Resting-State Functional Connectivity Analysis in Focal Neocortical Epilepsy

描述（由申请人提供）：癫痫是一种影响百分之一人口的毁灭性疾病。在30%的癫痫患者中，癫痫发作不能通过药物控制，导致严重的发病率甚至死亡率。在局灶性新皮质癫痫（FNE）中，癫痫发作通常起源于大脑外侧皮层。虽然目前的方法可以使难治性局灶性新皮质癫痫患者的癫痫手术完全不发作，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由于精确定位癫痫发作在大脑中的起源位置（称为癫痫区）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。在接受手术切除推定的癫痫区之前，本研究中的所有癫痫患者将接受无创脑磁图（MEG）记录。临床诊断和治疗将严格执行侵入性程序，用于研究目的的数据分析不会给患者带来任何额外的风险。非癫痫控制受试者志愿者也将接受无创脑磁图记录以进行比较。MEG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，它允许检查大脑中异常的功能连接。我们还将比较癫痫患者术前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。虽然过去在癫痫患者中进行了RSFC研究，但大多数研究都使用了功能性MRI技术，结果不一致。然而，与功能性MRI相比，MEG可以以更高的分辨率更直接地记录大脑活动，代表了一种新的和有前途的方法来研究癫痫的功能连接。在初步分析的基础上，期望本研究

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.