Common network related to hyperkinetic seizures revealed by functional lesion network mapping

Area of Science:

• Neuroscience
• Epileptology
• Functional Neuroimaging

Background:

• Hyperkinetic seizures (HKS) present with diverse anatomical lesion locations.
• Understanding the underlying functional network is crucial for effective treatment.

Purpose of the Study:

• To investigate if heterogeneous lesions causing HKS connect to a common functional brain network.
• To identify specific brain regions and networks associated with HKS.

Main Methods:

• Utilized functional magnetic resonance imaging (fMRI) whole-brain functional connectivity analysis in 1000 healthy participants.
• Mapped functional networks connected to lesion sites in patients with HKS.
• Employed a case-control design for specificity evaluation and assessed therapeutic relevance via deep brain stimulation outcomes.

Main Results:

• The anterior cingulate cortex (ACC) demonstrated high sensitivity and specificity (>90% overlap) for HKS-related lesions.
• A 94% overlap of HKS lesion locations was observed within the reversed connectivity pattern between the ACC and the whole brain.
• Functional connectivity between the ACC and deep brain stimulation targets correlated with seizure control (r=.49, p<.01) in drug-resistant epilepsy patients.

Conclusions:

• HKS may represent a network disorder originating from lesions connected to the ACC.
• The ACC is a potential therapeutic target for interventions aimed at controlling HKS.
• Findings highlight the importance of functional network analysis in understanding and treating epilepsy syndromes.