Lee Dong Ah, Ko Junghae, Kim Sung-Tae, Lee Ho-Joon, Park Kang Min
Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
Epilepsia Open. 2024 Dec;9(6):2408-2418. doi: 10.1002/epi4.13076. Epub 2024 Oct 10.
This study aimed to investigate the differences in structural connectivity and glymphatic system function between patients with temporal lobe epilepsy (TLE) and hippocampal sclerosis (HS) and healthy controls. Additionally, we analyzed the association between structural connectivity, glymphatic system function, and antiseizure medication (ASM) response.
We retrospectively enrolled patients with TLE and HS and healthy controls who underwent diffusion tensor imaging at our hospital. We assessed structural connectivity in patients with TLE and HS and healthy controls by calculating network measures using graph theory and evaluated glymphatic system function using the diffusion tensor image analysis along the perivascular space (DTI-ALPS) index. Patients with TLE and HS were categorized into two groups: ASM poor and good responders.
We enrolled 55 patients with TLE and HS and 53 healthy controls. Of the 55 patients with TLE and HS, 39 were ASM poor responders, and 16 were ASM good responders. The assortativity coefficient in patients with TLE and HS was higher than that in healthy controls (0.004 vs. -0.007, p = 0.004), and the assortativity coefficient in ASM poor responders was lower than that in ASM good responders (-0.001 vs. -0.197, p = 0.003). The DTI-ALPS index in patients with TLE and HS was lower than that in healthy controls (1.403 vs. 1.709, p < 0.001); however, the DTI-ALPS index did not differ between ASM poor and good responders (1.411 vs. 1.385, p = 0.628). The DTI-ALPS index had a significant negative correlation with age in patients with TLE and HS (r = -0.267, p = 0.049).
We confirmed increased assortativity coefficient in structural connectivity and decreased DTI-ALPS index in patients with TLE and HS compared with healthy controls. Additionally, we demonstrated an association between decreased assortativity coefficient in structural connectivity and ASM poor response in patients with TLE patients and HS.
This study investigates the relationship between brain connectivity changes and glymphatic system function with antiseizure medication response in patients with temporal lobe epilepsy and hippocampal sclerosis. The research reveals that these patients show altered brain connectivity and glymphatic function compared to healthy individuals. A key finding is the strong link between a specific connectivity measure (assortativity coefficient) and antiseizure medication response, providing valuable insights that could influence epilepsy treatment and future research directions.
本研究旨在调查颞叶癫痫（TLE）合并海马硬化（HS）患者与健康对照者在结构连接性和类淋巴系统功能方面的差异。此外，我们分析了结构连接性、类淋巴系统功能与抗癫痫药物（ASM）反应之间的关联。
我们回顾性纳入了在我院接受扩散张量成像的TLE合并HS患者以及健康对照者。我们通过使用图论计算网络指标来评估TLE合并HS患者和健康对照者的结构连接性，并使用沿血管周围间隙的扩散张量图像分析（DTI-ALPS）指数评估类淋巴系统功能。TLE合并HS患者被分为两组：ASM反应不佳者和ASM反应良好者。
我们纳入了55例TLE合并HS患者和53名健康对照者。在这55例TLE合并HS患者中，39例为ASM反应不佳者，16例为ASM反应良好者。TLE合并HS患者的聚类系数高于健康对照者（0.004对-0.007，p = 0.004），ASM反应不佳者的聚类系数低于ASM反应良好者（-0.001对-0.197，p = 0.003）。TLE合并HS患者的DTI-ALPS指数低于健康对照者（1.403对1.709，p < 0.001）；然而，ASM反应不佳者和ASM反应良好者之间的DTI-ALPS指数没有差异（1.411对1.385，p = 0.628）。TLE合并HS患者的DTI-ALPS指数与年龄呈显著负相关（r = -0.267，p = 0.049）。
我们证实，与健康对照者相比，TLE合并HS患者的结构连接性聚类系数增加，DTI-ALPS指数降低。此外，我们证明了TLE合并HS患者的结构连接性聚类系数降低与ASM反应不佳之间存在关联。
本研究调查了颞叶癫痫和海马硬化患者的脑连接性变化、类淋巴系统功能与抗癫痫药物反应之间的关系。研究表明，与健康个体相比，这些患者的脑连接性和类淋巴功能发生了改变。一个关键发现是特定连接性指标（聚类系数）与抗癫痫药物反应之间的紧密联系，这为可能影响癫痫治疗和未来研究方向提供了有价值的见解。
