Boddeti Ujwal, Farooque Pue, McGrath Hari, Percy Jennifer, Chishti Omar, Duckrow Robert B, Spencer Dennis, Zaveri Hitten P, Ksendzovsky Alexander
Surgical Neurology Branch, NINDS, National Institutes of Health, Bethesda, MD, 20892, USA.
Department of Neurosurgery, University of Maryland School of Medicine, 670 W Baltimore St, HSF3, Rm 9110, Baltimore, MD, 21201, USA.
Sci Rep. 2025 Mar 17;15(1):9106. doi: 10.1038/s41598-025-93978-3.
Over the last two decades, it has become increasingly clear that epilepsy is a network disorder. However, it is unclear whether these networks are established only during seizures or persist interictally. The goal of this study was to identify whether functional seizure networks exist interictally and evaluate if there is a structural basis to these networks. We identified four patients with mesial temporal lobe epilepsy who underwent resective epilepsy surgery. We estimated functional and structural connectivity across intracranial electrode contacts involved in seizure onset, early spread, and uninvolved controls. Across all interictal epochs considered, we found higher functional and white matter connectivity across cortical regions involved in seizure spread. Additionally, we observed that the patient in our cohort with the best seizure outcome had the highest functional connectivity across seizure contacts. Functional connectivity findings suggest the presence of an interictal seizure network that parallels underlying structural connectivity. Furthermore, our findings suggest that disruption or ablation of highly connected seizure regions may be necessary to achieve improved post-operative seizure freedom.
在过去二十年里，越来越清楚的是癫痫是一种网络障碍。然而，尚不清楚这些网络是仅在癫痫发作期间形成，还是在发作间期持续存在。本研究的目的是确定发作间期是否存在功能性癫痫发作网络，并评估这些网络是否有结构基础。我们确定了四名接受切除性癫痫手术的内侧颞叶癫痫患者。我们估计了涉及癫痫发作起始、早期传播的颅内电极触点以及未受累对照之间的功能和结构连通性。在所有考虑的发作间期时段中，我们发现在涉及癫痫传播的皮质区域之间存在更高的功能和白质连通性。此外，我们观察到我们队列中癫痫发作结果最佳的患者在癫痫发作触点之间具有最高的功能连通性。功能连通性研究结果表明存在一个与潜在结构连通性平行的发作间期癫痫发作网络。此外，我们的研究结果表明，可能有必要破坏或切除高度连通的癫痫发作区域，以实现术后更好的无癫痫发作状态。
