Functional and resting-state characterizations of a periventricular heterotopic nodule associated with epileptogenic activity.
Functional and resting-state characterizations of a periventricular heterotopic nodule associated with epileptogenic activity.
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DOI：
10.3171/2019.11.focus19765
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发表时间：
2020-02-01
影响因子：
4.1
通讯作者：
Lewis JW
中科院分区：
文献类型：
--
作者：
Nolan RL;Brandmeir N;Tucker ES;Magruder JL;Lee MR;Chen G;Lewis JW
本研究的目的是广泛描述癫痫患者脑室周围结节异位的一个区域，以揭示其可能的神经认知功能作用(S)。作者使用3-T磁共振成像方法，详尽地描述了一名患有药物反应性癫痫的高功能成年男性患者的单个右半球异位症，这种癫痫在青春期晚期表现出来。纤维束成像(扩散加权成像)和静息状态功能连接性磁共振(RsfMRI)显示，异位体在光谱上与皮质样成分一致，并与邻近的同侧皮质基底区相互连接。此外，PVNH区域还展示了异位离子的两个新的特征。首先，与rsfMRI不同的是，功能磁共振成像(FMRI)显示，当患者观看生物运动的动画视频场景(即卡通片)时，异位现象明显受到调制。其次，rsfMRI显示了在任务消极状态下相关的大脑活动，它独特地显示了一个相互连接的网络中的方向性，从大脑皮质和小脑病变中接收正向路径效应，而只输出到特定大脑焦点的负路径效应。这些发现是在对成人和儿童患者的非侵入性手术前脑成像策略的影响，以及这项研究对从神经多样性和进化角度理解认知的功能皮质结构的影响的背景下进行的。
The object of this study was to extensively characterize a region of periventricular nodular heterotopia (PVNH) in an epilepsy patient to reveal its possible neurocognitive functional role(s). The authors used 3-T MRI approaches to exhaustively characterize a single, right hemisphere heterotopion in a high-functioning adult male with medically responsive epilepsy, which had manifested during late adolescence. The heterotopion proved to be spectroscopically consistent with a cortical-like composition and was interconnected with nearby ipsilateral cortical fundi, as revealed by fiber tractography (diffusion-weighted imaging) and resting-state functional connectivity MRI (rsfMRI). Moreover, the region of PVNH demonstrated two novel characterizations for a heterotopion. First, functional MRI (fMRI), as distinct from rsfMRI, showed that the heterotopion was significantly modulated while the patient watched animated video scenes of biological motion (i.e., cartoons). Second, rsfMRI, which demonstrated correlated brain activity during a task-negative state, uniquely showed directionality within an interconnected network, receiving positive path effects from patent cortical and cerebellar foci while outputting only negative path effects to specific brain foci. These findings are addressed in the context of the impact on noninvasive presurgical brain mapping strategies for adult and pediatric patient workups, as well as the impact of this study on an understanding of the functional cortical architecture underlying cognition from a neurodiversity and evolutionary perspective.