Purpose

The aim of this study was to determine whether anti-seizure medication (ASM) response is associated with structural connectivity in diffusion tensor imaging (DTI) or functional co-variance network in arterial spin labeling (ASL) magnetic resonance imaging (MRI) in patients with focal epilepsy.

Methods

In this retrospective study conducted at a tertiary hospital, we enrolled 105 patients with focal epilepsy, of which 64 patients were good ASM responders, and 41 patients were poor ASM responders. All patients showed normal MRI findings on visual inspection and underwent DTI and ASL MRI from August 2018 to July 2020, with regular follow-up for at least 12 months after epilepsy diagnosis while taking ASMs. We calculated the structural connectivity based on DTI and functional co-variance network based on ASL MRI by using graph theory and analyzed their differences in relation to the ASM response.

Results

No differences were observed in structural connectivity between the good and poor ASM responders. However, significant differences were observed in functional co-variance network between the good and poor ASM responders. In comparison with good ASM responders, poor ASM responders showed a significantly greater characteristic path length (2.557 vs. 1.753, p = 0.034) and a lower local efficiency (2.311 vs. 3.927, p = 0.048).

Conclusion

Significant differences were observed in functional co-variance network based on ASL MRI between the good and poor ASM responders. These findings suggest that functional co-variance network could serve as a new biomarker of ASM response in focal epilepsy.

中文翻译：

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基于与局灶性癫痫抗癫痫药物反应相关的动脉自旋标记的网络差异

目的

本研究的目的是确定抗癫痫药物 (ASM) 反应是否与扩散张量成像 (DTI) 中的结构连通性或动脉自旋标记 (ASL) 磁共振成像 (MRI) 中的功能协方差网络相关与局灶性癫痫。

方法

在这项在三级医院进行的回顾性研究中，我们招募了 105 名局灶性癫痫患者，其中 64 名 ASM 反应良好，41 名 ASM 反应不佳。2018 年 8 月至 2020 年 7 月，所有患者的 MRI 检查结果均正常，并于 2018 年 8 月至 2020 年 7 月接受 DTI 和 ASL MRI 检查，在癫痫诊断后定期随访至少 12 个月，同时服用 ASM。我们使用图论计算了基于 DTI 的结构连通性和基于 ASL MRI 的功能协方差网络，并分析了它们与 ASM 响应相关的差异。

结果

良好和不良 ASM 反应者之间的结构连接性没有观察到差异。然而，在良好和不良 ASM 响应者之间的功能协方差网络中观察到显着差异。与良好的 ASM 响应者相比，较差的 ASM 响应者表现出明显更长的特征路径长度（2.557 对 1.753，p = 0.034）和更低的局部效率（2.311 对 3.927，p = 0.048）。

结论

在基于 ASL MRI 的功能协方差网络中，在良好和不良 ASM 反应者之间观察到显着差异。这些发现表明，功能性协方差网络可以作为局灶性癫痫中 ASM 反应的新生物标志物。