Abstract
Brain functions do not arise from isolated brain regions, but from interactions in widespread networks necessary for both normal and pathological conditions. These Intrinsic Connectivity Networks (ICNs) support cognitive processes such as language, memory, or executive functions, but can be disrupted by epileptic activity. Simultaneous EEG-fMRI can help explore the hemodynamic changes associated with focal or generalized epileptic discharges, thus providing information about both transient and non-transient impairment of cognitive networks related to spatio-temporal overlap with epileptic activity. In the following review, we discuss the importance of interictal discharges and their impact on cognition in different epilepsy syndromes. We explore the cognitive impact of interictal activity in both animal models and human connectivity networks in order to confirm that this effect could have a possible clinical impact for prescribing medication and characterizing post-surgical outcome. Future work is needed to further investigate electrophysiological changes, such as amplitude/latency of single evoked responses or spontaneous epileptic activity in either scalp or intracranial EEG and determine its relative change in hemodynamic response with subsequent network modifications.
Highlights
Epilepsy cannot be reduced solely to the dysfunction of the seizure onset zone (SOZ), as more widespread abnormalities can be seen, resulting in heterogeneous deficits across cognitive domains [1,2,3,4,5,6]
EEG-fMRI is classically used to estimate the localization of the epileptogenic zone in the context of presurgical investigation of epilepsies [28,29,30,31], and only a few studies have used EEG-fMRI to investigate the direct effect of epileptic activity on cognition [22, 32]
Dynamic Functional Connectivity (FC) and Children change during seizure onset and between the thalamus and graph theory metrics offset in the Default Mode Network (DMN) and thalamus DMN, which gradually networks?
Summary
Epilepsy cannot be reduced solely to the dysfunction of the seizure onset zone (SOZ), as more widespread abnormalities can be seen, resulting in heterogeneous deficits across cognitive domains [1,2,3,4,5,6]. This supports the view that epilepsy is a network disease associated with complex cognitive deficits [7,8,9,10,11]. EEG-fMRI is classically used to estimate the localization of the epileptogenic zone in the context of presurgical investigation of epilepsies [28,29,30,31], and only a few studies have used EEG-fMRI to investigate the direct effect of epileptic activity on cognition [22, 32]
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