Characterizing the role of the structural connectome in seizure dynamics
Characterizing the role of the structural connectome in seizure dynamics
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DOI：
10.1093/brain/awz125
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发表时间：
2019-07-01
期刊：
影响因子：
14.5
通讯作者：
Davis, Kathryn A.
中科院分区：
文献类型：
--
作者：
Shah, Preya;Ashourvan, Arian;Davis, Kathryn A.
人脑的结构支架是如何产生其复杂的功能动态的？这是转化神经科学中的一个核心问题，与癫痫特别相关，癫痫是一种影响全球5000多万受试者的疾病。对耐药局灶性癫痫的治疗通常是结构性的——通过手术或激光消融——但结构性目标，特别是在没有明显病变的患者中，主要是基于颅内脑电图的功能定位。不幸的是，在癫痫发作的大脑中，结构和功能连接之间的关系尚不清楚。在这项研究中，我们量化了9例单侧耐药局灶性癫痫患者的45次癫痫发作在癫痫发作前和癫痫发作期的结构-功能耦合，特别是白质连接和颅内脑电图之间的耦合。我们使用高角分辨率扩散成像（HARDI）神经束成像来构建结构连接网络，并将这些网络与共登记颅内脑电图的时变宽带和频率特异性功能网络相关联。在所有频带中，我们发现从临界前到临界期结构-功能耦合显著增加。我们证明了短程结构连接是这种耦合增加的主要原因。最后，我们发现每个患者的结构-功能耦合的时空模式都是高度刻板化的。这些结果表明，癫痫发作在传播过程中控制了潜在的结构连接体。绘制癫痫结构和功能连通性之间的关系可能会为阻止癫痫扩散的新疗法提供信息，并为有针对性的患者特异性干预铺平道路。
How does the human brain's structural scaffold give rise to its intricate functional dynamics? This is a central question in translational neuroscience that is particularly relevant to epilepsy, a disorder affecting over 50 million subjects worldwide. Treatment for medication-resistant focal epilepsy is often structural-through surgery or laser ablation-but structural targets, particularly in patients without clear lesions, are largely based on functional mapping via intracranial EEG. Unfortunately, the relationship between structural and functional connectivity in the seizing brain is poorly understood. In this study, we quantify structure-function coupling, specifically between white matter connections and intracranial EEG, across pre-ictal and ictal periods in 45 seizures from nine patients with unilateral drug-resistant focal epilepsy. We use high angular resolution diffusion imaging (HARDI) tractography to construct structural connectivity networks and correlate these networks with time-varying broadband and frequency-specific functional networks derived from coregistered intracranial EEG. Across all frequency bands, we find significant increases in structure-function coupling from pre-ictal to ictal periods. We demonstrate that short-range structural connections are primarily responsible for this increase in coupling. Finally, we find that spatiotemporal patterns of structure-function coupling are highly stereotyped for each patient. These results suggest that seizures harness the underlying structural connectome as they propagate. Mapping the relationship between structural and functional connectivity in epilepsy may inform new therapies to halt seizure spread, and pave the way for targeted patient-specific interventions.