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由单个脑海绵状血管畸形(CCM)引起的局灶性癫痫与局部和全局静息状态功能连接(FC)中断有关。

Focal epilepsy caused by single cerebral cavernous malformation (CCM) is associated with regional and global resting state functional connectivity (FC) disruption.

机构信息

Department of Neurosurgery, Louisiana State Unversity Health Science Center, Shreveport, LA 71103, United States.

School of Allied Health Professions, Department of Rehabilitation Sciences, Louisiana State Unversity Health Science Center, Shreveport, LA 71103, United States.

出版信息

Neuroimage Clin. 2019;24:102072. doi: 10.1016/j.nicl.2019.102072. Epub 2019 Nov 5.

Abstract

Epilepsy, including the type with focal onset, is increasingly viewed as a disorder of the brain network. Here we employed the functional connectivity (FC) metrics estimated from the resting state functional MRI (rsfMRI) to investigate the changes of brain network associated with focal epilepsy caused by single cerebral cavernous malformation (CCM). Eight CCM subjects and 21 age and gender matched controls were enrolled in the study. Seven of 8 CCM subjects underwent surgical resection of the CCM and became seizure free and 4 of the surgical subjects underwent a repeat rsfMRI study. We showed that there was both regional and global disruption of the FC values among the CCM subjects including decreased in homotopic FC (HFC) and global FC (GFC) in the regions of interest (ROIs) where the CCMs were located. There was also the disruption of the default mode network (DMN) especially the FC between the middle prefrontal cortex (MPFC) and the right lateral parietal cortex (LPR) among these individuals. We observed the trend of alleviation of these disruptions after the individual has become seizure free from the surgical resection of the CCM. Using a voxel-based approach, we found the disruption of the HFC and GFC in the brain tissue immediately adjacent to the CCM and the severity of the disruption appeared inversely proportional to the distance of the brain tissue to the lesion. Our findings confirm the disruption of normal brain networks from focal epilepsy, a process that may be reversible with successful surgical treatments rendering patients seizure free. Some voxel-based metrics may help identify the epileptogenic zone and guide the surgical resection.

摘要

癫痫,包括局灶性发作类型,越来越被视为一种脑网络紊乱。在这里,我们采用静息态功能磁共振成像(rsfMRI)中估计的功能连接(FC)指标来研究由单个脑海绵状血管畸形(CCM)引起的局灶性癫痫相关的脑网络变化。本研究纳入了 8 例 CCM 患者和 21 名年龄和性别匹配的对照者。8 例 CCM 患者中有 7 例接受了 CCM 的手术切除,术后无癫痫发作,其中 4 例手术患者接受了重复 rsfMRI 研究。我们发现 CCM 患者的 FC 值存在区域性和全局性破坏,包括位于 CCM 所在区域的同型 FC (HFC)和全局 FC (GFC)降低。这些个体的默认模式网络(DMN)也存在破坏,特别是中前额皮质(MPFC)和右侧外侧顶叶皮质(LPR)之间的 FC 破坏。我们观察到,在个体接受 CCM 切除手术后癫痫发作停止后,这些破坏有缓解的趋势。使用基于体素的方法,我们发现与 CCM 相邻的脑组织中的 HFC 和 GFC 破坏,破坏的严重程度与脑组织与病变的距离呈反比。我们的研究结果证实了局灶性癫痫导致正常脑网络的破坏,这一过程可能通过成功的手术治疗使患者无癫痫发作而得到逆转。一些基于体素的指标可能有助于确定致痫区并指导手术切除。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce87/6854067/62800c801d8c/gr1.jpg

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