Longitudinal alterations of cortical structural-functional coupling in temporal lobe epilepsy.

Area of Science:

• Neuroimaging
• Epilepsy research
• Systems neuroscience

Background:

• Temporal lobe epilepsy (TLE) is a neurological disorder characterized by recurrent seizures originating in the temporal lobe.
• Understanding the underlying neuropathophysiological mechanisms of TLE is crucial for developing effective treatments.

Purpose of the Study:

• To investigate longitudinal changes in cortical structural-functional (SF) coupling in TLE patients over a 2-year period.
• To explore the relationship between SF coupling alterations, brain network organization, and gene expression in TLE.

Main Methods:

• Utilized resting-state functional MRI and diffusion-weighted imaging in 28 TLE patients and 42 healthy controls (HCs).
• Assessed SF coupling at whole-brain, modular, and regional levels, analyzing its alignment with functional connectivity gradients and participation coefficients.
• Correlated longitudinal SF coupling changes with regional TLE-specific gene expression.

Main Results:

• TLE patients displayed higher baseline SF coupling in whole-brain, limbic, and default-mode modules compared to HCs.
• SF coupling increased in visual and dorsal attention modules at follow-up in TLE patients.
• Longitudinal changes in regional SF coupling in TLE patients positively correlated with CUX2 gene expression.

Conclusions:

• Aberrant SF coupling in TLE is associated with macroscale cortical hierarchies and functional segregation.
• Findings suggest a link between SF coupling alterations, gene expression (specifically CUX2), and TLE neuropathophysiology.
• This study enhances the understanding of the complex mechanisms underlying temporal lobe epilepsy.