Dataset Information

Disrupted structural and functional rich club organization of the brain connectome in patients with generalized tonic-clonic seizure.

ABSTRACT: Network studies have demonstrated that a small set of highly connected regions may play a central role in global information integration, together forming a rich club organization. Given that generalized tonic-clonic seizure (GTCS) has been conceptualized as a network disorder, we hypothesized that the rich club disturbances may be related to the network abnormalities of GTCS. Here, we used graph theoretical analysis to investigate the rich club organization of both structural and functional connectome in patients with GTCS (n?=?50) and healthy controls (n?=?60). We further measured the level of global efficiency and clustering in rich club and non-rich club organization. We, respectively, identified a small number of highly connected hubs as rich club organization from structural and functional networks. Patients were found to exhibit significantly reduced rich club connectivity among the central hubs. Meanwhile, both structural and functional network showed changed levels of global efficiency and clustering of rich club organization in GTCS. Furthermore, in patients, lower levels of rich club connectivity were found to be correlated with longer duration of illness and seizure frequency. Together, these findings suggest that GTCS is characterized by a selective disruption of rich club organization due to the long-term injurious effects of epileptic actions on the central hub regions, which potentially contribute to a reduced level of brain integration capacity among different functional domains and an added effect of illness on a preexisting vulnerability. Our findings emphasize a central role for abnormal rich club organization in the pathophysiological mechanism underlying GTCS. Hum Brain Mapp 37:4487-4499, 2016. © 2016 Wiley Periodicals, Inc.

SUBMITTER: Li R

PROVIDER: S-EPMC6867540 | biostudies-literature | 2016 Dec

REPOSITORIES: biostudies-literature

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Disrupted structural and functional rich club organization of the brain connectome in patients with generalized tonic-clonic seizure.

Li Rong R Liao Wei W Li Yibo Y Yu Yangyang Y Zhang Zhiqiang Z Lu Guangming G Chen Huafu H

Human brain mapping 20160728 12

Network studies have demonstrated that a small set of highly connected regions may play a central role in global information integration, together forming a rich club organization. Given that generalized tonic-clonic seizure (GTCS) has been conceptualized as a network disorder, we hypothesized that the rich club disturbances may be related to the network abnormalities of GTCS. Here, we used graph theoretical analysis to investigate the rich club organization of both structural and functional con ...[more]

PMID: 27466063

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Project description:ObjectiveThe purpose of this study was to assess the differences of topological characteristic and rich club organization between temporal lobe epilepsy (TLE) patients with focal seizure (FS) only and those with focal to bilateral tonic-clonic seizures (FBTCS).MethodsWe recruited 130 unilateral TLE patients, of which 57 patients with FS only and 73 patients with both FS and FBTCS, and 68 age- and gender-matched healthy controls (HC). Whole-brain networks were constructed based on diffusion weighted imaging data. Graph theory was applied to quantify the topological network metrics and rich club organization. Network-based statistic (NBS) analysis was administered to investigate the difference in edge-wise connectivity strength. The non-parametric permutation test was applied to evaluate the differences between groups. Benjamini-Hochberg FDR at the alpha of 5% was carried out for multiple comparations.ResultsIn comparison with HC, both the FS and FBTCS group displayed a significant reduction in whole-brain connectivity strength and global efficiency. The FBTCS group showed lower connectivity strength both in the rich club and feeder connections compared to HC. The FS group had lower connectivity strength in the feeder and local connections compared to HC. NBS analysis revealed a wider range of decreased connectivity strength in the FBTCS group, involving 90% of the rich club regions, mainly affecting temporal-subcortical, frontal-parietal, and frontal-temporal lobe, the majority decreasing connections were between temporal lobe and stratum. While the decreased connectivity strength in the FS group were relatively local, involving 50% of rich club regions, mainly concentrated on the temporal-subcortical lobe.ConclusionsNetwork integration was reduced in TLE. TLE with FBTCS selectively disrupted the rich club regions, while TLE with FS only were more likely to affect the non-rich club regions, emphasizing the contribution of rich club organization to seizure generalization.

Project description:The network nature of the brain is gradually becoming a consensus in the neuroscience field. A set of highly connected regions in the brain network called "rich-club" are crucial high efficiency communication hubs in the brain. The abnormal rich-club organization can reflect underlying abnormal brain function and metabolism, which receives increasing attention. Diabetes is one of the risk factors for neurological diseases, and most individuals with prediabetes will develop overt diabetes within their lifetime. However, the gradual impact of hyperglycemia on brain structures, including rich-club organization, remains unclear. We hypothesized that the brain follows a special disrupted pattern of rich-club organization in prediabetes and diabetes. We used cross-sectional baseline data from the population-based PolyvasculaR Evaluation for Cognitive Impairment and vaScular Events (PRECISE) study, which included 2218 participants with a mean age of 61.3 ± 6.6 years and 54.1% females comprising 1205 prediabetes, 504 diabetes, and 509 normal control subjects. The rich-club organization and network properties of the structural networks derived from diffusion tensor imaging data were investigated using a graph theory approach. Linear mixed models were used to assess associations between rich-club organization disruptions and the subjects' glucose status. Based on the graphical analysis methods, we observed the disrupted pattern of rich-club organization was from peripheral regions mainly located in frontal areas to rich-club regions mainly located in subcortical areas from prediabetes to diabetes. The rich-club organization disruptions were associated with elevated glucose levels. These findings provided more details of the process by which hyperglycemia affects the brain, contributing to a better understanding of the potential neurological consequences. Furthermore, the disrupted pattern observed in rich-club organization may serve as a potential neuroimaging marker for early detection and monitoring of neurological disorders in individuals with prediabetes or diabetes.

Project description:Partial seizures produce increased cerebral blood flow in the region of seizure onset. These regional cerebral blood flow increases can be detected by single photon emission computed tomography (ictal SPECT), providing a useful clinical tool for seizure localization. However, when partial seizures secondarily generalize, there are often questions of interpretation since propagation of seizures could produce ambiguous results. Ictal SPECT from secondarily generalized seizures has not been thoroughly investigated. We analysed ictal SPECT from 59 secondarily generalized tonic-clonic seizures obtained during epilepsy surgery evaluation in 53 patients. Ictal versus baseline interictal SPECT difference analysis was performed using ISAS (http://spect.yale.edu). SPECT injection times were classified based on video/EEG review as either pre-generalization, during generalization or in the immediate post-ictal period. We found that in the pre-generalization and generalization phases, ictal SPECT showed significantly more regions of cerebral blood flow increases than in partial seizures without secondary generalization. This made identification of a single unambiguous region of seizure onset impossible 50% of the time with ictal SPECT in secondarily generalized seizures. However, cerebral blood flow increases on ictal SPECT correctly identified the hemisphere (left versus right) of seizure onset in 84% of cases. In addition, when a single unambiguous region of cerebral blood flow increase was seen on ictal SPECT, this was the correct localization 80% of the time. In agreement with findings from partial seizures without secondary generalization, cerebral blood flow increases in the post-ictal period and cerebral blood flow decreases during or following seizures were not useful for localizing seizure onset. Interestingly, however, cerebral blood flow hypoperfusion during the generalization phase (but not pre-generalization) was greater on the side opposite to seizure onset in 90% of patients. These findings suggest that, with appropriate cautious interpretation, ictal SPECT in secondarily generalized seizures can help localize the region of seizure onset.

Dataset Information

Disrupted structural and functional rich club organization of the brain connectome in patients with generalized tonic-clonic seizure.

Publications

Disrupted structural and functional rich club organization of the brain connectome in patients with generalized tonic-clonic seizure.

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