Disruption of functional connectivity among subcortical arousal system and cortical networks in temporal lobe epilepsy
Disruption of functional connectivity among subcortical arousal system and cortical networks in temporal lobe epilepsy
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颞叶癫痫皮质下唤醒系统和皮质网络之间功能连接的破坏
DOI：
10.1007/s11682-018-0014-y
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发表时间：
2019-01
影响因子：
3.2
通讯作者：
Li Feng
中科院分区：
文献类型：
--
作者：
Rong Li;Chongyu Hu;Liangcheng Wang;Ding Liu;Dingyang Liu;Wei Liao;Bo Xiao;Huafu Chen;Li Feng
越来越多的证据表明颞叶癫痫（TLE）患者存在明显的前脑网络改变，然而，关于TLE患者意识受损的皮层下-皮层关系的相对准确的描述仍不清楚。我们对26例TLE患者和30例健康对照者进行了静息态MRI检查。所有纳入的患者均被诊断为局灶性颞叶癫痫发作期间意识受损。采用功能连接密度（Functional Connectivity Density）来确定TLE中是否发生了局部或远端网络的改变，并利用格兰杰因果分析（Granger causality analysis，GCA）进一步评估这些改变的脑网络之间因果影响的方向和程度。患者在几个唤醒结构中表现出局部功能连接性增加，例如中脑、丘脑和皮质区域，包括双侧前额叶皮质（PFC）、左侧上级颞极、左侧后额叶和小脑（P<0.05，FDR校正）。GCA分析显示，患者组各脑区间的因果效应显著小于对照组（P<0.05，未校正），包括中脑、丘脑和PFC之间的兴奋和抑制作用降低，小脑对PFC的抑制作用减弱。这些发现表明，意识-TLE中的损害性发作与皮层下唤醒系统和皮层网络之间的功能改变和信息处理中断有关。了解颞叶癫痫的功能网络和神经支配通路，有助于深入了解癫痫相关意识丧失的机制。
Growingevidencehasdemonstratedwidespreadbrainnetworkalterationsintemporallobeepilepsy(TLE).However,therelatively accurate portrait of the subcortical-cortical relationship for impaired consciousness in TLE remains unclear. We proposed that consciousness-impairingseizuresmayinvadesubcorticalarousalsystemandcorrespondingcorticalregions,resultinginfunctional abnormalitiesandinformationflowdisturbancesbetweensubcorticalandcorticalnetworks.Weperformedresting-statefMRIin26 patients with TLE and 30 matched healthy controls. All included patients were diagnosed with impaired awareness during focal temporal lobe seizures. Functional connectivity density was adopted to determine whether local or distant network alterations occurred in TLE, and Granger causality analysis (GCA) was utilized to assess the direction and magnitude of causal influence among these altered brain networks further. Patients showed increased local functional connectivity in several arousal structures, such as the midbrain, thalamus, and cortical regions including bilateral prefrontal cortex (PFC), left superior temporal pole, left posterior insula, and cerebellum (P<0.05, FDR corrected). GCA analysis revealed that the casual effects among these regions in patients were significantly sparser than those in controls (P<0.05, uncorrected), including decreased excitatory and inhibitory effects among the midbrain, thalamus and PFC, and decreased inhibitory effect from the cerebellum to PFC. These findings suggested that consciousness-impairing seizures in TLE are associated with functional alterations and disruption of information process between the subcortical arousal system and cortical network. Understanding the functional networks and innervation pathway involved in TLE can provide insights into the mechanism underlying seizure-related loss of consciousness.
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影响因子：
--
作者：
M. Steriade
通讯作者：
M. Steriade
影响因子：
5.6
作者：
BANCAUD, J;HENRIKSEN, O;PENRY, JK
通讯作者：
PENRY, JK
DOI：
10.1016/s1474-4422(12)70188-6
发表时间：
2012-09
期刊：
The Lancet. Neurology
影响因子：
--
作者：
Blumenfeld H
通讯作者：
Blumenfeld H
影响因子：
3.7
作者：
Ji GJ;Zhang Z;Zhang H;Wang J;Liu DQ;Zang YF;Liao W;Lu G
通讯作者：
Lu G
影响因子：
16.2
作者：
Palaniyappan L;Simmonite M;White TP;Liddle EB;Liddle PF
通讯作者：
Liddle PF