Paper Info
Title
Seizure Frequency Is Associated With Effective Connectivity Of The Hippocampal-Diencephalic-Cingulate In Epilepsy With Unilateral Mesial Temporal Sclerosis
Abstract
Background: Temporal lobe epilepsy (TLE) with mesial temporal sclerosis (MTS) is a common intractable epilepsy. To seek neural correlates of seizure recurrence, this study investigated aberrant intrinsic effective connectivity (iEC) in TLE with unilateral MTS and their associations with seizure frequency.Methods: Thirty patients with unilateral MTS (left/right MTS = 14/16) and 37 age-matched healthy controls underwent resting-state functional magnetic resonance imaging (rsfMRI) on a 3-Tesla magnetic resonance imaging (MRI) system. The structural equation modeling was employed to estimate the iEC of the three candidate epilepsy models, including the Papez circuit, hippocampal-diencephalic-cingulate (HDC) model, and simplified HDC model. After comparing the performance of model fitting, the best model was selected to compare iEC among the study groups. The linear regression analysis was performed to associate abnormal iEC with seizure frequency.Results: The simplified HDC model was the best model to estimate iEC across the three study groups (p < 0.05), and it composed of the 26 interconnected pathway between the mesial temporal lobe, thalamus, and cingulate cortices. The linear regression analysis revealed a significant relationship between the shared iEC alterations in both patient groups and seizure frequency (adjusted-R-2 = 0.350; p = 0.037), including the three paths of mammillary body (MB) -> bilateral anterior thalamic nuclei (left: standardized beta-value = 0.580, p = 0.013; right: standardized beta-value = -0.711, p = 0.006) and right hippocampus -> MB (standardized beta-value = 0.541, p = 0.045).Conclusions: Our findings provide new insights into neurophysiological significance relevant to seizure recurrence. Aberrant iEC on the neural paths connected to the MB can be a potential imaging marker, aiding the therapeutic management in TLE with unilateral MTS.
Year
DOI
Venue
2021
10.1089/brain.2020.0835
BRAIN CONNECTIVITY
Keywords
DocType
Volume
effective connectivity, Papez circuit, resting-state functional magnetic resonance imaging, seizure frequency, temporal lobe epilepsy
Journal
11
Issue
ISSN
Citations 
6
2158-0014
0
PageRank 
References 
Authors
0.34
0
4
Name
Order
Citations
PageRank
Yao-Chia Shih100.34
Fa-Hsuan Lin224624.33
Horng-Huei Liou300.34
Wen-Yih Isaac Tseng422327.33