Abstract
Background: We compared resting-state functional connectivity (RSFC) among limbic and temporal lobe regions between patients with medial temporal lobe epilepsy (mTLE) and healthy control subjects to identify imaging evidence of functional networks related to seizure frequency, age of seizure onset, and duration of epilepsy.Methods: Twelve patients with drug-resistant, unilateral medial temporal lobe epilepsy and 12 healthy control subjects matched for age, sex, and handedness participated in the imaging experiments. We used network-based statistics to compare functional connectivity graphs in patients with mTLE and healthy controls to investigate the relationship between functional connectivity abnormalities and seizure frequency.Results: Among mTLE patients, we found functional network abnormalities throughout the limbic system, but primarily in the hemisphere ipsilateral to the seizure focus. The RSFCs between ipsilateral hypothalamus and ventral anterior cingulate cortex and between ipsilateral subiculum and contralateral posterior cingulate cortex were highly correlated with seizure frequency.Discussion: These findings suggest that in mTLE, changes in limbic networks ipsilateral to the epileptic focus are common. The pathological changes in connectivity between cingulate cortex, hypothalamus and subiculum ipsilateral to the seizure focus were correlated with increased seizure frequency.
Highlights
The limbic system of the brain is a complex network of structurally and functionally linked anatomic regions [1]
Using network-based statistics, we identified connectivity changes associated with medial temporal lobe epilepsy (mTLE) and with seizure frequency in mTLE
resting-state functional connectivity (RS FC) within the limbic system decreased in mTLE, more so than limbic—temporal connectivity
Summary
The limbic system of the brain is a complex network of structurally and functionally linked anatomic regions [1]. Among its components are areas in anteromedial temporal lobe including the amygdala, hippocampal complex, and entorhinal cortex, as well as the cingulate cortex. These areas are interconnected with each other via the thalamus ( the anterior thalamic and medial dorsal nuclear groups as well as the midline thalamic nuclear group), and project to the hypothalamus and midbrain, and anteromedial temporal lobe. Given the role of the limbic system in long-term recall and in emotion, it has been postulated that the high prevalence of memory, mood, and affective symptoms among patients with mTLE correlates with a disruption of normal limbic function [5,6,7]. We compared resting-state functional connectivity (RSFC) among limbic and temporal lobe regions between patients with medial temporal lobe epilepsy (mTLE) and healthy control subjects to identify imaging evidence of functional networks related to seizure frequency, age of seizure onset, and duration of epilepsy
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