by 27 publications

References 61 publications

Metabolic patterns and seizure outcomes following anterior temporal lobectomy

Metabolic patterns and seizure outcomes following anterior temporal lobectomy

Inward Glucose Transfer Accounts for Insulin‐Dependent Increase in Brain Glucose Metabolism Associated with Diet‐Induced Obesity

Metabolic covariance networks combining graph theory measuring aberrant topological patterns in mesial temporal lobe epilepsy

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