Besseling René M H, Jansen Jacobus F A, de Louw Anton J A, Vlooswijk Mariëlle C G, Hoeberigs M Christianne, Aldenkamp Albert P, Backes Walter H, Hofman Paul A M
Epilepsy center Kempenhaeghe, Heeze, the Netherlands.
Research School for Mental Health & Neuroscience, Maastricht University, Maastricht, the Netherlands.
PLoS One. 2016 Nov 18;11(11):e0166022. doi: 10.1371/journal.pone.0166022. eCollection 2016.
Focal cortical dysplasia (FCD) is a congenital malformation of cortical development that often leads to medically refractory epilepsy. Focal resection can be an effective treatment, but is challenging as the surgically relevant abnormality may exceed the MR-visible lesion. The aim of the current study is to develop methodology to characterize the profile of functional connectivity around FCDs using resting-state functional MRI and in the individual patient. The detection of aberrant connectivity may provide a means to more completely delineate the clinically relevant lesion.
Fifteen FCD patients (age, mean±SD: 31±11 years; 11 males) and 16 matched healthy controls (35±9 years; 7 males) underwent structural and functional imaging at 3 Tesla. The cortical surface was reconstructed from the T1-weighted scan and the registered functional MRI data was spatially normalized to a common anatomical standard space employing the gyral pattern. Seed-based functional connectivity was determined in all subjects for all dysplasia locations. A single patient was excluded based on an aberrant FCD seed time series. Functional connectivity as a function of geodesic distance (along the cortical surface) was compared between the individual patients and the homotopic normative connectivity profiles derived from the controls.
In 12/14 patients, aberrant profiles of functional connectivity were found, which demonstrated both hyper- and hypoconnectivity as well as combinations. Abnormal functional connectivity was typically found (also) beyond the lesion visible on structural MRI, while functional connectivity profiles not related to a lesion appeared normal in patients.
This novel functional MRI technique has potential for delineating functionally aberrant from normal cortex beyond the structural lesion in FCD, which remains to be confirmed in future research.
局灶性皮质发育不良（FCD）是一种皮质发育的先天性畸形，常导致药物难治性癫痫。局灶性切除可能是一种有效的治疗方法，但具有挑战性，因为与手术相关的异常可能超出磁共振成像（MR）可见的病变范围。本研究的目的是开发一种方法，利用静息态功能磁共振成像来表征FCD周围功能连接的特征，并应用于个体患者。检测异常连接可能提供一种手段，以更完整地描绘临床相关病变。
15例FCD患者（年龄，均值±标准差：31±11岁；11例男性）和16例匹配的健康对照者（35±9岁；7例男性）在3特斯拉下接受结构和功能成像。从T1加权扫描重建皮质表面，并使用脑回模式将配准的功能磁共振成像数据空间归一化到一个共同的解剖标准空间。在所有受试者中，针对所有发育异常部位确定基于种子点的功能连接。基于一个异常的FCD种子时间序列排除了一名患者。将个体患者与从对照者得出的同位正常连接特征进行比较，分析功能连接作为测地距离（沿皮质表面）的函数。
在14例患者中的12例中发现了功能连接异常特征，表现为连接增强和减弱以及两者的组合。异常功能连接通常也出现在结构磁共振成像可见病变之外，而在患者中与病变无关的功能连接特征看起来正常。
这种新型功能磁共振成像技术有潜力在FCD中描绘出结构病变之外功能异常的皮质与正常皮质，这有待未来研究证实。
