The network is more important than the node: stereo-EEG evidence of neurocognitive networks in epilepsy.

Autor:	Murray NWG; School of Psychological Sciences, Macquarie University, Sydney, Australia.; Westmead Comprehensive Epilepsy Centre, The University of Sydney, Sydney, Australia., Kneebone AC; School of Psychology, University of Queensland, Brisbane, Australia.; Department of Neurology and Stroke, Flinders Medical Centre, Adelaide, Australia., Graham PL; School of Mathematical and Physical Sciences, Macquarie University, Sydney, Australia., Wong CH; Westmead Comprehensive Epilepsy Centre, The University of Sydney, Sydney, Australia., Savage G; School of Psychological Sciences, Macquarie University, Sydney, Australia., Gillinder L; Advanced Epilepsy Unit, The Mater Hospital, Brisbane, Australia., Fong MWK; Westmead Comprehensive Epilepsy Centre, The University of Sydney, Sydney, Australia.; Comprehensive Epilepsy Center, Department of Neurology, Yale University School of Medicine, New Haven, CT, United States.
Jazyk:	angličtina
Zdroj:	Frontiers in network physiology [Front Netw Physiol] 2024 Jul 24; Vol. 4, pp. 1424004. Date of Electronic Publication: 2024 Jul 24 (Print Publication: 2024).
DOI:	10.3389/fnetp.2024.1424004
Abstrakt:	Introduction: Neuropsychological assessment forms an integral part of the presurgical evaluation for patients with medically refractory focal epilepsy. Our understanding of cognitive impairment in epilepsy is based on seminal lesional studies that have demonstrated important structure-function relationships within the brain. However, a growing body of literature demonstrating heterogeneity in the cognitive profiles of patients with focal epilepsy (e.g., temporal lobe epilepsy; TLE) has led researchers to speculate that cognition may be impacted by regions outside the seizure onset zone, such as those involved in the interictal or "irritative" network. Methods: Neuropsychological data from 48 patients who underwent stereoelectroencephalography (SEEG) monitoring between 2012 and 2023 were reviewed. Patients were categorized based on the site of seizure onset, as well as their irritative network, to determine the impact of wider network activity on cognition. Neuropsychological data were compared with normative standards (i.e., z = 0), and between groups. Results: There were very few distinguishing cognitive features between patients when categorized based purely on the seizure onset zone (i.e., frontal lobe vs. temporal lobe epilepsy). In contrast, patients with localized irritative networks (i.e., frontal or temporal interictal epileptiform discharges [IEDs]) demonstrated more circumscribed profiles of impairment compared with those demonstrating wider irritative networks (i.e., frontotemporal IEDs). Furthermore, the directionality of propagation within the irritative network was found to influence the manifestations of cognitive impairment. Discussion: The findings suggest that neuropsychological assessment is sensitive to network activity beyond the site of seizure onset. As such, an overly focal interpretation may not accurately reflect the distribution of the underlying pathology. This has important implications for presurgical work-up in epilepsy, as well as subsequent surgical outcomes. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2024 Murray, Kneebone, Graham, Wong, Savage, Gillinder and Fong.)
Databáze:	MEDLINE
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