Li Wei, Jiang Yuchao, Qin Yingjie, Li Xiuli, Lei Du, Zhang Heng, Lei Ding, Yao Dezhong, Luo Cheng, Gong Qiyong, Zhou Dong, An Dongmei
Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
MOE Key Lab for Neuroinformation, Center for Information in Medicine, School of life Science and technology, The Clinical Hospital of Chengdu Brain Science Institute, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.
Brain Topogr. 2022 Nov;35(5-6):692-701. doi: 10.1007/s10548-022-00912-1. Epub 2022 Sep 8.
To explore the resting state networks (RSNs) alterations in patients with unilateral mesial temporal lobe epilepsy (mTLE) before and after successful surgery.
Resting-state functional MRI and T1-weighted structural MRI were obtained in 37 mTLE patients who achieved seizure freedom after anterior temporal lobectomy. Patients were scanned before surgery and at two years after surgery. Twenty-eight age- and sex-matched healthy controls were scanned once. Functional connectivity (FC) changes within and between ten common RSNs before and after surgery, and FC changes between hippocampus and RSNs were explored.
Before surgery, decreased FC was found within visual network and basal ganglia network, while after surgery, FC within basal ganglia network further decreased but FC within sensorimotor network and dorsal attention network increased. Before surgery, between-network FC related to basal ganglia network, visual network and dorsal attention network decreased, while between-network FC related to default mode network increased. After surgery, between-network FC related to visual network and dorsal attention network significantly increased. In addition, before surgery, ipsilateral hippocampus showed decreased FC with visual network, basal ganglia network, sensorimotor network, default mode network and frontoparietal network, while contralateral rostral hippocampus showed increased FC with salience network. After surgery, no obvious FC changes were found between contralateral hippocampus and these RSNs.
MTLE patients showed significant RSNs alterations before and after surgery. Basal ganglia network showed progressive decline in functional connectivity. Successful surgery may lead to RSNs reorganization. These results provide preliminary evidence for postoperative functional remodeling at whole-brain-network level.
探讨单侧内侧颞叶癫痫（mTLE）患者在成功手术后静息态网络（RSNs）的变化。
对37例在接受前颞叶切除术后实现无癫痫发作的mTLE患者进行静息态功能磁共振成像（fMRI）和T1加权结构磁共振成像扫描。患者在手术前和手术后两年进行扫描。对28名年龄和性别匹配的健康对照者进行一次扫描。探讨手术前后10个常见RSNs内部和之间的功能连接（FC）变化，以及海马体与RSNs之间的FC变化。
手术前，视觉网络和基底神经节网络内的FC降低，而手术后，基底神经节网络内的FC进一步降低，但感觉运动网络和背侧注意网络内的FC增加。手术前，与基底神经节网络、视觉网络和背侧注意网络相关的网络间FC降低，而与默认模式网络相关的网络间FC增加。手术后，与视觉网络和背侧注意网络相关的网络间FC显著增加。此外，手术前，同侧海马体与视觉网络、基底神经节网络、感觉运动网络、默认模式网络和额顶叶网络的FC降低，而对侧喙海马体与突显网络的FC增加。手术后，对侧海马体与这些RSNs之间未发现明显的FC变化。
mTLE患者在手术前后显示出显著的RSNs变化。基底神经节网络的功能连接呈渐进性下降。成功的手术可能导致RSNs重组。这些结果为全脑网络水平的术后功能重塑提供了初步证据。
