RFIC Center, Kwangwoon University, Seoul, Republic of Korea.
Department of Pediatrics, Pediatric Epilepsy Clinic, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Sci Rep. 2018 Feb 21;8(1):3414. doi: 10.1038/s41598-018-21764-5.
Corpus callosotomy (CC) is an effective palliative surgical treatment for patients with Lennox-Gastaut Syndrome (LGS). However, research on the long-term functional effects of CC is sparse. We aimed to investigate these effects and their associated clinical conditions over the two years after CC. Long-term clinical EEG recordings of 30 patients with LGS who had good and bad seizure outcome after CC were collected and retrospectively studied. It was found that CC caused brain network 'hubs' to shift from paramedian to lateral regions in the good-recovery group, which reorganized the brain network into a more homogeneous state. We also found increased local clustering coefficients in patients with bad outcomes and decreases, implying enhanced network integration, in patients with good outcomes. The small worldness of brain networks in patients with good outcomes increased in the two years after CC, whereas it decreased in patients with bad outcomes. The covariation of small-worldness with the rate of reduction in seizure frequency suggests that this can be used as an indicator of CC outcome. Local and global network changes during the long-term state might be associated with the postoperative recovery process and could serve as indicators for CC outcome and long-term LGS recovery.
胼胝体切开术（CC）是 Lennox-Gastaut 综合征（LGS）患者的一种有效姑息性手术治疗方法。然而，关于 CC 的长期功能效果的研究很少。我们旨在调查 CC 后两年内这些效果及其相关临床情况。收集了 30 例 LGS 患者 CC 后癫痫发作结局良好和不良的长期临床 EEG 记录，并进行了回顾性研究。结果发现，CC 导致大脑网络“枢纽”从旁中线区域转移到侧区域，使大脑网络重组为更均匀的状态。我们还发现，不良结局患者的局部聚类系数增加，而良好结局患者的局部聚类系数减少，这表明网络整合增强。CC 后两年，良好结局患者的脑网络小世界性增加，而不良结局患者的脑网络小世界性减少。小世界性与癫痫发作频率降低率的共变表明，这可以用作 CC 结局的指标。长期状态下局部和全局网络的变化可能与术后恢复过程有关，可作为 CC 结局和长期 LGS 恢复的指标。
