论文标题

颅内EEG结构连接耦合预测局灶性癫痫的手术结局

Intracranial EEG structure-function coupling predicts surgical outcomes in focal epilepsy

论文作者

Sinha, Nishant, Duncan, John S., Diehl, Beate, Chowdhury, Fahmida A., de Tisi, Jane, Miserocchi, Anna, McEvoy, Andrew W., Davis, Kathryn A., Vos, Sjoerd B., Winston, Gavin P., Wang, Yujiang, Taylor, Peter N.

论文摘要

在许多神经系统条件下,已经报道了对结构和功能性脑网络的改变。但是,结构和功能之间的关系 - 它们的耦合 - 相对尚未探索,尤其是在干预的背景下。癫痫手术改变了大脑结构和网络,以控制癫痫发作的功能异常。鉴于手术是一种旨在改变功能的结构修饰,我们假设术前更强的结构功能耦合与术后癫痫发作控制更大的机会有关。我们使用颅内脑电图(手术前),结构MRI(手术前后)和扩散MRI(手术前)(手术前)的数据(手术前),使用耐药性局灶性癫痫的39名受试者构建了结构和功能性脑网络。我们使用虚拟手术调查了全球IEEG网络级别的两个空间尺度和b)在两个空间量表的术前结构功能耦合a)在单个IEEG电极触点下进行分辨率。在全球网络水平上,无癫痫发作的个体在术前的结构 - 功能耦合都比无癫痫发作的个体具有更强的术前耦合。通过分辨单个IEEG接触,虚拟手术方法提供了互补的信息来定位癫痫发作组织。在预测癫痫发作结果时,结构功能耦合度量比临床属性更为重要,并且他们共同预测了癫痫发作的结果,精度为85%,灵敏度为87%。当结构功能功能耦合很强时,由手术引起的结构变化转化为控制癫痫发作的基本假设是有效的。绘制有助于使用虚拟手术的结构功能耦合的区域可能有助于手术计划。

Alterations to structural and functional brain networks have been reported across many neurological conditions. However, the relationship between structure and function -- their coupling -- is relatively unexplored, particularly in the context of an intervention. Epilepsy surgery alters the brain structure and networks to control the functional abnormality of seizures. Given that surgery is a structural modification aiming to alter the function, we hypothesized that stronger structure-function coupling preoperatively is associated with a greater chance of post-operative seizure control. We constructed structural and functional brain networks in 39 subjects with medication-resistant focal epilepsy using data from intracranial EEG (pre-surgery), structural MRI (pre-and post-surgery), and diffusion MRI (pre-surgery). We investigated pre-operative structure-function coupling at two spatial scales a) at the global iEEG network level and b) at the resolution of individual iEEG electrode contacts using virtual surgeries. At global network level, seizure-free individuals had stronger structure-function coupling pre-operatively than those that were not seizure-free regardless of the choice of interictal segment or frequency band. At the resolution of individual iEEG contacts, the virtual surgery approach provided complementary information to localize epileptogenic tissues. In predicting seizure outcomes, structure-function coupling measures were more important than clinical attributes, and together they predicted seizure outcomes with an accuracy of 85% and sensitivity of 87%. The underlying assumption that the structural changes induced by surgery translate to the functional level to control seizures is valid when the structure-functional coupling is strong. Mapping the regions that contribute to structure-functional coupling using virtual surgeries may help aid surgical planning.

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