Department of Neurology, Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Department of Radiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Ann Clin Transl Neurol. 2024 Sep;11(9):2277-2288. doi: 10.1002/acn3.52135. Epub 2024 Aug 16.
This study aims to investigate whether alterations in white matter topological networks are associated with focal to bilateral tonic-clonic seizures (FBTCS) in temporal lobe epilepsy (TLE). Additionally, we investigated the variables contributing to memory impairment in TLE.
This cross-sectional study included 88 unilateral people with TLE (45 left/43 right), and 42 healthy controls. Graph theory analysis was employed to compare the FBTCS (+) group (n = 51) with the FBTCS (-) group (n = 37). The FBTCS (+) group was subcategorized into current-FBTCS (n = 31) and remote-FBTCS (n = 20), based on the history of FBTCS within 1 year or longer than 1 year before scanning, respectively. We evaluated the discriminatory power of topological network properties by receiver operating characteristic (ROC) analysis. Generalized linear models (GLMs) were employed to investigate variables associated with memory impairment in TLE.
Global efficiency (Eg) was significantly reduced in the FBTCS (+) group, especially in the current-FBTCS subgroup. Greater disruption of regional properties in the ipsilateral occipital and temporal association cortices was observed in the FBTCS (+) group. ROC analysis revealed that Eg, normalized characteristic shortest path length, and nodal efficiency of the ipsilateral middle temporal gyrus could distinguish between FBTCS (+) and FBTCS (-) groups. Additionally, GLMs linked the occurrence of current FBTCS with poorer verbal memory outcomes in TLE.
Our study suggests that abnormal networks could be the structural basis of seizure propagation in FBTCS. Strategies aimed at reducing the occurrence of FBTCS could potentially improve the memory outcomes in people with TLE.
本研究旨在探讨白质拓扑网络的改变是否与颞叶癫痫（TLE）中的局灶双侧强直阵挛发作（FBTCS）有关。此外，我们还研究了导致 TLE 患者记忆障碍的变量。
这项横断面研究纳入了 88 名单侧 TLE 患者（45 名左侧/43 名右侧）和 42 名健康对照者。采用图论分析比较 FBTCS（+）组（n=51）和 FBTCS（-）组（n=37）。FBTCS（+）组根据发作后 1 年内或 1 年以上的 FBTCS 病史分为当前 FBTCS（n=31）和远期 FBTCS（n=20）亚组。我们通过接受者操作特征（ROC）分析评估拓扑网络性质的鉴别能力。采用广义线性模型（GLM）分析与 TLE 患者记忆障碍相关的变量。
FBTCS（+）组的全局效率（Eg）显著降低，尤其是在当前 FBTCS 亚组中。FBTCS（+）组同侧枕叶和颞叶联合皮质的区域性质破坏更为明显。ROC 分析显示，Eg、标准化特征最短路径长度和同侧颞中回的节点效率可区分 FBTCS（+）和 FBTCS（-）组。此外，GLM 显示当前 FBTCS 的发生与 TLE 患者的言语记忆结果较差相关。
本研究表明异常网络可能是 FBTCS 中发作传播的结构基础。减少 FBTCS 发生的策略可能会改善 TLE 患者的记忆结果。
