Departments of Neurology, West China Hospital, Sichuan University, Chengdu, China.
Departments of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China.
CNS Neurosci Ther. 2023 May;29(5):1325-1331. doi: 10.1111/cns.14104. Epub 2023 Feb 5.
Periventricular nodular heterotopia (PNH) is a common type of heterotopia usually characterized by epilepsy. Previous studies have identified alterations in structural and functional connectivity related to this disorder, but its local functional neural basis has received less attention. The purpose of this study was to combine univariate analysis and a Gaussian process classifier (GPC) to assess local activity and further explore neuropathological mechanisms in PNH-related epilepsy.
We used a 3.0-T scanner to acquire resting-state data and measure local regional homogeneity (ReHo) alterations in 38 patients with PNH-related epilepsy and 38 healthy controls (HCs). We first assessed ReHo alterations by comparing the PNH group to the HC group using traditional univariate analysis. Next, we applied a GPC to explore whether ReHo could be used to differentiate PNH patients from healthy patients at an individual level.
Compared to HCs, PNH-related epilepsy patients exhibited lower ReHo in the left insula extending to the putamen as well as in the subgenual anterior cingulate cortex (sgACC) extending to the orbitofrontal cortex (OFC) [p < 0.05, family-wise error corrected]. Both of these regions were also correlated with epilepsy duration. Furthermore, the ReHo GPC classification yielded a 76.32% accuracy (sensitivity = 71.05% and specificity = 81.58%) with p < 0.001 after permutation testing.
Using the resting-state approach, we identified localized activity alterations in the left insula extending to the putamen and the sgACC extending to the OFC, providing pathophysiological evidence of PNH. These local connectivity patterns may provide a means to differentiate PNH patients from HCs.
室周结节性异位（PNH）是一种常见的异位类型，通常以癫痫为特征。先前的研究已经确定了与这种疾病相关的结构和功能连接的改变，但它的局部功能神经基础受到的关注较少。本研究旨在结合单变量分析和高斯过程分类器（GPC）来评估 PNH 相关癫痫的局部活动，并进一步探讨神经病理学机制。
我们使用 3.0T 扫描仪获取静息状态数据，并测量 38 例 PNH 相关癫痫患者和 38 例健康对照者（HCs）的局部区域同质性（ReHo）改变。我们首先通过将 PNH 组与 HC 组进行比较，使用传统的单变量分析来评估 ReHo 的改变。接下来，我们应用 GPC 来探索 ReHo 是否可以在个体水平上区分 PNH 患者和健康患者。
与 HCs 相比，PNH 相关癫痫患者的左侧岛叶延伸至壳核以及前扣带皮层的亚区（sgACC）延伸至眶额皮层（OFC）的 ReHo 降低（p<0.05，经校正的家族错误率）。这两个区域也与癫痫持续时间相关。此外，ReHo GPC 分类在经过置换检验后得出 76.32%的准确率（敏感性为 71.05%，特异性为 81.58%），p<0.001。
使用静息态方法，我们发现左侧岛叶延伸至壳核和 sgACC 延伸至 OFC 的局部活动改变，为 PNH 提供了病理生理学证据。这些局部连接模式可能为区分 PNH 患者和 HCs 提供一种手段。
