神经科学
颞叶
功能磁共振成像
连接体
癫痫
白质
心理学
默认模式网络
功能成像
人类连接体项目
认知
灰质
磁共振成像
功能连接
医学
放射科
作者
Ke Xie,Jessica Royer,Sara Larivière,Raúl Rodríguez‐Cruces,Stefan Frässle,Donna Gift Cabalo,Alexander Ngo,Jordan DeKraker,Hans Auer,Shahin Tavakol,Yifei Weng,Chifaou Abdallah,Linda Horwood,Birgit Frauscher,Lorenzo Caciagli,Andrea Bernasconi,Neda Bernasconi,Zhiqiang Zhang,Luis Concha,Boris C. Bernhardt
标识
DOI:10.1101/2023.05.23.541934
摘要
Temporal lobe epilepsy (TLE) is one of the most common pharmaco-resistant epilepsies in adults. While hippocampal pathology is the hallmark of this condition, emerging evidence indicates that brain alterations extend beyond the mesiotemporal epicenter and affect macroscale brain function and cognition. We studied macroscale functional reorganization in TLE, explored structural substrates, and examined cognitive associations. We investigated a multisite cohort of 95 patients with pharmaco-resistant TLE and 95 healthy controls using state-of-the-art multimodal 3T magnetic resonance imaging (MRI). We quantified macroscale functional topographic organization using connectome dimensionality reduction techniques and estimated directional functional flow using generative models of effective connectivity. We observed atypical functional topographies in patients with TLE relative to controls, manifesting as reduced functional differentiation between sensory/motor networks and transmodal systems such as the default mode network, with peak alterations in bilateral temporal and ventromedial prefrontal cortices. TLE-related topographic changes were consistent in all three included sites and reflected reductions in hierarchical flow patterns between cortical systems. Integration of parallel multimodal MRI data indicated that these findings were independent of TLE-related cortical grey matter atrophy, but mediated by microstructural alterations in the superficial white matter immediately beneath the cortex. The magnitude of functional perturbations was robustly associated with behavioral markers of memory function. Overall, this work provides converging evidence for macroscale functional imbalances, contributing microstructural alterations, and their associations with cognitive dysfunction in TLE.
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