Altered functional connectivity in seizure onset zones revealed by fMRI intrinsic connectivity.
Altered functional connectivity in seizure onset zones revealed by fMRI intrinsic connectivity.
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DOI：
10.1212/wnl.0000000000001068
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发表时间：
2014-12-09
期刊：
影响因子：
9.9
通讯作者：
Constable RT
中科院分区：
文献类型：
--
作者：
Lee HW;Arora J;Papademetris X;Tokoglu F;Negishi M;Scheinost D;Farooque P;Blumenfeld H;Spencer DD;Constable RT
本研究的目的是通过使用内在连通性对比(ICC)来研究静息fMRI获得的难治性部分癫痫患者致痫网络的功能连通性(FC)的变化。内在连通性对比(ICC)是一种基于体素的网络程度测量方法，反映到每个体素的连接数量。我们测量了大脑半球内和大脑半球间-ICC(ICCintra−INTER)之间的差异，这可以揭示致痫区域的局部性连接异常，而当减去这些值时，更多的全球网络变化将被消除。对29例术后至少1年随访的患者进行了ICCIntra−间期MAP与基于脑电记录的癫痫起始区(SOZ)的比较。两位独立评价者盲目解读icEEG和fMRI数据，比较不同临床因素的符合率。ICEEG SOZ与ICCIntra−间期MAP的符合率为72.4%(21/29)，手术效果好的患者，尤其是有颞叶癫痫或颞侧癫痫定位的患者，两者的符合率较高。颞叶外癫痫组的一致性也好于TLE组。在85.7%(18/21)的癫痫患者中，−间期ICCintra在SOZ内为负值，表明癫痫大脑半球内的Fc低于大脑半球间的Fc。使用fMRI-ICC MAP评估FC的改变有助于定位SOZ，SOZ有可能作为一种无创性的术前诊断工具来改善手术结果。此外，该方法显示，在局灶性癫痫中，在存在区域性和全局性网络异常的情况下，半球内和半球间的Fc都可能发生改变。
The purpose of this study was to investigate functional connectivity (FC) changes in epileptogenic networks in intractable partial epilepsy obtained from resting-state fMRI by using intrinsic connectivity contrast (ICC), a voxel-based network measure of degree that reflects the number of connections to each voxel. We measured differences between intrahemispheric- and interhemispheric-ICC (ICCintra−inter) that could reveal localized connectivity abnormalities in epileptogenic zones while more global network changes would be eliminated when subtracting these values. The ICCintra−inter map was compared with the seizure onset zone (SOZ) based on intracranial EEG (icEEG) recordings in 29 patients with at least 1 year of postsurgical follow-up. Two independent reviewers blindly interpreted the icEEG and fMRI data, and the concordance rates were compared for various clinical factors. Concordance between the icEEG SOZ and ICCintra−inter map was observed in 72.4% (21/29) of the patients, which was higher in patients with good surgical outcome, especially in those patients with temporal lobe epilepsy (TLE) or lateral temporal seizure localization. Concordance was also better in the extratemporal lobe epilepsy than the TLE group. In 85.7% (18/21) of the cases, the ICCintra−inter values were negative in the SOZ, indicating decreased FC within the epileptic hemisphere relative to between hemispheres. Assessing alterations in FC using fMRI-ICC map can help localize the SOZ, which has potential as a noninvasive presurgical diagnostic tool to improve surgical outcome. In addition, the method reveals that, in focal epilepsy, both intrahemispheric- and interhemispheric-FC may be altered, in the presence of both regional as well as global network abnormalities.