Presurgical hyperconnectivity of the ablation volume is associated with seizure-freedom after magnetic resonance-guided laser interstitial thermal therapy
| Autor: | Prasanna Jayakar, Shaina Sedighim, Ann Hyslop, Nolan Altman, Iahn Cajigas, Santiago Medina, Aria Fallah, Benjamin R. Morgan, Byron Bernal, Alexander G. Weil, Walter J. Jermakowicz, John Ragheb, Evan Cole Lewis, George M. Ibrahim, Ian Miller, Simeon M. Wong, Nathan Schoen, Priya Sharma, Sanjiv Bhatia, Esperanza Pacheco-Jacome, Mirriam Mikhail, Carolina Sandoval-Garcia, Magno R. Guillen |
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| Rok vydání: | 2018 |
| Předmět: |
Male
0301 basic medicine Drug Resistant Epilepsy medicine.medical_specialty Adolescent Rest medicine.medical_treatment Neurosurgical Procedures Young Adult 03 medical and health sciences Epilepsy 0302 clinical medicine Laser Interstitial Thermal Therapy Monitoring Intraoperative Neural Pathways Image Processing Computer-Assisted medicine Humans Child medicine.diagnostic_test Resting state fMRI business.industry Functional connectivity Hyperconnectivity Magnetic resonance imaging General Medicine Seizure freedom medicine.disease Ablation Magnetic Resonance Imaging Treatment Outcome 030104 developmental biology Neurology Female Laser Therapy Neurology (clinical) Radiology business 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Seizure. 61:89-93 |
| ISSN: | 1059-1311 |
| DOI: | 10.1016/j.seizure.2018.08.006 |
| Popis: | Magnetic Resonance-guided Laser Interstitial Thermal Therapy (MRgLITT) is an emerging minimally-invasive alternative to resective surgery for medically-intractable epilepsy. The precise lesioning effect produced by MRgLITT supplies opportunities to glean insights into epileptogenic regions and their interactions with functional brain networks. In this exploratory analysis, we sought to characterize associations between MRgLITT ablation zones and large-scale brain networks that portended seizure outcome using resting-state fMRI.Presurgical fMRI and intraoperatively volumetric structural imaging were obtained, from which the ablation volume was segmented. The network properties of the ablation volume within the brain's large-scale brain networks were characterized using graph theory and compared between children who were and were not rendered seizure-free.Of the seventeen included children, five achieved seizure freedom following MRgLITT. Greater functional connectivity of the ablation volume to canonical resting-state networks was associated with seizure-freedom (p 0.05, FDR-corrected). The ablated volume in children who subsequently became seizure-free following MRgLITT had significantly greater strength, and eigenvector centrality within the large-scale brain network.These findings provide novel insights into the interaction between epileptogenic cortex and large-scale brain networks. The association between ablation volume and resting-state networks may supply novel avenues for presurgical planning and patient stratification. |
| Databáze: | OpenAIRE |
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