Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37212, USA.
Department of Radiology and Radiological Sciences, Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN 37212, USA.
Cereb Cortex. 2022 Dec 8;32(24):5555-5568. doi: 10.1093/cercor/bhac035.
Brain network alterations have been studied extensively in patients with mesial temporal lobe epilepsy (mTLE) and other focal epilepsies using resting-state functional magnetic resonance imaging (fMRI). However, little has been done to characterize the basic fMRI signal alterations caused by focal epilepsy. Here, we characterize how mTLE affects the fMRI signal in epileptic foci and networks. Resting-state fMRI and diffusion MRI were collected from 47 unilateral mTLE patients and 96 healthy controls. FMRI activity, quantified by amplitude of low-frequency fluctuations, was increased in the epileptic focus and connected regions in mTLE. Evidence for spread of this epileptic fMRI activity was found through linear relationships of regional activity across subjects, the association of these relationships with functional connectivity, and increased activity along white matter tracts. These fMRI activity increases were found to be dependent on the epileptic focus, where the activity was related to disease severity, suggesting the focus to be the origin of these pathological alterations. Furthermore, we found fMRI activity decreases in the default mode network of right mTLE patients with different properties than the activity increases found in the epileptic focus. This work provides insights into basic fMRI signal alterations and their potential spread across networks in focal epilepsy.
脑网络改变已在使用静息态功能磁共振成像(rs-fMRI)的内侧颞叶癫痫(MTLE)和其他局灶性癫痫患者中进行了广泛研究。然而,对于由局灶性癫痫引起的基本 fMRI 信号改变的特征描述却很少。在这里,我们描述了 MTLE 如何影响癫痫灶和网络中的 fMRI 信号。对 47 例单侧 MTLE 患者和 96 例健康对照者进行了静息态 fMRI 和弥散张量成像(DTI)采集。癫痫灶和 MTLE 连接区域的 fMRI 活性(低频波动幅度量化)增加。通过跨受试者的区域活动的线性关系、这些关系与功能连接的关联以及沿白质束的活性增加,发现了这种癫痫 fMRI 活性传播的证据。这些 fMRI 活性增加被认为与癫痫灶有关,其中活性与疾病严重程度有关,提示癫痫灶是这些病理改变的起源。此外,我们发现右 MTLE 患者的默认模式网络中的 fMRI 活性降低,其性质与在癫痫灶中发现的活性增加不同。这项工作提供了对局灶性癫痫中基本 fMRI 信号改变及其在网络中潜在传播的深入了解。