MRI Structural and Functional Connectivity Changes in Temporal Lobe Epilepsy

项目概要/摘要 众所周知，颞叶癫痫（TLE）引起癫痫发作，对整个大脑产生广泛影响， 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缺陷，主要是记忆和语言相关功能，这表明 癫痫发作传播网络与这些认知功能相关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是否 一个耐药的TLE患者在手术切除肿瘤后， 癫痫发作的焦点因此，挑战在于量化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，以确定最 合适的外科候选人本项目的总体目标是调查和量化的关系 癫痫发作传播中的功能和结构网络完整性与TLE非癫痫发作中的语言网络之间的关系 侵入性地使用磁共振成像（MRI）;并将这些网络改变与疾病和 手术前后的认知特征。功能连接和结构连接将 在TLE患者的癫痫发作传播以及语言和记忆网络中进行测量 治疗结构连接性将用扩散张量MRI方法量化，而功能MRI方法将用扩散张量MRI方法量化。 将用于确定功能连接参数。这些措施将被比作健康 控制，以及网络中功能和结构连接之间的关系将是 测定网络的结构和功能连接将与疾病相关 术前患者的特征、语言和记忆功能。最后，一个新的统计 方法，稳健的生物参数映射（rBPM），将用于开发多变量，多模式线性 术前MRI连通性、疾病特征和神经心理学测试分数的模型来预测 术后癫痫发作和认知结果。 这项研究的最终影响是提供结构，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。这些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进展 条件;并可能通过提供更准确的方法来预测这种疾病的临床治疗 这些患者的术后癫痫发作和认知结果。此外，所提出的方法可能是 扩展并应用于成人和儿童的其他形式的局灶性癫痫，以增加 手术治疗这些患者。

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.