Resting-State Functional Connectivity Analysis in Focal Neocortical Epilepsy

局灶性新皮质癫痫的静息态功能连接分析

• 批准号: 8782165
• 负责人: Dario J Englot
• 金额: $ 5.89万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-07-01 至 2015-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8782165
• 关键词: Affect; Area; Blood; Brain; Brain Diseases; Brain Neoplasms; Brain imaging; Brain region; Clinical; Clinical Data; Clinical Treatment; Computer software; Data; Data Analyses; Detection; Deterioration; Disease; Distal; Electrodes; Electroencephalography; Epilepsy; Excision; Exhibits; Failure; Freedom; Functional Magnetic Resonance Imaging; Functional disorder; Generations; Goals; Human; Image; Imaging Techniques; Individual; Investigation; Laboratories; Lateral; Lead; Magnetic Resonance Imaging; Magnetoencephalography; Maps; Measurement; Measures; Morbidity - disease rate; Neurologic; Neurons; Operative Surgical Procedures; Outcome; Parietal; Partial Epilepsies; Patients; Pattern; Pharmaceutical Preparations; Population; Postoperative Period; Procedures; Refractory; Reporting; Research; Resolution; Rest; Risk; Scalp structure; Seizures; Side; Signal Transduction; Structure; Techniques; Temporal Lobe Epilepsy; Tissues; association cortex; base; clinical Diagnosis; cranium; improved; magnetic field; mortality; neocortical; network dysfunction; neuropsychological; novel; public health relevance; stem; treatment strategy; volunteer

DESCRIPTION (provided by applicant): Epilepsy is a devastating disorder affecting one percent of the population. Seizures cannot be controlled by medications in thirty percent of patients with epilepsy, causing significant morbidity and even mortality. In focal neocortical epilepsy (FNE), seizures typically originate from the lateral cortex of the brain. While epilepsy surgery can lead to complete seizure-freedom in patients with medically-intractable focal neocortical epilepsy with current approaches, nearly half of these cases fail to adequately control seizures. Failures in the surgical treatment of FNE stem in part from limited techniques for accurately mapping where seizures originate in the brain (termed the epileptogenic zone), and a limited understanding of epileptic brain networks. The goal of this study is to reach a better understanding of brain network dysfunction in FNE patients. Before undergoing surgical resection of a presumed epileptogenic zone, all epilepsy patients in this study will receive noninvasive magnetoencephalography (MEG) recordings. Invasive procedures will be performed strictly for clinical diagnosis and treatment, and data analysis for research purposes will not subject patients to any additional risk. Non-epileptic control subject volunteers will als undergo noninvasive MEG recordings for comparison. MEG data will be analyzed using customized software to measure resting-state functional connectivity (RSFC) throughout the brain. RSFC is statistical technique used to study coherence between signals from separate brain regions, and it allows examination of abnormal functional connections in the brain. We will also compare pre-operative RSFC maps in epilepsy patients with the resection area defined by post- operative magnetic resonance imaging (MRI), and relate these connectivity patterns to post-operative clinical outcomes. While RSFC studies have been performed in epilepsy patients in the past, most of these have utilized functional MRI techniques, and the results have been inconsistent. Compared to functional MRI, however, MEG allows more direct recordings of brain activity at a higher resolution, representing a novel and promising approach to the study of functional connectivity in epilepsy. Based on preliminary analyses, it is expected that this study will reveal widespread decreased connectivity in focal epilepsy patients compared to controls, but that within individual patients, the epileptogenic zone will represent the region of highest connectivity. Resection of tissue with highest connectivity will predict post- operative seizure freedom. This study will allow a better understanding of brain network dysfunction in epilepsy, and may ultimately lead to new targeted treatments for seizure disorders.

描述(由申请人提供)：癫痫是一种破坏性的疾病，影响百分之一的人口。在30%的癫痫患者中，癫痫发作无法通过药物控制，导致严重的发病率甚至死亡。在局灶性新皮质癫痫(FNE)中，癫痫发作通常起源于大脑的外侧皮质。虽然癫痫手术可以用目前的方法使药物难治性局灶性新皮质癫痫患者完全摆脱癫痫发作，但近一半的病例未能充分控制癫痫发作。FNE手术治疗失败的部分原因是准确定位癫痫发作起源于大脑(称为致痫区域)的技术有限，以及对癫痫脑网络的了解有限。本研究的目的是为了更好地了解FNE患者的脑网络功能障碍。在手术切除推测的致痫区域之前，本研究中的所有癫痫患者都将接受无创脑磁图(MEG)记录。侵入性手术将严格用于临床诊断和治疗，出于研究目的的数据分析不会使患者面临任何额外的风险。非癫痫控制受试者志愿者将接受无创性脑磁图记录，以供比较。脑磁图数据将使用定制软件进行分析，以测量整个大脑的静息状态功能连接(RSFC)。RSFC是一种统计技术，用于研究来自不同大脑区域的信号之间的一致性，它允许检查大脑中的异常功能连接。我们还将比较癫痫患者术前的RSFC图与术后磁共振成像(MRI)确定的切除区域，并将这些连接模式与术后临床结果联系起来。虽然过去对癫痫患者进行了RSFC研究，但大多数都利用了功能磁共振技术，结果并不一致。然而，与功能磁共振相比，脑磁图能够以更高的分辨率更直接地记录大脑活动，为癫痫功能连接的研究提供了一种新的、有前途的方法。根据初步分析，预计本研究将 结果显示，与对照组相比，局灶性癫痫患者的连通性普遍降低，但在个别患者中，致痫区域将代表连通性最高的区域。切除连通性最高的组织将预示术后癫痫发作的自由。这项研究将有助于更好地了解癫痫患者的大脑网络功能障碍，并最终可能导致癫痫障碍的新靶向治疗。

项目成果

Factors associated with failed focal neocortical epilepsy surgery.

与局灶性新皮质癫痫手术失败有关的因素。

• DOI: 10.1227/neu.0000000000000530
• 发表时间: 2014-12
• 期刊: Neurosurgery
• 影响因子: 4.8
• 作者: Englot DJ;Raygor KP;Molinaro AM;Garcia PA;Knowlton RC;Auguste KI;Chang EF
• 通讯作者: Chang EF

Seizure outcomes in nonresective epilepsy surgery: an update.

• DOI: 10.1007/s10143-016-0725-8
• 发表时间: 2017-04
• 期刊: Neurosurgical review
• 影响因子: 2.8
• 作者: Englot DJ;Birk H;Chang EF
• 通讯作者: Chang EF

Impact of Timing of Concurrent Chemoradiation for Newly Diagnosed Glioblastoma: A Critical Review of Current Evidence.

并发化学放疗对新诊断的胶质母细胞瘤的影响：当前证据的批判性综述。

• DOI: 10.1227/neu.0000000000000801
• 发表时间: 2015-08
• 期刊: Neurosurgery
• 影响因子: 4.8
• 作者: Han SJ;Englot DJ;Birk H;Molinaro AM;Chang SM;Clarke JL;Prados MD;Taylor JW;Berger MS;Butowski NA
• 通讯作者: Butowski NA

The Presto 1000: A novel automated transcranial Doppler ultrasound system.

• DOI: 10.1016/j.jocn.2015.05.026
• 发表时间: 2015-11
• 期刊: Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
• 作者: Han SJ;Rutledge WC;Englot DJ;Winkler EA;Browne JL;Pflugrath L;Cronsier D;Abla AA;Kliot M;Lawton MT
• 通讯作者: Lawton MT

Rates and Predictors of Seizure Freedom With Vagus Nerve Stimulation for Intractable Epilepsy.

• DOI: 10.1227/neu.0000000000001165
• 发表时间: 2016-09
• 期刊: Neurosurgery
• 影响因子: 4.8
• 作者: Englot DJ;Rolston JD;Wright CW;Hassnain KH;Chang EF
• 通讯作者: Chang EF