Abstract

Functional connectivity has been correlated with a patient's level of consciousness and has been found to be altered in several neuropsychiatric disorders. Absence epilepsy patients, who experience a loss of consciousness, are assumed to suffer from alterations in thalamocortical networks; however, previous studies have not explored the changes at a functional module level. We used resting-state functional magnetic resonance imaging to examine the alteration in functional connectivity that occurs in absence epilepsy patients. By parcellating the brain into 90 brain regions/nodes, we uncovered an altered functional connectivity within and between functional modules. Some brain regions had a greater number of altered connections and therefore behaved as key nodes in the changed network pattern; these regions included the superior frontal gyrus, the amygdala, and the putamen. In particular, the superior frontal gyrus demonstrated both an increased value of connections with other nodes of the frontal default mode network and a decreased value of connections with the limbic system. This divergence is positively correlated with epilepsy duration. These findings provide a new perspective and shed light on how functional connectivity and the balance of within/between module connections may contribute to both the state of consciousness and the development of absence epilepsy.

Highlights

  • Absence epilepsy is characterized by brief episodes of impaired consciousness that last 2–10 s and that are associated with bursting bilateral and symmetrical electroencephalography (EEG) discharges consisting of 2.5–5 Hz spike-andwave complexes on a normal background [1]

  • We found that absence epilepsy (AE) patients demonstrated an alteration in several functional links and that there was a significant divergence of functional connectivity within and between brain modules

  • We found that frontal nodes of the default mode network (DMN) showed increased connections within the DMN module and decreased connections to limbic system of AE patients

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Summary

Introduction

Absence epilepsy is characterized by brief episodes of impaired consciousness that last 2–10 s and that are associated with bursting bilateral and symmetrical electroencephalography (EEG) discharges consisting of 2.5–5 Hz spike-andwave complexes on a normal background [1] These spikeand-wave discharges (SWDs) begin and end abruptly [2], and the accompanying behavioral changes have been thoroughly investigated [3]. A model suggests that these discharges may be generated by oscillations between the thalamus and a slightly hyperexcitable cortex and depend on long-range corticothalamic and corticocortical network interactions [4] This model has been supported by previous studies which combined functional magnetic resonance imaging (fMRI) with simultaneous EEG recordings [5] and found an increased bilateral fMRI BOLD response in the thalamus and decreases in cortical areas (including the frontal and parietal cortices).

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