Abstract：
Epilepsy is increasingly recognised as a brain network disorder and many studies have investigated functional connectivity (FC) in children with epilepsy using functional MRI (fMRI). This systematic review of fMRI studies, published up to November 2023, investigated profiles of FC changes and their clinical relevance in children with focal epilepsy compared to healthy controls. A literature search in PubMed and Web of Science yielded 62 articles. We categorised the results into three groups: 1) differences in correlation-based FC between patients and controls; 2) differences in other FC measures between patients and controls; and 3) associations between FC and disease variables (for example, age of onset), cognitive and seizure outcomes. Studies revealed either increased or decreased FC across multiple brain regions in children with focal epilepsy. However, findings lacked consistency: conflicting FC alterations (decreased and increased FC) co-existed within or between brain regions across all focal epilepsy groups. The studies demonstrated overall that 1) interhemispheric connections often displayed abnormal connectivity and 2) connectivity within and between canonical functional networks was decreased, particularly for the default mode network. Focal epilepsy disrupted FC in children both locally (e.g., seizure-onset zones, or within-brain subnetworks) and globally (e.g., whole-brain network architecture). The wide variety of FC study methodologies limits clinical application of the results. Future research should employ longitudinal designs to understand the evolution of brain networks during the disease course and explore the potential of FC biomarkers for predicting cognitive and postsurgical seizure outcomes.
摘要：
癫痫越来越被认为是一种脑网络障碍，许多研究已经使用功能MRI（fMRI）研究了癫痫儿童的功能连接（FC）。这篇系统的fMRI研究综述，截至2023年11月发表的文章研究了局灶性癫痫患儿与健康对照组相比的FC变化及其临床相关性.在PubMed和WebofScience上进行的文献检索得出了62篇文章。我们将结果分为三组：1）患者和对照组之间基于相关性的FC的差异；2）患者和对照组之间其他FC测量的差异；以及3）FC和疾病变量之间的关联（例如，发病年龄)，认知和癫痫发作结果。研究表明，局灶性癫痫患儿的多个大脑区域的FC增加或减少。然而,研究结果缺乏一致性:在所有局灶性癫痫组的脑区内或脑区之间共存有冲突的FC改变(FC减少和增加).研究表明，总体而言，1）半球间连接经常显示出异常的连通性，2）规范功能网络内部和之间的连通性下降，特别是对于默认模式网络。局灶性癫痫在儿童中局部扰乱了FC(例如，癫痫发作区，或脑内子网)和全局(例如，全脑网络体系结构)。FC研究方法的多样性限制了结果的临床应用。未来的研究应该采用纵向设计来了解疾病过程中脑网络的演变，并探索FC生物标志物预测认知和手术后癫痫发作结果的潜力。
