Effective connectivity in temporal lobe epilepsy with hippocampal sclerosis

Park, Kang Min; Shin, Kyoungsoon; Ha, Sam Yeol; Park, J.; Kim, T. H.; Mun, Chi-Woong; Lee, B. I.; Kim, S. E.

doi:10.1111/ane.12669

Cited by 14 publications

(16 citation statements)

References 40 publications

(102 reference statements)

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“…There have been several studies showing involvement of the thalamus in patients with TLE with HS, with potential roles in seizure initiation and propagation [25][26][27]. The hippocampus has important reciprocal connections to the thalamus [28].…”

Section: Discussionmentioning

confidence: 99%

Intrinsic hippocampal and thalamic networks in temporal lobe epilepsy with hippocampal sclerosis according to drug response

Lee

Park

2020

Seizure

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The aim of this study was to investigate whether intrinsic hippocampal or thalamic networks in patients with temporal lobe epilepsy (TLE) with hippocampal sclerosis (HS) were different according to antiepileptic drug (AED) response. Methods: We enrolled 80 patients with TLE with HS and 40 healthy controls. Of the patients with TLE with HS, 43 were classified as a drug-resistant epilepsy (DRE) group, whereas 37 patients were enrolled as a drug-controlled epilepsy (DCE) group. We investigated the structural connectivity of the global brain, intrinsic hippocampal, and intrinsic thalamic networks based on structural volumes in the patients with DRE and DCE, and analyzed the differences between them. Results: There were significant alterations of the intrinsic hippocampal network compared with healthy controls. The average degree and the global efficiency were decreased, whereas the characteristic path length was increased in the patients with DRE compared with those in healthy controls. In the patients with DCE, only the small-worldness index was decreased compared with healthy controls. Compared to the patients with DCE, the mean clustering coefficient was increased in the patients with DRE. Conclusion:We found that the intrinsic hippocampal network in patients with TLE with HS was different according to AED response. The patients with DRE had more severe disruptions of the intrinsic hippocampal network than those with DCE compared with healthy controls. These findings suggested that the hippocampal network might be related to AED response and could be a new biomarker of medical outcome in patients with TLE with HS.

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Section: Discussionmentioning

confidence: 99%

Intrinsic hippocampal and thalamic networks in temporal lobe epilepsy with hippocampal sclerosis according to drug response

Lee

Park

2020

Seizure

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“…However, because most of the patients (81%) with MSA-C also showed some degree of vallecular residue, the difference between the two subtypes does not seem to reflect a pathophysiological difference. This seems to be related to the parkinsonian motor symptoms which could appear in MSA-C [9]. It has been reported that nigrostriatal-dopaminergic denervation is observed in patients with MSA-C, without parkinsonian signs [20].…”

Section: Discussionmentioning

confidence: 99%

“…A diagnosis of MSA was made by two designated, experienced neurologists according to the guidelines of the 2nd consensus of the Gilman criteria [9]. During each visit to the outpatient clinic, these neurologists asked the patients whether they had been experiencing any dysphagia symptoms, such as difficulty in swallowing, sensory changes in the oral cavity, difficulty in chewing, and aspiration.…”

Section: Methodsmentioning

confidence: 99%

Characteristics of Early Oropharyngeal Dysphagia in Patients with Multiple System Atrophy

et al. 2018

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Background/Aims: Dysphagia, a symptom of multiple system atrophy (MSA), is a major clinical concern. In this study, we investigate the characteristics of early oropharyngeal dysphagia (OD) in patients with MSA, and the differences between MSA subtypes. Methods: Patients enrolled in the study had previously been diagnosed with MSA at the clinic of the Department of Neurology, and had been referred for a videofluoroscopic swallowing study (VFSS), between 2005 and 2014, to check for dysphagia. The clinical characteristics and VFSS findings were analyzed and compared between the MSA subtypes. Results: This study enrolled 59 patients with MSA (24 men; 31 with MSA-P, 21 with MSA-C, and 7 with MSA-PC). Dysphagia symptoms were mostly limited to aspiration symptoms (90.48%) in patients with MSA-C, while difficulty in swallowing, increased mealtime, and drooling were frequent in those with MSA-P. The most common VFSS finding amongst patients was vallecular residue (n = 53, 89.8%), followed by penetration/aspiration (n = 40, 67.8%), and coating of the pharyngeal wall (n = 39, 66.1%). Comparison analysis between subtypes showed that apraxia and vallecular residue were more frequent and severe in MSA-P than in MSA-C (p = 0.033 and p = 0.010, respectively). Conclusion: Understanding early OD characteristics in patients with MSA and the differences between MSA subtypes could be helpful in managing dysphagia in patients with MSA. Several dysphagia symptoms similar to those of Parkinson disease were frequently observed in MSA-P, but not in MSA-C. A follow-up study is needed to elucidate the natural course of OD in MSA patients and the difference between MSA subtypes.

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“…speech or visual loss) by demonstrating the anatomical relation between epileptogenic foci and functionally activated areas [7]. Conventional task based (tb) fMRI has the capability of defining regions that are anatomically connected and activated during a given task of interest; whereas resting-state (rs) fMRI maps functional connections with their strength and direction by analyzing the baseline spontaneous fluctuations of blood oxygenation level dependent (BOLD) signals throughout the brain, resulting in several cognitive networks [1,[8][9][10]. Laterality index (LI) is an indirect marker for hemispheric dominancy of language and can be calculated from the data driven with tb-fMRI.…”

Section: Introductionmentioning

confidence: 99%

Correlation of language lateralization with resting state hippocampal connectivity in temporal lobe epilepsy patients

Koç¹,

Öner²,

Özer³

et al. 2020

Turk J Med Sci

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Background/aim The main purpose of this study is to evaluate the resting state hippocampal connectivity with language areas and to correlate them with laterality index calculations on single subject basis, hence to present hippocampal lateralization for language with rs-fMRI. Materials and methods Task based and rs-fMRI data were gathered from a total of 45 subjects in 3T scanner. BrainVoyager QX, SPM, and CONN softwares were used for data analysis. LI score of each subject was calculated and converted into normalized LI score (nLI). Intrahemispheric rs-connectivity analysis was performed between hippocampus and Broca’s regions on both sides. Correlation between these variables was measured with SPSS software. Results Right-TLE patients were found to have highest whereas left-TLE group were found to have lowest mean LI scores. Regarding hippocampal-lingual networks; left intrahemispheric connectivity values showed strong positive correlation with nLI values in left, right-TLE patients and healthy controls (P = 0.035, 0.014, 0.047). There were no significant correlation between right intrahemispheric connectivity values and nLI scores in all groups. Conclusion This study seems to depict the existence of resting state hippocampal-lingual functional network which correlates well with lateralization of language function in the left hemisphere in both temporal lobe epilepsy patients and healthy controls.

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Effective connectivity in temporal lobe epilepsy with hippocampal sclerosis

Abstract: The limbic networks of TLE patients with and without HS could be different, and the thalamus might play a critical role in TLE patients with HS.

Cited by 14 publications

References 40 publications

Intrinsic hippocampal and thalamic networks in temporal lobe epilepsy with hippocampal sclerosis according to drug response

Intrinsic hippocampal and thalamic networks in temporal lobe epilepsy with hippocampal sclerosis according to drug response

Characteristics of Early Oropharyngeal Dysphagia in Patients with Multiple System Atrophy

Correlation of language lateralization with resting state hippocampal connectivity in temporal lobe epilepsy patients

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