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Patterns of altered functional connectivity in mesial temporal lobe epilepsy
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Patterns of altered functional connectivity in mesial temporal lobe epilepsy

Author: Francesca Pittau Affiliation: Montreal Neurological Institute, McGill University, Montreal, Québec, Canada; Christophe Grova Affiliation: Montreal Neurological Institute, McGill University, Montreal, Québec, Canada; Biomedical Engineering Department, McGill University, Montreal, Québec, Canada; Friederike Moeller Affiliation: Montreal Neurological Institute, McGill University, Montreal, Québec, Canada; François Dubeau Affiliation: Montreal Neurological Institute, McGill University, Montreal, Québec, Canada; Jean Gotman Affiliation: Montreal Neurological Institute, McGill University, Montreal, Québec, Canada
Edition/Format: Article Article : English
Publication:Epilepsia, v53 n6 (June 2012): 1013-1023
Other Databases: WorldCatWorldCatWorldCat
Summary:
Purpose:  In mesial temporal lobe epilepsy (MTLE) the epileptogenic area is confined to the mesial temporal lobe, but other cortical and subcortical areas are also affected and cognitive and psychiatric impairments are usually documented. Functional connectivity methods are based on the correlation of the blood oxygen level dependent (BOLD) signal between brain regions, which exhibit consistent and reproducible functional networks from resting state data. The aim of this study is to compare functional connectivity of patients with MTLE during the interictal period with healthy subjects. We hypothesize that patients show reduced functional connectivity compared to controls, the interest being to determine which regions show this reduction.
Methods:  We selected electroencephalography-functional magnetic resonance imaging (EEG-fMRI) resting state data without EEG spikes from 16 patients with right and 7 patients with left MTLE. EEG-fMRI resting state data of 23 healthy subjects matched for age, sex, and manual preference were selected as controls. Four volumes of interest in the left and right amygdalae and hippocampi (LA, RA, LH, and RH) were manually segmented in the anatomic MRI of each subject. The averaged BOLD time course within each volume of interest was used to detect brain regions with BOLD signal correlated with it. Group differences between patients and controls were estimated.
Key Findings:  In patients with right MTLE, group difference functional connectivity maps (RMTLE − controls) showed for RA and RH decreased connectivity with the brain areas of the default mode network (DMN), the ventromesial limbic prefrontal regions, and contralateral mesial temporal structures; and for LA and LH, decreased connectivity with DMN and contralateral hippocampus. Additional decreased connectivity was found between LA and pons and between LH and ventromesial limbic prefrontal structures. In patients with left MTLE, functional connectivity maps (LMTLE − controls) showed for LA and LH decreased connectivity with DMN, contralateral hippocampus, and bilateral ventromesial limbic prefrontal regions; no change in connectivity was detected for RA; and for RH, there was decreased connectivity with DMN, bilateral ventromesial limbic prefrontal regions, and contralateral amygdala and hippocampus.
Significance:  In unilateral MTLE, amygdala and hippocampus on the affected and to a lesser extent on the healthy side are less connected, and are also less connected with the dopaminergic mesolimbic and the DMNs. Changes in functional connectivity between mesial temporal lobe structures and these structures may explain cognitive and psychiatric impairments often found in patients with MTLE.  Read more...
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Document Type: Article
All Authors / Contributors: Francesca Pittau Affiliation: Montreal Neurological Institute, McGill University, Montreal, Québec, Canada; Christophe Grova Affiliation: Montreal Neurological Institute, McGill University, Montreal, Québec, Canada; Biomedical Engineering Department, McGill University, Montreal, Québec, Canada; Friederike Moeller Affiliation: Montreal Neurological Institute, McGill University, Montreal, Québec, Canada; François Dubeau Affiliation: Montreal Neurological Institute, McGill University, Montreal, Québec, Canada; Jean Gotman Affiliation: Montreal Neurological Institute, McGill University, Montreal, Québec, Canada
ISSN:0013-9580
Language Note: English
Unique Identifier: 5155536989
Notes: Address correspondence to Jean Gotman, Montreal Neurological Institute, McGill University, 3801 University Street, H3A 2B4, Montréal, QC, Canada. E-mail: jean.gotman@mcgill.ca
Accepted February 27, 2012; Early View publication May 11, 2012.
Number of Figures: 3
Number of Tables: 1
Figure S1. Volumetric comparison(mm³) between right and left amygdala and hippocampusfor LMTLE, RMTLE and controls (boxplot representation). In theRMTLE group the RH is smaller than the LH, so the value of thedifference RH-LH is negative. In the LMTLE the LH is smallerthan the RH, so the value of the difference RH-LH ispositive. This difference is smaller in LMTLE. No differences ofvolume were detected for amygdalae. In controls there were nodifferences between amygdalae and hippocampi.
Table S1. Clinical characteristics of the MTLE patients.
Awards:
Other Titles: Functional Connectivity in MTLE
Responsibility: F. Pittau et al.

Abstract:

Purpose:  In mesial temporal lobe epilepsy (MTLE) the epileptogenic area is confined to the mesial temporal lobe, but other cortical and subcortical areas are also affected and cognitive and psychiatric impairments are usually documented. Functional connectivity methods are based on the correlation of the blood oxygen level dependent (BOLD) signal between brain regions, which exhibit consistent and reproducible functional networks from resting state data. The aim of this study is to compare functional connectivity of patients with MTLE during the interictal period with healthy subjects. We hypothesize that patients show reduced functional connectivity compared to controls, the interest being to determine which regions show this reduction.
Methods:  We selected electroencephalography-functional magnetic resonance imaging (EEG-fMRI) resting state data without EEG spikes from 16 patients with right and 7 patients with left MTLE. EEG-fMRI resting state data of 23 healthy subjects matched for age, sex, and manual preference were selected as controls. Four volumes of interest in the left and right amygdalae and hippocampi (LA, RA, LH, and RH) were manually segmented in the anatomic MRI of each subject. The averaged BOLD time course within each volume of interest was used to detect brain regions with BOLD signal correlated with it. Group differences between patients and controls were estimated.
Key Findings:  In patients with right MTLE, group difference functional connectivity maps (RMTLE − controls) showed for RA and RH decreased connectivity with the brain areas of the default mode network (DMN), the ventromesial limbic prefrontal regions, and contralateral mesial temporal structures; and for LA and LH, decreased connectivity with DMN and contralateral hippocampus. Additional decreased connectivity was found between LA and pons and between LH and ventromesial limbic prefrontal structures. In patients with left MTLE, functional connectivity maps (LMTLE − controls) showed for LA and LH decreased connectivity with DMN, contralateral hippocampus, and bilateral ventromesial limbic prefrontal regions; no change in connectivity was detected for RA; and for RH, there was decreased connectivity with DMN, bilateral ventromesial limbic prefrontal regions, and contralateral amygdala and hippocampus.
Significance:  In unilateral MTLE, amygdala and hippocampus on the affected and to a lesser extent on the healthy side are less connected, and are also less connected with the dopaminergic mesolimbic and the DMNs. Changes in functional connectivity between mesial temporal lobe structures and these structures may explain cognitive and psychiatric impairments often found in patients with MTLE.

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Methods:  We selected electroencephalography-functional magnetic resonance imaging (EEG-fMRI) resting state data without EEG spikes from 16 patients with right and 7 patients with left MTLE. EEG-fMRI resting state data of 23 healthy subjects matched for age, sex, and manual preference were selected as controls. Four volumes of interest in the left and right amygdalae and hippocampi (LA, RA, LH, and RH) were manually segmented in the anatomic MRI of each subject. The averaged BOLD time course within each volume of interest was used to detect brain regions with BOLD signal correlated with it. Group differences between patients and controls were estimated.
Key Findings:  In patients with right MTLE, group difference functional connectivity maps (RMTLE − controls) showed for RA and RH decreased connectivity with the brain areas of the default mode network (DMN), the ventromesial limbic prefrontal regions, and contralateral mesial temporal structures; and for LA and LH, decreased connectivity with DMN and contralateral hippocampus. Additional decreased connectivity was found between LA and pons and between LH and ventromesial limbic prefrontal structures. In patients with left MTLE, functional connectivity maps (LMTLE − controls) showed for LA and LH decreased connectivity with DMN, contralateral hippocampus, and bilateral ventromesial limbic prefrontal regions; no change in connectivity was detected for RA; and for RH, there was decreased connectivity with DMN, bilateral ventromesial limbic prefrontal regions, and contralateral amygdala and hippocampus.
Significance:  In unilateral MTLE, amygdala and hippocampus on the affected and to a lesser extent on the healthy side are less connected, and are also less connected with the dopaminergic mesolimbic and the DMNs. Changes in functional connectivity between mesial temporal lobe structures and these structures may explain cognitive and psychiatric impairments often found in patients with MTLE.
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