Ibrahim George M, Morgan Benjamin R, Smith Mary Lou, Kerr Elizabeth, Donner Elizabeth, Go Cristina Y, Doesburg Sam, Taylor Margot, Widjaja Elysa, Rutka James T, Snead O Carter
Division of Neurosurgery, Hospital for Sick Children, Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.
Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada.
Epilepsy Behav. 2015 Oct;51:281-5. doi: 10.1016/j.yebeh.2015.07.039. Epub 2015 Aug 25.
Although developmental outcomes may improve following functional hemispherotomy for lateralized, catastrophic childhood epilepsy, the neuronal processes mediating these improvements are unknown. We report the case of a 14-year-old child with neurocognitive impairment who underwent functional hemispherotomy with longitudinal resting-state fMRI. Compared with preoperative fMRI, we report significantly more robust thalamo-default mode network connectivity on postoperative neuroimaging. Furthermore, we show decreased connectivity to nodes within the disconnected hemisphere, providing direct evidence that functional interactions are dependent upon structural connectivity. Since the vascular supply to these nodes remains intact, although they are disconnected from the remainder of the brain, these findings also confirm that blood-oxygen level dependent oscillations are driven primarily by neuronal activity. The current study highlights the importance of thalamocortical interactions in the understanding of neural oscillations and cognitive function, and their impairment in childhood epilepsy.
尽管对于单侧化、灾难性儿童癫痫进行功能性大脑半球切除术可能会改善发育结局，但介导这些改善的神经元过程尚不清楚。我们报告了一名14岁患有神经认知障碍的儿童的病例，该儿童接受了功能性大脑半球切除术并进行了纵向静息态功能磁共振成像。与术前功能磁共振成像相比，我们报告术后神经影像显示丘脑-默认模式网络连接显著增强。此外，我们还发现与断开连接的半球内节点的连接减少，这提供了直接证据表明功能相互作用依赖于结构连接。由于这些节点的血管供应保持完整，尽管它们与大脑其余部分断开连接，但这些发现也证实了血氧水平依赖振荡主要由神经元活动驱动。当前研究强调了丘脑皮质相互作用在理解神经振荡和认知功能及其在儿童癫痫中的损害方面的重要性。
