| Autor: |
McKavanagh A; Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom.; Department of Neuroradiology, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom., Kreilkamp BAK; Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom.; Department of Neuroradiology, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom.; Department of Neurology, University Medicine Göttingen, Göttingen, Germany., Chen Y; Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom.; Department of Neuroradiology, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom., Denby C; Department of Neuroradiology, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom., Bracewell M; Department of Neuroradiology, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom.; School of Medical Sciences, Bangor University, Bangor, United Kingdom.; School of Psychology, Bangor University, Bangor, United Kingdom., Das K; Department of Neuroradiology, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom., De Bezenac C; Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom.; Department of Neuroradiology, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom., Marson AG; Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom.; Department of Neuroradiology, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom., Taylor PN; CNNP Lab, Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle, United Kingdom., Keller SS; Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom.; Department of Neuroradiology, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom. |
| Abstrakt: |
Introduction: Idiopathic generalized epilepsy (IGE) is a collection of generalized nonlesional epileptic network disorders. Around 20-40% of patients with IGE are refractory to antiseizure medication, and mechanisms underlying refractoriness are poorly understood. Here, we characterize structural brain network alterations and determine whether network alterations differ between patients with refractory and nonrefractory IGE. Methods: Thirty-three patients with IGE (10 nonrefractory and 23 refractory) and 39 age- and sex-matched healthy controls were studied. Network nodes were segmented from T1-weighted images, while connections between these nodes (edges) were reconstructed from diffusion magnetic resonance imaging (MRI). Diffusion networks of fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and streamline count (Count) were studied. Differences between all patients, refractory, nonrefractory, and control groups were computed using network-based statistics. Nodal volume differences between groups were computed using Cohen's d effect size calculation. Results: Patients had significantly decreased bihemispheric FA and Count networks and increased MD and RD networks compared with controls. Alterations in network architecture, with respect to controls, differed depending on treatment outcome, including predominant FA network alterations in refractory IGE and increased nodal volume in nonrefractory IGE. Diffusion MRI networks were not influenced by nodal volume. Discussion: Although a nonlesional disorder, patients with IGE have bihemispheric structural network alterations that may differ between patients with refractory and nonrefractory IGE. Given that distinct nodal volume and FA network alterations were observed between treatment outcome groups, a multifaceted network analysis may be useful for identifying imaging biomarkers of refractory IGE. |
