Modi Shilpi, Ankeeta A, Hinds Walter, Sperling Michael R, He Xiaosong, Tracy Joseph I
Department of Neurology, Comprehensive Epilepsy Centre, Thomas Jefferson University, Philadelphia, PA, USA.
Department of Psychology, University of Science and Technology of China, Hefei, Anhui, People's Republic of China.
Sci Rep. 2025 Jul 1;15(1):22182. doi: 10.1038/s41598-025-96418-4.
Temporal lobe epilepsy (TLE) is the most common focal epilepsy, with focal to bilateral tonic-clonic seizures (FBTCS+) a more severe form of the disorder. Evidence has underscored the critical role of the thalamus, mesial temporal region, basal ganglia and cerebellum, along with the cortex, in the propagation, termination, and modulation of seizure activity. We examined time variant patterns of interaction within and between 7 cortical and 4 subcortical systems in 55 healthy controls and 56 patients with TLE (n = 40 with FBTCS+ and 15 without), isolating those patterns most distinctive of FBTCS+ utilizing tools from dynamic network neuroscience on inter-ictal resting state fMRI data. A complex set of subcortio-cortico interactions appeared to support the secondary generalization characteristic of FBTCS+ status, specifically integrations involving the caudate and cereb-5 subcortical subsystems with the ventral attention network, suggesting motor and attention system communications are dysregulated. These abnormal subcortico-cortico dynamics were more prominent in current versus a remote history of FBTCS+. We concluded that the inter-ictal state provided a breeding ground for reconfiguring dynamic communication within and between multiple cortical-subcortical systems. These findings broaden our understanding of seizure propagation effects in TLE, pointing toward biomarkers that may mark the transition from focal seizures to the more severe form of TLE (FBTCS +).
颞叶癫痫(TLE)是最常见的局灶性癫痫,而局灶性至双侧强直阵挛发作(FBTCS+)是该疾病更严重的一种形式。有证据强调了丘脑、内侧颞叶区域、基底神经节和小脑以及皮质在癫痫发作活动的传播、终止和调节中的关键作用。我们研究了55名健康对照者和56名TLE患者(其中40名有FBTCS+,15名没有)的7个皮质系统和4个皮质下系统内部以及之间的时变相互作用模式,利用动态网络神经科学工具,根据发作间期静息态功能磁共振成像数据分离出那些最具FBTCS+特征的模式。一组复杂的皮质下-皮质相互作用似乎支持FBTCS+状态的继发性泛化特征,特别是涉及尾状核和脑-5皮质下子系统与腹侧注意网络的整合,这表明运动和注意系统的通信失调。这些异常的皮质下-皮质动态在有FBTCS+近期发作史的患者中比有远期发作史的患者更为突出。我们得出结论,发作间期状态为多个皮质-皮质下系统内部以及之间重新配置动态通信提供了温床。这些发现拓宽了我们对TLE中癫痫发作传播效应的理解,指出了可能标志着从局灶性癫痫发作转变为更严重形式的TLE(FBTCS+)的生物标志物。