Abstract

Abnormal neural activity may facilitate seizure spread and symptom manifestation in epilepsy1. Epilepsy is defined as non-lesional (NLE) when a structural lesion cannot be localized via standard neuroimaging2. NLE is known to have worse response to surgery compared to epilepsy with detected lesions3,4. We examined whether patient resting-state fMRI (rsfMRI) can detect functional connectivity (FC) metric alterations in the onset zone (OZ) and early spread zone (ESZ) in NLE. These metrics consist of amplitude of low-frequency fluctuations (ALFF) and fractional ALFF (fALFF), measures of intensity in fMRI-relevant frequency bands; regional homogeneity (ReHo), a measure of local synchronicity; degree of centrality (DoC), a measure of voxel connectivity; and voxel-mirrored homotopic connectivity (VMHC), a measure of synchronicity with the analogous voxel in the contralateral hemisphere5-11. We aimed to see whether noninvasive imaging techniques can uncover alterations in seizure-related regions.

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