Resting‐state functional brain networks in adults with a new diagnosis of focal epilepsy

Alonazi, Batil; Keller, Simon S.; Fallon, Nicholas; Adams, V.; Das, Kumar; Marson, Anthony G; Sluming, Vanessa

doi:10.1002/brb3.1168

Cited by 20 publications

(27 citation statements)

References 82 publications

(210 reference statements)

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“…As such, our imaging findings are ‘collapsed’ across patients with likely newly diagnosed nonlesional temporal and frontal lobe epilepsy, which constitutes the vast majority of focal epilepsies. This is an inherent shortcoming of our pragmatic approach, but this is necessary in imaging studies of NDfE [13,44]. The epileptogenic focus could be determined by long‐term follow‐up of newly diagnosed patients who later become refractory, experience many more seizures and be evaluated using a variety of investigative tools.…”

Section: Discussionmentioning

confidence: 99%

Thalamohippocampal atrophy in focal epilepsy of unknown cause at the time of diagnosis

Leek

Neason

Kreilkamp

et al. 2020

Euro J of Neurology

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Background and purposePatients with chronic focal epilepsy may have atrophy of brain structures important for the generation and maintenance of seizures. However, little research has been conducted in patients with newly diagnosed focal epilepsy (NDfE), despite it being a crucial point in time for understanding the underlying biology of the disorder. We aimed to determine whether patients with NDfE show evidence of volumetric abnormalities of subcortical structures.MethodsEighty‐two patients with NDfE and 40 healthy controls underwent magnetic resonance imaging scanning using a standard clinical protocol. Volume estimation of the left and right hippocampus, thalamus, caudate nucleus, putamen and cerebral hemisphere was performed for all participants and normalised to whole brain volume. Volumes lower than two standard deviations below the control mean were considered abnormal. Volumes were analysed with respect to patient clinical characteristics, including treatment outcome 12 months after diagnosis.ResultsVolume of the left hippocampus (p(FDR‐corr) = 0.04) and left (p(FDR‐corr) = 0.002) and right (p(FDR‐corr) = 0.04) thalamus was significantly smaller in patients relative to controls. Relative to the normal volume limits in controls, 11% patients had left hippocampal atrophy, 17% had left thalamic atrophy and 9% had right thalamic atrophy. We did not find evidence of a relationship between volumes and future seizure control or with other clinical characteristics of epilepsy.ConclusionsVolumetric abnormalities of structures known to be important for the generation and maintenance of focal seizures are established at the time of epilepsy diagnosis and are not necessarily a result of the chronicity of the disorder.

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Section: Discussionmentioning

confidence: 99%

Thalamohippocampal atrophy in focal epilepsy of unknown cause at the time of diagnosis

Leek

Neason

Kreilkamp

et al. 2020

Euro J of Neurology

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“…The reasoning for identification and use of these seeds is described in greater detail by the originators of CONN 15 . We performed voxel-wise statistical analysis over the whole brain using an uncorrected level (p < 0.001) before a familywise error rate (FWE) correction was applied at the cluster level (p < 0.05) 21 .…”

Section: Methodsmentioning

confidence: 99%

Resting-state brain functional connectivity in patients with chronic pain who responded to subanesthetic-dose ketamine

Motoyama

Oshiro

Takao

et al. 2019

Sci Rep

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Ketamine has been used to treat chronic pain; however, it is still unknown as to what types of chronic pain is ketamine effective against. To identify the effect of administration of subanesthetic-dose ketamine in patients with chronic pain and to clarify the mechanism of the effect, we retrospectively investigated brain functional connectivity using resting-state functional magnetic resonance imaging (rs-fMRI). Patients were divided into responders (Group R: ≥50% improvement on Numerical Rating Scale) and non-responders (Group NR). We compared the differences in terms of brain functional connectivity by seed-to-voxel correlation analysis. Two-sample t-test revealed significant lower connectivity between the medial prefrontal cortex (mPFC) and precuneus in Group R. We also found a significant negative correlation between the improvement rate and functional connectivity strength between the mPFC and precuneus. These findings suggest that subanesthetic-dose ketamine is effective in patients with chronic pain whose brain functional connectivity between the mPFC and precuneus is low. We believe that the current study explored for the first time the correlation between brain functional connectivity and the effect of subanesthetic-dose ketamine for chronic pain and indicated the possibility of use of the predictive marker in pharmacological treatment of chronic pain.

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“…Taking into account that roughly 2/3 of patients with NDE are expected to achieve 12 months of remission within 2 years21 22 approximately 72 patients with NDE (48/24 patients who achieve/do not achieve remission) and 48 controls are required to detect large effect sizes of 1.2 or above (large effects sizes are supported by our previous findings),23 with power 90% and significance level of 0.001. Given the nature of the study and that a panel of biomarkers will be tested, a low significance level has been chosen to control for the false discovery rate (type I error) 24.…”

Section: Methods and Analysismentioning

confidence: 84%

“…Large-scale functional networks . Using our recently described resting-state analysis techniques,23 we will identify and analyse features of the major resting-state networks, including the fronto-parietal attentional network, default mode network, salience network and language network. All analyses will be performed using the functional connectivity toolbox 47…”

Section: Methods and Analysismentioning

confidence: 99%

Investigating imaging network markers of cognitive dysfunction and pharmacoresistance in newly diagnosed epilepsy: a protocol for an observational cohort study in the UK

et al. 2019

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IntroductionEpilepsy is one of the most common serious brain disorders, characterised by seizures that severely affect a person’s quality of life and, frequently, their cognitive and mental health. Although most existing work has examined chronic epilepsy, newly diagnosed patients present a unique opportunity to understand the underlying biology of epilepsy and predict effective treatment pathways. The objective of this prospective cohort study is to examine whether cognitive dysfunction is associated with measurable brain architectural and connectivity impairments at diagnosis and whether the outcome of antiepileptic drug treatment can be predicted using these measures.Methods and analysis107 patients with newly diagnosed focal epilepsy from two National Health Service Trusts and 48 healthy controls (aged 16–65 years) will be recruited over a period of 30 months. Baseline assessments will include neuropsychological evaluation, structural and functional Magnetic Resonance Imaging (MRI), Electroencephalography (EEG), and a blood and saliva sample. Patients will be followed up every 6 months for a 24-month period to assess treatment outcomes. Connectivity- and network-based analyses of EEG and MRI data will be carried out and examined in relation to neuropsychological evaluation and patient treatment outcomes. Patient outcomes will also be investigated with respect to analysis of molecular isoforms of high mobility group box-1 from blood and saliva samples.Ethics and disseminationThis study was approved by the North West, Liverpool East Research Ethics Committee (19/NW/0384) through the Integrated Research Application System (Project ID 260623). Health Research Authority (HRA) approval was provided on 22 August 2019. The project is sponsored by the UoL (UoL001449) and funded by a UK Medical Research Council (MRC) research grant (MR/S00355X/1). Findings will be presented at national and international meetings and conferences and published in peer-reviewed journals.Trial registration numberIRAS Project ID 260623.

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Resting‐state functional brain networks in adults with a new diagnosis of focal epilepsy

Cited by 20 publications

References 82 publications

Thalamohippocampal atrophy in focal epilepsy of unknown cause at the time of diagnosis

Thalamohippocampal atrophy in focal epilepsy of unknown cause at the time of diagnosis

Resting-state brain functional connectivity in patients with chronic pain who responded to subanesthetic-dose ketamine

Investigating imaging network markers of cognitive dysfunction and pharmacoresistance in newly diagnosed epilepsy: a protocol for an observational cohort study in the UK

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