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Abnormal directed connectivity of resting state networks in focal epilepsy.
NeuroImage: Clinical ( IF 4.2 ) Pub Date : 2020-07-06 , DOI: 10.1016/j.nicl.2020.102336
Margherita Carboni 1 , Pia De Stefano 2 , Bernd J Vorderwülbecke 3 , Sebastien Tourbier 4 , Emeline Mullier 4 , Maria Rubega 5 , Shahan Momjian 6 , Karl Schaller 6 , Patric Hagmann 4 , Margitta Seeck 2 , Christoph M Michel 7 , Pieter van Mierlo 8 , Serge Vulliemoz 2
Affiliation  

Objective

Epilepsy diagnosis can be difficult in the absence of interictal epileptic discharges (IED) on scalp EEG. We used high-density EEG to measure connectivity in large‐scale functional networks of patients with focal epilepsy (Temporal and Extratemporal Lobe Epilepsy, TLE and ETLE) and tested for network alterations during resting wakefulness without IEDs, compared to healthy controls. We measured global efficiency as a marker of integration within networks.

Methods

We analysed 49 adult patients with focal epilepsy and 16 healthy subjects who underwent high-density-EEG and structural MRI. We estimated cortical activity using electric source analysis in 82 atlas-based cortical regions based on the individual MRI. We applied directed connectivity analysis (Partial Directed Coherence) on these sources and performed graph analysis: we computed the Global Efficiency on the whole brain and on each resting state network. We tested these features in different group of patients.

Results

Compared to controls, efficiency was increased in both TLE and ETLE (p < 0.05). The somato-motor-network, the ventral-attention-network and the default-mode-network had a significantly increased efficiency (p < 0.05) in both TLE and ETLE as well as TLE with hippocampal sclerosis.

Significance

During interictal scalp EEG epochs without IED, patients with focal epilepsy show brain functional connectivity alterations in the whole brain and in specific resting-state-networks. This higher integration reflects a chronic effect of pathological activity within these structures and complement previous work on altered information outflow. These findings could increase the diagnostic sensitivity of scalp EEG to identify epileptic activity in the absence of IED.



中文翻译:

局灶性癫痫中静止状态网络的异常定向连接。

目的

在头皮脑电图上没有发作间期癫痫放电(IED)的情况下,癫痫诊断可能很困难。我们使用高密度脑电图来测量局灶性癫痫患者的大型功能网络(颞叶和颞叶癫痫,TLE和ETLE)的连通性,并与健康对照相比,在没有IED的清醒状态下测试网络变化。我们将全球效率衡量为网络内部集成的标志。

方法

我们分析了49位成年人的局灶性癫痫患者和16位接受了高密度脑电图和结构MRI的健康受试者。我们基于单独的MRI使用电源分析在82个基于图集的皮质区域中估计了皮质活动。我们在这些来源上应用了定向连通性分析(部分定向相干性)并进行了图分析:我们计算了整个大脑和每个静止状态网络的全局效率。我们在不同的患者组中测试了这些功能。

结果

与对照组相比,TLE和ETLE的效率均提高(p <0.05)。在TLE和ETLE以及海马硬化的TLE中,躯体运动网络,腹侧注意网络和默认模式网络的效率显着提高(p <0.05)。

意义

在没有IED的发作性头皮脑电图时期,患有局灶性癫痫的患者在整个大脑和特定的静息状态网络中均显示出大脑功能的连接性改变。这种更高的整合度反映了这些结构内病理活动的长期影响,并补充了先前有关改变信息流出的工作。这些发现可能会增加头皮脑电图在没有IED的情况下识别癫痫活动的诊断敏感性。

更新日期:2020-07-14
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