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Related Concept Videos

Lateralization01:28

Lateralization

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Brain lateralization refers to the division of mental processes and functions between the two hemispheres of the brain, a phenomenon that optimizes neural efficiency and underpins complex abilities in humans. This specialization allows each hemisphere to perform tasks where it has a comparative advantage, facilitating more refined cognitive capabilities across different domains.
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Network Analysis of the Default Mode Network Using Functional Connectivity MRI in Temporal Lobe Epilepsy
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Functional connectivity between mesial temporal and default mode structures may help lateralize surgical temporal

Saramati Narasimhan1,2,3,4, Hernán F J González2,3,4, Graham W Johnson2,3,4

  • 11Department of Neurological Surgery and.

Journal of Neurosurgery
|April 1, 2022
PubMed
Summary

Functional MRI connectivity analysis aids in lateralizing mesial temporal lobe epilepsy (mTLE). This method accurately identifies the seizure focus, potentially reducing the need for invasive monitoring and improving surgical planning for epilepsy patients.

Keywords:
SEEGconnectivitydefault mode networkfMRItemporal lobe epilepsy

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Area of Science:

  • Neuroimaging
  • Epilepsy Research
  • Network Neuroscience

Background:

  • Mesial temporal lobe epilepsy (mTLE) is a common surgically treatable epilepsy syndrome.
  • Preoperative lateralization of mTLE is challenging due to rapid seizure spread.
  • Abnormal connectivity in temporal lobe and resting-state networks in mTLE is known, but inter-network connectivity's role in lateralization is unclear.

Purpose of the Study:

  • To investigate if functional MRI (fMRI) connectivity between mesial temporal structures and resting-state networks can aid in lateralizing mesial temporal lobe epilepsy (mTLE).
  • To evaluate the clinical utility of a resting-state connectivity model for lateralizing unilateral mTLE.

Main Methods:

  • Resting-state fMRI data acquired from 52 mTLE patients (left or right) and 52 controls.
  • Functional connectivity evaluated using Pearson correlation, network-based statistic, and dynamic causal modeling.
  • Receiver operating characteristic (ROC) curve analysis used to assess lateralization accuracy.

Main Results:

  • Right mTLE patients showed decreased connectivity between the right hippocampus and default mode network.
  • Network-based statistic identified decreased connectivity in a network including the right hippocampus/amygdala distinguishing left from right mTLE.
  • Dynamic causal modeling showed cross-hemispheric hippocampal/amygdala connectivity directed towards the epileptogenic side.
  • A regression model incorporating connectivity patterns achieved an area under the ROC curve of 0.87 for lateralization.

Conclusions:

  • fMRI connectivity between mesial temporal structures and the default mode network can aid in mTLE lateralization.
  • This approach may reduce the need for intracranial monitoring.
  • Findings can guide surgical planning for mTLE patients.