Mapping Functional Connectivity Signatures of Pharmacoresistant Focal Cortical Dysplasia-Related Epilepsy

Authors

Hua Xie, Center for Neuroscience Research, Children's National Hospital, The George Washington University School of Medicine, Washington, DC, USA.
Venkata Sita Illapani, Center for Neuroscience Research, Children's National Hospital, The George Washington University School of Medicine, Washington, DC, USA.
L Gilbert Vezina, Center for Neuroscience Research, Children's National Hospital, The George Washington University School of Medicine, Washington, DC, USA.
Taha Gholipour, Department of Neurosciences, University of California San Diego, San Diego, CA, USA.
Chima Oluigbo, Center for Neuroscience Research, Children's National Hospital, The George Washington University School of Medicine, Washington, DC, USA.
William D. Gaillard, Center for Neuroscience Research, Children's National Hospital, The George Washington University School of Medicine, Washington, DC, USA.
Nathan T. Cohen, Center for Neuroscience Research, Children's National Hospital, The George Washington University School of Medicine, Washington, DC, USA.

Document Type

Journal Article

Publication Date

8-27-2024

Journal

Annals of neurology

DOI

10.1002/ana.27069

Abstract

OBJECTIVE: To determine common network alterations in focal cortical dysplasia pharmacoresistant epilepsy (FCD-PRE) using functional connectivity analysis of resting-state functional magnetic resonance imaging (rsfMRI). METHODS: This is a retrospective imaging cohort from Children's National Hospital (Washington, DC, USA) from January, 2011 to January, 2022. Patients with 3-T MRI-confirmed FCD-PRE underwent rsfMRI as part of routine clinical care. Patients were included if they were age 5-22 years at the time of the scan, and had a minimum of 18 months of follow-up. Healthy, typically-developing controls were included from Children's National Hospital (n = 16) and matched from Human Connectome Project-Development public dataset (n = 100). RESULTS: A total of 42 FCD-PRE patients (20 M:22 F, aged 14.2 ± 4.1 years) and 116 healthy controls (56 M:60 F, aged 13.7 ± 3.3 years) with rsfMRI were included. Seed-based functional connectivity maps were generated for each FCD, and each seed was used to generate a patient-specific z-scored connectivity map on 116 controls. FCD-PRE patients had mutual altered connectivity in regions of dorsal attention, default mode, and control networks. Functional connectivity was diminished within the FCD dominant functional network, as well as in homotopic regions. Cluster specific connectivity patterns varied by pathological subtype. Higher FCD connectivity to the limbic network was associated with increased odds of Engel I outcome. INTERPRETATION: This study demonstrates diminished functional connectivity patterns in FCD-PRE, which may represent a neuromarker for the disease, independent of FCD location, involving the dorsal attention, default mode, and control functional networks. Higher connectivity to the limbic network is associated with a seizure-free outcome. Future multicenter, prospective studies are needed to allow for much earlier detection of signatures of treatment-resistant epilepsy. ANN NEUROL 2024.

APA Citation

Xie, Hua; Illapani, Venkata Sita; Vezina, L Gilbert; Gholipour, Taha; Oluigbo, Chima; Gaillard, William D.; and Cohen, Nathan T., "Mapping Functional Connectivity Signatures of Pharmacoresistant Focal Cortical Dysplasia-Related Epilepsy" (2024). GW Authored Works. Paper 5426.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/5426

Department

Radiology