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Postoperative seizure freedom does not normalize altered connectivity in temporal lobe epilepsy.

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Title: Postoperative seizure freedom does not normalize altered connectivity in temporal lobe epilepsy.
Authors: Maccotta, Luigi, Lopez, Mayra A., Adeyemo, Babatunde, Ances, Beau M., Day, Brian K., Eisenman, Lawrence N., Dowling, Joshua L., Leuthardt, Eric C., Schlaggar, Bradley L., Hogan, Robert Edward
Source: Epilepsia (Series 4). Nov2017, Vol. 58 Issue 11, p1842-1851. 10p.
Subjects: Temporal lobe epilepsy, Epilepsy surgery, Spasms, Cognitive ability, Postoperative period, Functional magnetic resonance imaging, Therapeutics
Abstract: Objectives Specific changes in the functional connectivity of brain networks occur in patients with epilepsy. Yet whether such changes reflect a stable disease effect or one that is a function of active seizure burden remains unclear. Here, we longitudinally assessed the connectivity of canonical cognitive functional networks in patients with intractable temporal lobe epilepsy ( TLE), both before and after patients underwent epilepsy surgery and achieved seizure freedom. Methods Seventeen patients with intractable TLE who underwent epilepsy surgery with Engel class I outcome and 17 matched healthy controls took part in the study. The functional connectivity of a set of cognitive functional networks derived from typical cognitive tasks was assessed in patients, preoperatively and postoperatively, as well as in controls, using stringent methods of artifact reduction. Results Preoperatively, functional networks in TLE patients differed significantly from healthy controls, with differences that largely, but not exclusively, involved the default mode and temporal/auditory subnetworks. However, undergoing epilepsy surgery and achieving seizure freedom did not lead to significant changes in network connectivity, with postoperative functional network abnormalities closely mirroring the preoperative state. Significance This result argues for a stable chronic effect of the disease on brain connectivity, with changes that are largely 'burned in' by the time a patient with intractable TLE undergoes epilepsy surgery, which typically occurs years after the initial diagnosis. The result has potential implications for the treatment of intractable epilepsy, suggesting that delaying surgical intervention that may achieve seizure freedom may lead to functional network changes that are no longer reversible by the time of epilepsy surgery. [ABSTRACT FROM AUTHOR]
Copyright of Epilepsia (Series 4) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Postoperative seizure freedom does not normalize altered connectivity in temporal lobe epilepsy.
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  Data: <searchLink fieldCode="AR" term="%22Maccotta%2C+Luigi%22">Maccotta, Luigi</searchLink><br /><searchLink fieldCode="AR" term="%22Lopez%2C+Mayra+A%2E%22">Lopez, Mayra A.</searchLink><br /><searchLink fieldCode="AR" term="%22Adeyemo%2C+Babatunde%22">Adeyemo, Babatunde</searchLink><br /><searchLink fieldCode="AR" term="%22Ances%2C+Beau+M%2E%22">Ances, Beau M.</searchLink><br /><searchLink fieldCode="AR" term="%22Day%2C+Brian+K%2E%22">Day, Brian K.</searchLink><br /><searchLink fieldCode="AR" term="%22Eisenman%2C+Lawrence+N%2E%22">Eisenman, Lawrence N.</searchLink><br /><searchLink fieldCode="AR" term="%22Dowling%2C+Joshua+L%2E%22">Dowling, Joshua L.</searchLink><br /><searchLink fieldCode="AR" term="%22Leuthardt%2C+Eric+C%2E%22">Leuthardt, Eric C.</searchLink><br /><searchLink fieldCode="AR" term="%22Schlaggar%2C+Bradley+L%2E%22">Schlaggar, Bradley L.</searchLink><br /><searchLink fieldCode="AR" term="%22Hogan%2C+Robert+Edward%22">Hogan, Robert Edward</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22Epilepsia+%28Series+4%29%22">Epilepsia (Series 4)</searchLink>. Nov2017, Vol. 58 Issue 11, p1842-1851. 10p.
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  Data: <searchLink fieldCode="DE" term="%22Temporal+lobe+epilepsy%22">Temporal lobe epilepsy</searchLink><br /><searchLink fieldCode="DE" term="%22Epilepsy+surgery%22">Epilepsy surgery</searchLink><br /><searchLink fieldCode="DE" term="%22Spasms%22">Spasms</searchLink><br /><searchLink fieldCode="DE" term="%22Cognitive+ability%22">Cognitive ability</searchLink><br /><searchLink fieldCode="DE" term="%22Postoperative+period%22">Postoperative period</searchLink><br /><searchLink fieldCode="DE" term="%22Functional+magnetic+resonance+imaging%22">Functional magnetic resonance imaging</searchLink><br /><searchLink fieldCode="DE" term="%22Therapeutics%22">Therapeutics</searchLink>
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  Label: Abstract
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  Data: Objectives Specific changes in the functional connectivity of brain networks occur in patients with epilepsy. Yet whether such changes reflect a stable disease effect or one that is a function of active seizure burden remains unclear. Here, we longitudinally assessed the connectivity of canonical cognitive functional networks in patients with intractable temporal lobe epilepsy ( TLE), both before and after patients underwent epilepsy surgery and achieved seizure freedom. Methods Seventeen patients with intractable TLE who underwent epilepsy surgery with Engel class I outcome and 17 matched healthy controls took part in the study. The functional connectivity of a set of cognitive functional networks derived from typical cognitive tasks was assessed in patients, preoperatively and postoperatively, as well as in controls, using stringent methods of artifact reduction. Results Preoperatively, functional networks in TLE patients differed significantly from healthy controls, with differences that largely, but not exclusively, involved the default mode and temporal/auditory subnetworks. However, undergoing epilepsy surgery and achieving seizure freedom did not lead to significant changes in network connectivity, with postoperative functional network abnormalities closely mirroring the preoperative state. Significance This result argues for a stable chronic effect of the disease on brain connectivity, with changes that are largely 'burned in' by the time a patient with intractable TLE undergoes epilepsy surgery, which typically occurs years after the initial diagnosis. The result has potential implications for the treatment of intractable epilepsy, suggesting that delaying surgical intervention that may achieve seizure freedom may lead to functional network changes that are no longer reversible by the time of epilepsy surgery. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Epilepsia (Series 4) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/epi.13867
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      – SubjectFull: Temporal lobe epilepsy
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      – SubjectFull: Spasms
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      – SubjectFull: Cognitive ability
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      – SubjectFull: Functional magnetic resonance imaging
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      – SubjectFull: Therapeutics
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      – TitleFull: Postoperative seizure freedom does not normalize altered connectivity in temporal lobe epilepsy.
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              Text: Nov2017
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