The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 611731,China | High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, P.R. China.
The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 611731,China.
Curr Neuropharmacol. 2022;20(1):254-266. doi: 10.2174/1570159X19666210325130624.
Default Mode Network (DMN) is recognized to be involved in the generation and propagation of epileptic activities in various epilepsies. Converging evidence has suggested disturbed Functional Connectivity (FC) in epilepsies, which was inferred to be related to underlying pathological mechanisms. However, abnormal changes of FC in DMN revealed by different studies are controversial, which obscures the role of DMN in distinct epilepsies.
The present work aims to investigate the voxel-wise FC in DMN across epilepsies Methods: A systematic review was conducted on 22 published articles before October 2020, indexed in PubMed and Web of Science. A meta-analysis with a random-effect model was performed using the effect-size signed differential mapping approach. Subgroup analyses were performed in three groups: Idiopathic Generalized Epilepsy (IGE), mixed Temporal Lobe Epilepsy (TLE), and mixed Focal Epilepsy (FE) with different foci.
The meta-analysis suggested commonly decreased FC in mesial prefrontal cortices across different epilepsies. Additionally decreased FC in posterior DMN was observed in IGE. The TLE showed decreased FC in temporal lobe regions and increased FC in the dorsal posterior cingulate cortex. Interestingly, an opposite finding in the ventral and dorsal middle frontal gyrus was observed in TLE. The FE demonstrated increased FC in the cuneus.
The current findings revealed both common and specific alterations of FC in DMN across different epilepsies, highlighting the contribution of these dysfunctions to epileptic activities and cognitive behaviors in patients. Furthermore, the current study provided powerful evidence to support DMN as a potential candidate for effective intervention in epilepsy.
默认模式网络(DMN)被认为参与了各种癫痫中的癫痫活动的产生和传播。越来越多的证据表明,癫痫患者的功能连接(FC)受到干扰,这被认为与潜在的病理机制有关。然而,不同研究中 DMN 的 FC 异常变化存在争议,这使得 DMN 在不同癫痫中的作用变得模糊不清。
本研究旨在研究癫痫患者 DMN 的体素水平 FC。
对 2020 年 10 月前在 PubMed 和 Web of Science 上索引的 22 篇已发表文章进行了系统综述。使用效应大小符号差异映射方法,采用随机效应模型进行荟萃分析。在三个亚组中进行了亚组分析:特发性全面性癫痫(IGE)、混合颞叶癫痫(TLE)和不同病灶的混合局灶性癫痫(FE)。
荟萃分析表明,不同癫痫患者 DMN 的内侧前额叶皮质 FC 普遍降低。IGE 患者后 DMN 的 FC 也降低。TLE 患者颞叶区域的 FC 降低,后扣带回皮质的 FC 增加。有趣的是,TLE 患者中背侧和腹侧中额回的 FC 相反。FE 患者楔前叶的 FC 增加。
本研究结果揭示了不同癫痫患者 DMN 的 FC 既有共同的改变,也有特异的改变,强调了这些功能障碍对患者癫痫活动和认知行为的贡献。此外,本研究为 DMN 作为癫痫有效干预的潜在候选者提供了有力证据。