Connecting Mind, Brain, and Seizures by Default Mode.

Effective Connectivity Within the Default Mode Network in Left Temporal Lobe Epilepsy: Findings From the Epilepsy Connectome Project Cook CJ, Hwang G, Mathis J, et al. Brain Connect. 2018. doi:10.1089/brain.2018.0600. [Epub ahead of print]; PMID: 30398367 The Epilepsy Connectome Project examines the differences in connectomes between patients with temporal lobe epilepsy (TLE) and healthy controls. Using these data, the effective connectivity of the default mode network (DMN) in patients with left TLE compared to healthy controls was investigated using spectral dynamic causal modeling of resting state functional magnetic resonance imaging data. Group comparisons were made using 2 parametric empirical Bayes (PEB) models. The first level of each PEB model consisted of each participant's spectral dynamic causal modeling. Two different second-level models were constructed: the first comparing effective connectivity of the groups directly and the second using the Rey Auditory Verbal Learning Test (RAVLT) delayed free recall index as a covariate at the second level in order to assess effective connectivity controlling for the poor memory performance of patients with left TLE. After an automated search over the nested parameter space and thresholding parameters at 95% posterior probability, both models revealed numerous connections in the DMN that lead to inhibition of the left hippocampal formation. Left hippocampal formation inhibition may be an inherent result of the left temporal epileptogenic focus as memory differences were controlled for in one model and the same connections remained. An excitatory connection from the posterior cingulate cortex to the medial prefrontal cortex was found to be concomitant with left hippocampal formation inhibition in patients with TLE when including RAVLT delayed free recall at the second level.