Epilepsy Research
Volume 88, Issue 2 , Pages 168-178, February 2010

Functional epileptic network in left mesial temporal lobe epilepsy detected using resting fMRI

  • Victoria L. Morgan

      Affiliations

    • 1161 21st Avenue South, AA 1105 MCN, Vanderbilt University Institute of Imaging Science, Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN 37232-2310, USA
    • Corresponding Author InformationCorresponding author. Tel.: +1 615 343 5720; fax: +1 615 322 0734.
    • ,
  • John C. Gore

      Affiliations

    • 1161 21st Avenue South, AA 1105 MCN, Vanderbilt University Institute of Imaging Science, Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN 37232-2310, USA
    • Tel.: +1 615 322 8357; fax: +1 615 322 0734.
    • ,
  • Bassel Abou-Khalil

      Affiliations

    • 1161 21st Avenue South, A 0122 MCN, Epilepsy Division, Department of Neurology, Vanderbilt University, Nashville, TN 37232-2551, USA
    • Tel.: +1 615 936 0060; fax: +1 615 936 0223.

Received 20 July 2009; received in revised form 26 October 2009; accepted 29 October 2009.

Summary 

The purpose of this study was to determine transient functional signal activity in a small, homogeneous group of left temporal lobe epilepsy (TLE) patients, without the use of EEG; and to use one of these activated regions to identify a possible epileptogenic network across the whole brain in this group. Resting functional MRI scanning was performed on five left TLE patients who underwent selective amygdalohippocampectomy resulting in seizure control and 10 healthy control subjects. Activation maps of functional signal peaks were calculated using a data-driven analysis, 2dTCA, across the group of patients. In addition to the expected region of activation in the left anterior hippocampus, the results of the 2dTCA analysis revealed activity in the bilateral insular cortex and default-mode network which are not commonly reported using fMRI, but are supported by other electrical and functional changes. The region of activation corresponding to the anterior hippocampal region of resection (presumably the epileptogenic region) was used as a seed region for fMRI functional connectivity analysis. This revealed increased negative connectivity in the patients as compared to controls across a network including thalamic, brainstem, frontal and parietal regions consistent with theories of inhibited function in subcortical and cortical structures during ictal propagation.

Keywords: Temporal lobe epilepsy, Brain, Functional MRI, Connectivity

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PII: S0920-1211(09)00324-6

doi:10.1016/j.eplepsyres.2009.10.018

Epilepsy Research
Volume 88, Issue 2 , Pages 168-178, February 2010

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