背景:新的证据表明,颞叶癫痫(TLE)涉及以过度兴奋和其他癫痫发作相关的神经可塑性为代表的网络破坏。然而,这些协会没有很好的特征。我们的研究从前瞻性癫痫Connectome项目研究中,与健康对照(HCs)相比,TLE患者的全脑白质连接体异常。此外,我们评估了异常的白质连接是否与认知障碍和局灶性至双侧强直阵挛性(FBTC)癫痫发作的病史有差异.
方法:使用DESIGNER指南对多壳连接体MRI数据进行预处理。IITDestrieux灰质图谱用于使用MRTrix3导出162×162结构连接矩阵(SCM)。应用了ComBat数据协调来协调扫描仪升级前后的SCM。使用无阈值的基于网络的统计数据对协调的SCM进行统计分析。然后将认知障碍状态和FBTC癫痫发作状态与这些发现相关联。
结果:我们采用了142名受试者的连接体测量,包括92例TLE患者(36例男性,平均年龄=40.1±11.7岁)和50HCs(25名男性,平均年龄=32.6±10.2岁)。我们的分析显示,与对照组相比,TLE组的白质束横截面积(CSA)总体显着减少,表明白质束完整性和连通性异常降低,除了在连通性的图论测量和基于网络的统计方面存在明显差异。局灶性和广泛性认知障碍的TLE患者通过CSA降低显示白质连接体的趋势水平异常高于无认知障碍的患者。具有阳性FBTC癫痫发作史的患者也显示出通过CSA降低的趋势水平相关性。
结论:在TLE患者中观察到广泛的全球异常白质连接组变化,其特征是癫痫发作史和认知障碍,为将来的研究奠定基础,以扩展和验证新型生物标志物,并进一步阐明TLE对脑可塑性的影响。
BACKGROUND: Emerging evidence illustrates that temporal lobe epilepsy (TLE) involves network disruptions represented by hyperexcitability and other seizure-related neural plasticity. However, these associations are not well-characterized. Our study characterizes the whole brain white matter
connectome abnormalities in TLE patients compared to healthy controls (HCs) from the prospective Epilepsy
Connectome Project study. Furthermore, we assessed whether aberrant white matter connections are differentially related to cognitive impairment and a history of focal-to-bilateral tonic-clonic (FBTC) seizures.
METHODS: Multi-shell
connectome MRI data were preprocessed using the DESIGNER guidelines. The IIT Destrieux gray matter atlas was used to derive the 162 × 162 structural connectivity matrices (SCMs) using MRTrix3. ComBat data harmonization was applied to harmonize the SCMs from pre- and post-scanner upgrade acquisitions. Threshold-free network-based statistics were used for statistical analysis of the harmonized SCMs. Cognitive impairment status and FBTC seizure status were then correlated with these findings.
RESULTS: We employed
connectome measurements from 142 subjects, including 92 patients with TLE (36 males, mean age = 40.1 ± 11.7 years) and 50 HCs (25 males, mean age = 32.6 ± 10.2 years). Our analysis revealed overall significant decreases in cross-sectional area (CSA) of the white matter tract in TLE group compared to controls, indicating decreased white matter tract integrity and connectivity abnormalities in addition to apparent differences in graph theoretic measures of connectivity and network-based statistics. Focal and generalized cognitive impaired TLE patients showcased higher trend-level abnormalities in the white matter connectome via decreased CSA than those with no cognitive impairment. Patients with a positive FBTC seizure history also showed trend-level findings of association via decreased CSA.
CONCLUSIONS: Widespread global aberrant white matter
connectome changes were observed in TLE patients and characterized by seizure history and cognitive impairment, laying a foundation for future studies to expand on and validate the novel biomarkers and further elucidate TLE\'s impact on brain plasticity.