Dynamic multimodal connectivity analysis of brain networks in focal epilepsy

局灶性癫痫脑网络的动态多模态连接分析

• 批准号: 10678514
• 负责人: Derek J Doss
• 金额: $ 3.28万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-01 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10678514
• 关键词: Academic Medical Centers; Activities of Daily Living; Acute; Address; Adult; Affect; Anatomy; Area; Arousal; Awareness; Brain; Brain Diseases; Brain region; Chronic; Cognitive; Cognitive deficits; Conscious; Data; Disease; Distant; Electroencephalography; Electrophysiology (science); Engineering; Environment; Epilepsy; Fellowship; Focal Seizure; Frequencies; Functional Magnetic Resonance Imaging; Functional disorder; Goals; Image; Impairment; Knowledge; Lead; Link; Mediating; Memory; Mentors; Modality; Nature; Neocortex; Neurocognitive; Neurocognitive Deficit; Operative Surgical Procedures; Partial Epilepsies; Pathology; Patients; Persons; Population; Quality of life; Recurrence; Regional Anatomy; Research Training; Rest; Scalp structure; Seizures; Structure; Temporal Lobe; Temporal Lobe Epilepsy; Unconscious State; Work; atmospheric sciences; comparison control; executive function; functional magnetic resonance imaging/electroencephalography; improved; multimodality; neocortical; nervous system disorder; network dysfunction; neurocognitive test; neuroregulation; new therapeutic target; postoperative recovery; processing speed; scientific atmosphere; sustained attention; vigilance

PROJECT SUMMARY/ABSTRACT Epilepsy is a debilitating neurological disorder that affects 1% of the population worldwide and temporal lobe epilepsy (TLE) is the most common form. Seizure onset in TLE is typically localized to the mesial temporal lobe, however, patients can suffer from distant effects such as loss of consciousness during seizures (ictally) and neurocognitive deficits between seizures (interictally), both of which impair one’s activities of daily living, ability to work, and quality of life. Prior work investigating these global effects have resulted in the Network Inhibition Hypothesis, which states that focal seizure activity observed with stereotactic electroencephalography (SEEG) spreads to subcortical structures responsible for neocortical activation, resulting in ictal loss of consciousness in focal impaired awareness seizures (FIAS). Studies with functional MRI (fMRI) have provided evidence that the same anatomical areas have abnormal functional connectivity (FC). It thought that recurrent FIAS lead to chronic interictal decreases in subcortical to neocortical FC, but this knowledge gap but this knowledge gap has not been addressed. We aim to relate FC of ictal and interictal states using SEEG (Aim 1). I specifically hypothesize during FIAS ictal FC will decrease in the same anatomical regions as those implicated in interictal FC abnormalities. In addition to recurrent seizures, patients can also have devastating interictal neurocognitive deficits. These widespread neurocognitive deficits suggest that there is a common factor, which is thought to be the subcortical arousal structures. It has been shown that fMRI FC abnormalities of subcortical to neocortical structures are associated with neurocognitive deficits, seizure frequency, and can recover after surgery. While general subcortical to neocortical abnormalities have been outlined, there is a gap in understanding of specific brain networks associated with neurocognitive deficits. This could be due in part to not adequately controlling for arousal state. The high vigilance or “sustained attention” state, is a state of cognitive engagement mediated by subcortical arousal structures which fluctuates at rest. It is associated with subcortical to neocortical FC changes, associated with extratemporal neurocognitive deficits, the state active during neurocognitive testing, and thought to be a confounder for resting-state fMRI by some. We aim to link specific subcortical to neocortical network abnormalities with neurocognitive deficits by controlling for the high vigilance state with fMRI-EEG (Aim 2). I specifically hypothesize that during high vigilance states, patients will have significantly decreased FC within subcortical to neocortical networks compared to controls, that the decrease will be associated with extratemporal neurocognitive deficits, and that the network will recover after successful surgery. This proposed fellowship will provide research training in a collaborative research atmosphere with expert mentors. Research training will be conducted in an environment that combines an academic medical center with a level 4 epilepsy center, world class imaging institute, and engineering all on one campus. Studying multiple modalities to characterize epileptic networks may lead to improved neuromodulation targets for TLE.

项目总结/文摘