Department of Neurology, West China Hospital, Sichuan University, No. 37 GuoXue Alley, Chengdu, 610041, China.
Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, No. 37 GuoXue Alley, Chengdu, 610041, China.
Seizure. 2021 Apr;87:1-6. doi: 10.1016/j.seizure.2021.02.009. Epub 2021 Feb 12.
Focal cortical dysplasia (FCD) appears to be strongly associated with intractable epilepsy. Although patients with FCD are candidates for epilepsy surgery, gray matter structural abnormalities can extend beyond the primary lesion, which makes surgery less effective. The objective of this study was to evaluate functional connectivity patterns in epilepsy associated with FCD to explore the underlying pathological mechanism of this disorder.
A total of 34 patients (14 men) with FCD and epilepsy [mean age ± standard deviation (SD), 24.5 ± 9.8 years; range, 8-47 years] and 34 age-matched healthy controls (14 men, 24.6 ± 9.7 years) underwent functional magnetic resonance imaging. Independent component analysis (ICA), seed-based functional connectivity, and graph theory were applied to analyze functional connectivity patterns in the brain.
Patients showed more connections among dorsal attention network, anterior default mode network, and sensorimotor brain networks than healthy controls based on ICA. Analysis of connectivity between regions of interest (ROIs) showed greater functional connectivity in patients between frontal and temporal regions, but lower connectivity between the cerebellum and frontal regions. The normalized characteristic path length was significantly higher in group of patients, but the two groups showed no significant differences in global or regional efficiency, clustering coefficient or characteristic path length.
Analysis of ICA-derived and ROI-based functional connectivity suggests that disrupted interactions and dysconnectivity in large-scale neural networks and frontotemporal-cerebellar regions may contribute to underlying pathological mechanisms in FCD-related epilepsy.
局灶性皮质发育不良（FCD）似乎与难治性癫痫密切相关。尽管 FCD 患者是癫痫手术的候选者，但灰质结构异常可能超出原发性病变，这使得手术效果较差。本研究旨在评估与 FCD 相关的癫痫的功能连接模式，以探索该疾病的潜在病理机制。
共纳入 34 例 FCD 伴癫痫患者（男 14 例）[平均年龄±标准差（SD），24.5±9.8 岁；年龄范围 8-47 岁]和 34 例年龄匹配的健康对照者（男 14 例，24.6±9.7 岁）行功能磁共振成像。采用独立成分分析（ICA）、基于种子的功能连接和图论分析方法分析脑内功能连接模式。
基于 ICA，患者组的背侧注意网络、前默认模式网络和感觉运动网络之间的连接较健康对照组更多。感兴趣区（ROI）间连接分析显示，患者组额颞区之间的功能连接更强，但小脑与额叶区之间的连接较弱。患者组的标准化特征路径长度显著较高，但两组的全局或区域效率、聚类系数或特征路径长度均无显著差异。
ICA 衍生和 ROI 基础的功能连接分析表明，大规模神经网络和额颞顶叶-小脑区域的交互和连接中断可能导致 FCD 相关癫痫的潜在病理机制。
