MRI Structural and Functional Connectivity Changes in Temporal Lobe Epilepsy

项目摘要/摘要 众所周知，颞叶癫痫(TLE)会导致癫痫发作，其影响遍及整个大脑 导致复杂的事件，包括意识丧失和运动现象。此外，重复 癫痫发作也会产生认知障碍，主要是记忆和语言相关功能，这表明 癫痫传播网络和与这些认知功能相关的网络之间的相互作用。 这些广泛的联系及其潜在的相互作用可能在决定 耐药的TLE患者在手术切除TLE后癫痫发作消失，且没有认知能力下降。 癫痫发作的焦点。因此，挑战是量化TLE中的神经元重组并利用这一点 准确预测手术后癫痫发作和认知结果的信息，以便识别最 合适的外科候选人。这个项目的总体目标是调查和量化这种关系 非TLE患者癫痫发作传播中功能网络和结构网络完整性与语言网络的关系 使用磁共振成像(MRI)进行侵入性检查；并将这些网络改变与疾病和 手术前后的认知特点。功能连通和结构连通都将 对TLE患者术前癫痫发作传播及语言记忆网络进行测量 治疗。结构的连通性将用扩散张量磁共振方法进行量化，而功能磁共振则 将用于确定功能连接参数。这些措施将被比作健康的 网络中的功能连接和结构连接之间的关系将是 下定决心。然后，网络的结构和功能连接将与疾病相关 术前患者的特点和语言记忆功能。最后，一种新的统计方法 将使用稳健生物参数映射(RBPM)方法来开发多变量、多模线性 术前MRI连接性模型、疾病特征和神经心理测试评分的预测 手术后癫痫发作与认知结局。 这项研究的最终影响是提供了结构、功能和行为之间的联系 TLE中最相关和最广泛的两个大脑网络。这一信息将提供一个重要的 识别和量化神经重组及其相关后果的研究进展 通过提供一种更准确的预测方法，可能会改善这种疾病的临床治疗。 这些患者手术后癫痫发作和认知结局。此外，建议的方法可能是 扩大和应用于成人和儿童的其他形式的局灶性癫痫，以增加对 对这些患者进行外科治疗。

PROJECT SUMMARY/ABSTRACT It is known that temporal lobe epilepsy (TLE) causes seizures with widespread effects across the brain that result in complex events including loss of consciousness and motor phenomena. Additionally, repeated seizures can also produce cognitive deficits, primarily of memory and language related functions, suggesting an interaction between seizure propagation networks and those associated with these cognitive functions. These extensive connections and their potential interaction may play an important role in determining whether a drug-resistant TLE patient becomes seizure free and is without cognitive decline after surgical resection of the seizure focus. Therefore, the challenge is to quantify neuronal reorganization in TLE and utilize this information to accurately predict post-surgical seizure and cognitive outcome in order to identify the most appropriate surgical candidates. The overall goal of this project is to investigate and quantify the relationship between functional and structural network integrity in seizure propagation and language networks in TLE non- invasively using Magnetic Resonance Imaging (MRI); and to relate these network alterations to disease and cognitive characteristics before and after surgery. Both functional connectivity and structural connectivity will be measured in seizure propagation and language and memory networks of TLE patients prior to surgical treatment. The structural connectivity will be quantified with diffusion tensor MRI methods, while functional MRI will be used to determine the functional connectivity parameters. These measures will be compared to healthy controls, and the relationships between functional and structural connectivity in the networks will be determined. The structural and functional connectivity of the networks will then be related to the disease characteristics and language and memory function of the patients prior to surgery. Finally, a novel statistical method, robust Biological Parametric Mapping (rBPM), will be used to develop multivariate, multimodal linear models of presurgical MRI connectivity, disease characteristics and neuropsychological test scores to predict post-surgical seizure and cognitive outcome. The ultimate impact of this research is to provide the link between the structure, function and behavior of the two most relevant and widespread brain networks in TLE. This information would provide a significant advancement in identifying and quantifying neural reorganization and its consequences associated with this condition; and may improve clinical treatment of this disease by providing a more accurate method to predict post-surgical seizure and cognitive outcome in these patients. Furthermore, the proposed approach may be expanded and applied to other forms of focal epilepsy in both adults and children to increase the utilization of surgical treatment for these patients.