绘制耐药性局灶性皮质发育不良相关癫痫的功能连接特征。

IF 8.1 1区 医学 Q1 CLINICAL NEUROLOGY Annals of Neurology Pub Date : 2024-08-27 DOI:10.1002/ana.27069
Hua Xie, Venkata Sita Priyanka Illapani, L Gilbert Vezina, Taha Gholipour, Chima Oluigbo, William D Gaillard, Nathan T Cohen
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引用次数: 0

摘要

目的利用静息态功能磁共振成像(rsfMRI)的功能连接分析,确定局灶性皮质发育不良耐药癫痫(FCD-PRE)的常见网络改变:这是2011年1月至2022年1月期间美国华盛顿特区儿童国立医院(Children's National Hospital)的回顾性成像队列。经 3-T 磁共振成像证实为 FCD-PRE 的患者接受了 rsfMRI 作为常规临床治疗的一部分。扫描时患者年龄为 5-22 岁,随访时间至少为 18 个月。健康、发育正常的对照组来自国立儿童医院(n = 16),匹配组来自人类连接组计划-发育公共数据集(n = 100):共纳入了42名FCD-PRE患者(20名男性:22名女性,年龄为14.2 ± 4.1岁)和116名健康对照组(56名男性:60名女性,年龄为13.7 ± 3.3岁)的rsfMRI。每个 FCD 都生成了基于种子的功能连接图,每个种子用于生成 116 个对照组的特定患者 z 评分连接图。FCD-PRE患者在背侧注意、默认模式和控制网络区域的连接性相互改变。功能性连通性在 FCD 优势功能网络内以及同位区域内都有所减弱。不同病理亚型的簇特异性连接模式各不相同。FCD与边缘网络较高的连通性与恩格尔I型结果的几率增加有关:这项研究表明,FCD-PRE的功能连接模式减弱,这可能代表了该疾病的神经标记物,与FCD位置无关,涉及背侧注意、默认模式和控制功能网络。边缘网络的连接性越高,无癫痫发作的结果就越好。未来需要开展多中心、前瞻性研究,以便更早地发现耐药癫痫的特征。ann neurol 2024。
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Mapping Functional Connectivity Signatures of Pharmacoresistant Focal Cortical Dysplasia-Related Epilepsy.

Objective: To determine common network alterations in focal cortical dysplasia pharmacoresistant epilepsy (FCD-PRE) using functional connectivity analysis of resting-state functional magnetic resonance imaging (rsfMRI).

Methods: This is a retrospective imaging cohort from Children's National Hospital (Washington, DC, USA) from January, 2011 to January, 2022. Patients with 3-T MRI-confirmed FCD-PRE underwent rsfMRI as part of routine clinical care. Patients were included if they were age 5-22 years at the time of the scan, and had a minimum of 18 months of follow-up. Healthy, typically-developing controls were included from Children's National Hospital (n = 16) and matched from Human Connectome Project-Development public dataset (n = 100).

Results: A total of 42 FCD-PRE patients (20 M:22 F, aged 14.2 ± 4.1 years) and 116 healthy controls (56 M:60 F, aged 13.7 ± 3.3 years) with rsfMRI were included. Seed-based functional connectivity maps were generated for each FCD, and each seed was used to generate a patient-specific z-scored connectivity map on 116 controls. FCD-PRE patients had mutual altered connectivity in regions of dorsal attention, default mode, and control networks. Functional connectivity was diminished within the FCD dominant functional network, as well as in homotopic regions. Cluster specific connectivity patterns varied by pathological subtype. Higher FCD connectivity to the limbic network was associated with increased odds of Engel I outcome.

Interpretation: This study demonstrates diminished functional connectivity patterns in FCD-PRE, which may represent a neuromarker for the disease, independent of FCD location, involving the dorsal attention, default mode, and control functional networks. Higher connectivity to the limbic network is associated with a seizure-free outcome. Future multicenter, prospective studies are needed to allow for much earlier detection of signatures of treatment-resistant epilepsy. ANN NEUROL 2024.

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来源期刊
Annals of Neurology
Annals of Neurology 医学-临床神经学
CiteScore
18.00
自引率
1.80%
发文量
270
审稿时长
3-8 weeks
期刊介绍: Annals of Neurology publishes original articles with potential for high impact in understanding the pathogenesis, clinical and laboratory features, diagnosis, treatment, outcomes and science underlying diseases of the human nervous system. Articles should ideally be of broad interest to the academic neurological community rather than solely to subspecialists in a particular field. Studies involving experimental model system, including those in cell and organ cultures and animals, of direct translational relevance to the understanding of neurological disease are also encouraged.
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