Default mode network connectivity indicates episodic memory capacity in mesial temporal lobe epilepsy
Default mode network connectivity indicates episodic memory capacity in mesial temporal lobe epilepsy
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DOI：
10.1111/epi.12098
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发表时间：
2013-05-01
期刊：
影响因子：
5.6
通讯作者：
McAndrews, Mary Pat
中科院分区：
文献类型：
--
作者：
McCormick, Cornelia;Quraan, Maher;McAndrews, Mary Pat
目的 静息态功能连接在神经系统疾病（包括内侧颞叶癫痫 (mTLE)）中的临床相关性仍不清楚。这项研究调查了默认模式网络中的连接性如何随着其节点之一海马体（HC）的单侧损伤而变化，以及如何在临床上利用这种连接性来表征记忆缺陷并指示术后记忆变化。方法 对 19 名健康对照者、20 名右侧 mTLE 患者和 18 名左侧 mTLE 患者进行功能性磁共振成像 (fMRI) 静息态扫描和神经心理记忆评估（沃灵顿单词和面孔识别测试）。此外，其中一半患者可以获得术后功能磁共振成像静息状态和记忆变化（术后记忆表现、术前记忆表现）数据。主要发现 mTLE 患者表现出从后扣带皮层 (PCC) 到致痫性 HC 的连接性减少，而 PCC 到对侧 HC 的连接性增加。 PCC 与致癫痫 HC 的连接性更强，与更好的术前记忆和更大的术后记忆衰退相关。 PCC 与对侧 HC 的连接越强，术后记忆力下降越少。手术后，PCC 与剩余 HC 的连接性较术前有所增加，并且与术后记忆功能的相关性增强。值得注意的是，该指数在解释手术后记忆变化的方差方面优于其他指数（海马体积、术前记忆评分）。意义我们的结果证明了大脑内在连接性在评估 mTLE 患者的认知能力和表明术后认知发病率方面具有显着的临床意义。
Purpose The clinical relevance of resting state functional connectivity in neurologic disorders, including mesial temporal lobe epilepsy (mTLE), remains unclear. This study investigated how connectivity in the default mode network changes with unilateral damage to one of its nodes, the hippocampus (HC), and how such connectivity can be exploited clinically to characterize memory deficits and indicate postsurgical memory change. Methods Functional magnetic resonance imaging (fMRI) resting state scans and neuropsychological memory assessments (Warrington Recognition Tests for Words and Faces) were performed on 19 healthy controls, 20 patients with right mTLE, and 18 patients with left mTLE. In addition, postsurgical fMRI resting state and memory change (postsurgical memory performancepresurgical memory performance) data were available for half of these patients. Key Findings Patients with mTLE showed reduced connectivity from the posterior cingulate cortex (PCC) to the epileptogenic HC and increased PCC connectivity to the contralateral HC. Stronger PCC connectivity to the epileptogenic HC was associated with better presurgical memory and with greater postsurgical memory decline. Stronger PCC connectivity to the contralateral HC was associated with less postsurgical memory decline. Following surgery, PCC connectivity to the remaining HC increased from presurgical values and showed enhanced correlation with postsurgical memory function. It is notable that this index was superior to others (hippocampal volume, preoperative memory scores) in explaining variance in memory change following surgery. Significance Our results demonstrate the striking clinical significance of the brain's intrinsic connectivity in evaluating cognitive capacity and indicating the potential of postsurgical cognitive morbidity in patients with mTLE.