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, China.
Research Unit of NeuroInformation (2019RU035), Chinese Academy of Medical Sciences, Chengdu, China.
Epilepsia Open. 2023 Sep;8(3):1038-1048. doi: 10.1002/epi4.12781. Epub 2023 Jul 27.
To investigate potential functional and structural large-scale network disturbances in untreated patients with generalized tonic-clonic seizures (GTCS) and the effects of antiseizure drugs.
In this study, 41 patients with GTCS, comprising 21 untreated patients and 20 patients who received antiseizure medications (ASMs), and 29 healthy controls were recruited to construct large-scale brain networks based on resting-state functional magnetic resonance imaging and diffusion tensor imaging. Structural and functional connectivity and network-level weighted correlation probability (NWCP) were further investigated to identify network features that corresponded to response to ASMs.
Untreated patients showed more extensive enhancement of functional and structural connections than controls. Specifically, we observed abnormally enhanced connections between the default mode network (DMN) and the frontal-parietal network. In addition, treated patients showed similar functional connection strength to that of the control group. However, all patients exhibited similar structural network alterations. Moreover, the NWCP value was lower for connections within the DMN and between the DMN and other networks in the untreated patients; receiving ASMs could reverse this pattern.
Our study identified alterations in structural and functional connectivity in patients with GTCS. The influence of ASMs may be more noticeable within the functional network; moreover, abnormalities in both the functional and structural coupling state may be improved by ASM treatment. Therefore, the coupling state of structural and functional connectivity may be used as an indicator of the efficacy of ASMs.
研究未经治疗的全面性强直-阵挛发作（GTCS）患者潜在的功能和结构的大规模网络紊乱，以及抗癫痫药物的影响。
本研究纳入了 41 名 GTCS 患者，包括 21 名未经治疗的患者和 20 名接受抗癫痫药物（ASMs）治疗的患者，以及 29 名健康对照者，以基于静息态功能磁共振成像和弥散张量成像构建大规模脑网络。进一步研究了结构和功能连接以及网络级加权相关概率（NWCP），以识别与 ASM 反应相关的网络特征。
未经治疗的患者显示出比对照组更广泛的功能和结构连接增强。具体而言，我们观察到默认模式网络（DMN）与额顶叶网络之间异常增强的连接。此外，治疗组患者的功能连接强度与对照组相似。然而，所有患者都表现出相似的结构网络改变。此外，DMN 内和 DMN 与其他网络之间的连接的 NWCP 值在未经治疗的患者中较低；接受 ASM 治疗可以逆转这种模式。
我们的研究确定了 GTCS 患者结构和功能连接的改变。ASMs 的影响在功能网络内可能更为明显；此外，功能和结构连接状态的异常可能通过 ASM 治疗得到改善。因此，结构和功能连接的耦合状态可以作为 ASM 疗效的指标。
