Multimodal Imaging and Connectome Analysis Lab, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada.
Department of Neurology, Medical University of South Carolina, Charleston, South Carolina.
Epilepsia. 2019 Apr;60(4):593-604. doi: 10.1111/epi.14688. Epub 2019 Mar 19.
Epilepsy is among the most common chronic neurologic disorders, with 30%-40% of patients having seizures despite antiepileptic drug treatment. The advent of brain imaging and network analyses has greatly improved the understanding of this condition. In particular, developments in magnetic resonance imaging (MRI) have provided measures for the noninvasive characterization and detection of lesions causing epilepsy. MRI techniques can probe structural and functional connectivity, and network analyses have shaped our understanding of whole-brain anomalies associated with focal epilepsies. This review considers the progress made by neuroimaging and connectomics in the study of drug-resistant epilepsies due to focal substrates, particularly temporal lobe epilepsy related to mesiotemporal sclerosis and extratemporal lobe epilepsies associated with malformations of cortical development. In these disorders, there is evidence of widespread disturbances of structural and functional connectivity that may contribute to the clinical and cognitive prognosis of individual patients. It is hoped that studying the interplay between macroscale network anomalies and lesional profiles will improve our understanding of focal epilepsies and assist treatment choices.
癫痫是最常见的慢性神经障碍之一,尽管进行了抗癫痫药物治疗,但仍有 30%-40%的患者出现癫痫发作。脑成像和网络分析的出现极大地提高了对这种疾病的认识。特别是磁共振成像(MRI)的发展为导致癫痫的病变的无创特征和检测提供了手段。MRI 技术可以探测结构和功能连接,网络分析改变了我们对与局灶性癫痫相关的全脑异常的理解。这篇综述考虑了神经影像学和连接组学在研究由于局灶性病变导致的耐药性癫痫方面的进展,特别是与内侧颞叶硬化相关的颞叶癫痫和与皮质发育畸形相关的外侧颞叶癫痫。在这些疾病中,有证据表明结构和功能连接广泛紊乱,这可能会影响个体患者的临床和认知预后。希望研究宏观网络异常和病变特征之间的相互作用,能够提高我们对局灶性癫痫的认识,并帮助选择治疗方法。
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