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Altered thalamic connectivity patterns in pediatric temporal lobe epilepsy: A gradient mapping study.

Xiyu Feng1, Hua Xie2, Rory J Piper1,3

  • 1UCL Great Ormond Street Institute of Child Health, London, UK.

Epilepsia
|July 3, 2025
PubMed
Summary
This summary is machine-generated.

Pediatric temporal lobe epilepsy (TLE) shows altered thalamic connectivity, particularly to the basal ganglia and mesial temporal regions. These changes may predict seizure outcomes and suggest new therapeutic targets.

Keywords:
epilepsyfunctional connectivitygradientspediatricthalamus

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Area of Science:

  • Neuroscience
  • Pediatric Neurology
  • Epilepsy Research

Background:

  • The thalamus plays a crucial role in seizure propagation and is a target for neuromodulation in epilepsy.
  • Pediatric temporal lobe epilepsy (TLE) presents unique challenges due to diverse etiologies and impacts on brain maturation.
  • Previous studies on thalamic connectivity changes in TLE have primarily focused on adults.

Purpose of the Study:

  • To investigate whole-brain thalamic connectivity patterns in children with TLE using a novel gradient mapping technique.
  • To compare thalamic connectivity gradients between pediatric TLE patients and healthy controls.
  • To examine associations between thalamic connectivity gradients and clinical factors like seizure history, hippocampal sclerosis, and surgical outcomes.

Main Methods:

  • Functional magnetic resonance imaging (fMRI) was performed on 62 children with TLE (ages 5-18) and 61 controls (ages 6-20) during a covert verb generation task.
  • Thalamic connectivity gradients were computed to identify primary axes of variation.
  • Statistical comparisons were made between groups, and correlations with clinical variables were analyzed.

Main Results:

  • Two primary thalamic connectivity gradients were identified: an anterior-posterior axis (G1) and a superior-inferior axis (G2).
  • Children with TLE exhibited increased thalamic connectivity to the bilateral basal ganglia and mesial temporal regions compared to controls.
  • Increased anterior thalamic-basal ganglia connectivity correlated with a history of focal to bilateral tonic-clonic seizures (FBTCS).
  • Hippocampal sclerosis was linked to reduced thalamo-hippocampal connectivity, with stronger ipsilateral connectivity predicting better surgical outcomes.

Conclusions:

  • Pediatric TLE is characterized by distinct thalamic connectivity patterns, including heightened connections to the basal ganglia and mesial temporal regions.
  • Findings suggest a potential inhibitory role of basal ganglia output in modulating thalamo-cortical seizure transmission.
  • Thalamo-hippocampal connectivity may serve as a predictive marker for post-surgical seizure control in pediatric TLE.