OBJECTIVES The aim of this longitudinal study was to clarify whether significant alterations in structural connectivity occur over time in patients with newly diagnosed focal epilepsy of unknown origin. METHODS A total of 40 patients with newly diagnosed focal epilepsy of unknown origin and with normal brain magnetic resonance imaging (MRI) on visual inspection were enrolled. All subjects underwent MRI twice involving three-dimensional volumetric T1-weighted imaging, which were suitable for structural volume analysis. Gray matter volumes were obtained using the FreeSurfer image analysis suite, and structural connectivity analyses were performed using Matlab-based BRain Analysis using graPH theory software. RESULTS The median interval between the two MRI scans was 18.5 months in patients with epilepsy. There was a general tendency toward decreased gray matter volumes on the second scan compared with the initial scan. However, the volumes of the right and left thalamus and brainstem on the second MRI scan had an increased tendency compared with those on the initial MRI scan. In measures of connectivity, there were significant differences between the two MRI scans. The mean clustering coefficient, global efficiency, local efficiency, and the small-worldness index were significantly increased, whereas the characteristic path length was decreased on the second MRI scan compared with the initial MRI scan. CONCLUSIONS The structural connectivity in patients with newly diagnosed focal epilepsy of unknown origin increases over time in the initial stage. These alterations and increases in structural connectivity may be related to underlying epileptogenicity in the initial stages of epilepsy.

中文翻译：

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新诊断不明原因局灶性癫痫患者结构连接的纵向分析

目的 本纵向研究的目的是阐明新诊断的不明来源局灶性癫痫患者的结构连接是否随时间发生显着改变。方法 纳入40例初诊不明原因局灶性癫痫，目视检查脑部磁共振成像（MRI）正常的患者。所有受试者均接受 MRI 两次，涉及三维体积 T1 加权成像，适用于结构体积分析。使用 FreeSurfer 图像分析套件获得灰质体积，并使用基于 Matlab 的 BRain 分析使用 graPH 理论软件进行结构连接分析。结果 癫痫患者两次 MRI 扫描之间的中位间隔为 18.5 个月。与初始扫描相比，第二次扫描的灰质体积普遍减少。然而，与最初的 MRI 扫描相比，第二次 MRI 扫描的左右丘脑和脑干的体积有增加的趋势。在连通性测量方面，两次 MRI 扫描之间存在显着差异。平均聚类系数、全局效率、局部效率和小世界指数显着增加，而与初始 MRI 扫描相比，第二次 MRI 扫描的特征路径长度减少。结论 新诊断的不明原因局灶性癫痫患者的结构连接在初始阶段随着时间的推移而增加。