Yuan Siyu, Huang Hui, Cai Bingyang, Li Jiwei, Zhang Miao, Luo Jie
School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China.
Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Neurosci. 2023 Jun 8;17:1165982. doi: 10.3389/fnins.2023.1165982. eCollection 2023.
To investigate the relationship between glucose metabolism and functional activity in the epileptogenic network of patients with mesial temporal lobe epilepsy (MTLE) and to determine whether this relationship is associated with surgical outcomes.
F-FDG PET and resting-state functional MRI (rs-fMRI) scans were performed on a hybrid PET/MR scanner in 38 MTLE patients with hippocampal sclerosis (MR-HS), 35 MR-negative patients and 34 healthy controls (HC). Glucose metabolism was measured using F-FDG PET standardized uptake value ratio (SUVR) relative to cerebellum; Functional activity was obtained by fractional amplitude of low-frequency fluctuation (fALFF). The betweenness centrality (BC) of metabolic covariance network and functional network were calculated using graph theoretical analysis. Differences in SUVR, fALFF, BC and the spatial voxel-wise SUVR-fALFF couplings of the epileptogenic network, consisting of default mode network (DMN) and thalamus, were evaluated by Mann-Whitney U test (using the false discovery rate [FDR] for multiple comparison correction). The top ten SUVR-fALFF couplings were selected by Fisher score to predict surgical outcomes using logistic regression model.
The results showed decreased SUVR-fALFF coupling in the bilateral middle frontal gyrus ( = 0.0230, = 0.0296) in MR-HS patients compared to healthy controls. Coupling in the ipsilateral hippocampus was marginally increased ( = 0.0802) in MR-HS patients along with decreased BC of metabolic covariance network and functional network ( = 0.0152; = 0.0429). With Fisher score ranking, the top ten SUVR-fALFF couplings in regions from DMN and thalamic subnuclei could predict surgical outcomes with the best performance being a combination of ten SUVR-fALFF couplings with an AUC of 0.914.
These findings suggest that the altered neuroenergetic coupling in the epileptogenic network is associated with surgical outcomes of MTLE patients, which may provide insight into their pathogenesis and help with preoperative evaluation.
探讨内侧颞叶癫痫（MTLE）患者致痫网络中葡萄糖代谢与功能活动之间的关系，并确定这种关系是否与手术结果相关。
对38例伴有海马硬化的MTLE患者（MR-HS）、35例MR阴性患者和34例健康对照（HC）在混合型PET/MR扫描仪上进行F-FDG PET和静息态功能MRI（rs-fMRI）扫描。使用相对于小脑的F-FDG PET标准化摄取值比率（SUVR）测量葡萄糖代谢；通过低频波动分数振幅（fALFF）获得功能活动。使用图论分析计算代谢协方差网络和功能网络的中介中心性（BC）。采用曼-惠特尼U检验（使用错误发现率[FDR]进行多重比较校正）评估致痫网络（由默认模式网络[DMN]和丘脑组成）的SUVR、fALFF、BC以及空间体素级SUVR-fALFF耦合的差异。通过Fisher评分选择前十大SUVR-fALFF耦合，使用逻辑回归模型预测手术结果。
结果显示，与健康对照相比，MR-HS患者双侧额中回的SUVR-fALFF耦合降低（=0.0230，=0.0296）。MR-HS患者同侧海马的耦合略有增加（=0.0802），同时代谢协方差网络和功能网络的BC降低（=0.0152；=0.0429）。根据Fisher评分排名，DMN和丘脑亚核区域的前十大SUVR-fALFF耦合可预测手术结果，最佳表现是十种SUVR-fALFF耦合的组合，AUC为0.914。
这些发现表明，致痫网络中神经能量耦合的改变与MTLE患者的手术结果相关，这可能为其发病机制提供见解，并有助于术前评估。
