Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Huaxi MR Research Center, Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Neuroimage Clin. 2023;40:103536. doi: 10.1016/j.nicl.2023.103536. Epub 2023 Nov 3.
The purpose of this study was to assess the differences of topological characteristic and rich club organization between temporal lobe epilepsy (TLE) patients with focal seizure (FS) only and those with focal to bilateral tonic-clonic seizures (FBTCS).
We recruited 130 unilateral TLE patients, of which 57 patients with FS only and 73 patients with both FS and FBTCS, and 68 age- and gender-matched healthy controls (HC). Whole-brain networks were constructed based on diffusion weighted imaging data. Graph theory was applied to quantify the topological network metrics and rich club organization. Network-based statistic (NBS) analysis was administered to investigate the difference in edge-wise connectivity strength. The non-parametric permutation test was applied to evaluate the differences between groups. Benjamini-Hochberg FDR at the alpha of 5% was carried out for multiple comparations.
In comparison with HC, both the FS and FBTCS group displayed a significant reduction in whole-brain connectivity strength and global efficiency. The FBTCS group showed lower connectivity strength both in the rich club and feeder connections compared to HC. The FS group had lower connectivity strength in the feeder and local connections compared to HC. NBS analysis revealed a wider range of decreased connectivity strength in the FBTCS group, involving 90% of the rich club regions, mainly affecting temporal-subcortical, frontal-parietal, and frontal-temporal lobe, the majority decreasing connections were between temporal lobe and stratum. While the decreased connectivity strength in the FS group were relatively local, involving 50% of rich club regions, mainly concentrated on the temporal-subcortical lobe.
Network integration was reduced in TLE. TLE with FBTCS selectively disrupted the rich club regions, while TLE with FS only were more likely to affect the non-rich club regions, emphasizing the contribution of rich club organization to seizure generalization.
本研究旨在评估仅局灶性发作（FS）的颞叶癫痫（TLE）患者与既有 FS 又有双侧强直-阵挛发作（FBTCS）的 TLE 患者之间，颞叶网络拓扑特征和富俱乐部组织的差异。
我们招募了 130 名单侧 TLE 患者，其中 57 名患者仅出现 FS，73 名患者同时出现 FS 和 FBTCS，以及 68 名年龄和性别匹配的健康对照者（HC）。基于弥散加权成像数据构建全脑网络。采用图论方法量化拓扑网络指标和富俱乐部组织。实施网络基态统计（NBS）分析以研究边缘连接强度的差异。采用非参数置换检验进行组间差异评估。采用 Benjamini-Hochberg FDR 方法对多重比较进行校正，设定 alpha 值为 5%。
与 HC 相比，FS 和 FBTCS 组的全脑连接强度和全局效率均显著降低。FBTCS 组的富俱乐部和馈送连接的连接强度均低于 HC。FS 组的馈送和局部连接的连接强度均低于 HC。NBS 分析显示 FBTCS 组的连接强度降低范围更广，涉及 90%的富俱乐部区域，主要影响颞叶-皮质下、额顶叶和额颞叶，大部分降低的连接发生在颞叶与纹状体之间。而 FS 组的连接强度降低相对局限，涉及 50%的富俱乐部区域，主要集中在颞叶-皮质下区域。
TLE 患者的网络整合减少。FBTCS 相关 TLE 选择性破坏富俱乐部区域，而仅 FS 的 TLE 更可能影响非富俱乐部区域，强调富俱乐部组织对发作泛化的贡献。
