Profiles of resting state functional connectivity in temporal lobe epilepsy associated with post-laser interstitial thermal therapy seizure outcomes and semiologies

Mashaal Syed; Jingya Miao; Anish Sathe; Kichang Kang; Arichena Manmatharayan; Michael Kogan; Caio M Matias; Ashwini Sharan; Mahdi Alizadeh

doi:10.3389/fnimg.2023.1201682

Profiles of resting state functional connectivity in temporal lobe epilepsy associated with post-laser interstitial thermal therapy seizure outcomes and semiologies

Front Neuroimaging. 2023 Nov 9:2:1201682. doi: 10.3389/fnimg.2023.1201682. eCollection 2023.

Authors

Mashaal Syed¹, Jingya Miao¹, Anish Sathe¹, Kichang Kang¹, Arichena Manmatharayan², Michael Kogan³, Caio M Matias¹, Ashwini Sharan¹, Mahdi Alizadeh^{1

4}

Affiliations

¹ Department of Neurological Surgery, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, PA, United States.
² Department of Neurology, Detroit Medical Center, University Health Center, Detroit, MI, United States.
³ Department of Neurological Surgery, University of New Mexico, Albuquerque, NM, United States.
⁴ Thomas Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, Philadelphia, PA, United States.

Abstract

Introduction: It is now understood that in focal epilepsy, impacted neural regions are not limited to the epileptogenic zone. As such, further investigation into the underlying functional connectivity (FC) patterns in those enduring Temporal Lobe Epilepsy (TLE) with Mesial Temporal Sclerosis (MTS) is imperative to understanding the intricacies of the disease.

Methods: The rsfMRIs of 17 healthy participants, 10 left-sided TLE-MTS patients with a pre-operative history of focal impaired awareness seizures (FIA), and 13 left-sided TLE-MTS patients with a pre-operative history of focal aware seizures (FA) were compared to determine the existence of distinct FC patterns with respect to seizure types. Similarly, the rsfMRIs of the above-mentioned healthy participants, 16 left-sided TLE-MTS individuals who were seizure-free (SF) 12 months postoperatively, and 16 left-sided TLE-MTS persons without seizure freedom (nSF) were interrogated. The ROI-to-ROI connectivity analysis included a total of 175 regions of interest (ROIs) and accounted for both age and duration of epileptic activity. Significant correlations were determined via two-sample t-tests and Bonferroni correction (α = 0.05).

Results: Comparisons of FA and FIA groups depicted significant correlations between the contralateral anterior cingulate gyrus, subgenual region, and the contralateral cerebellum, lobule III (p-value = 2.26e-4, mean z-score = -0.05 ± 0.28, T = -4.23). Comparisons of SF with nSF depicted two significantly paired-ROIs; the contralateral amygdala and the contralateral precuneus (p-value = 2.9e-5, mean z-score = -0.12 ± 0.19, T = 4.98), as well as the contralateral locus coeruleus and the ipsilateral intralaminar nucleus (p-value= 1.37e-4, mean z-score = 0.06 ± 0.17, T = -4.41).

Significance: FC analysis proves to be a lucrative modality for exploring unique signatures with respect to seizure types and postoperative outcomes. By furthering our understanding of the differences between epileptic phenotypes, we can achieve improvement in future treatment modalities not limited to targeting advancements.

Keywords: focal aware seizures; focal impaired awareness seizures; functional connectivity; laser interstitial thermal therapy; seizure freedom; temporal lobe epilepsy.