Abstract Details

Title Resting-State Voxel-Based Pathophysiologic Changes in Medial Temporal Lobe Epilepsy

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P4 - Poster Session 4 (8:00 AM-9:00 AM)

Poster/Presentation
Number 10-004

Objective To identify neuroanatomical regions that are functionally altered at rest in medial temporal lobe epilepsy (MTLE) and assess their concordance with the MTLE-atrophy network.

Background MTLE is associated with a specific pattern of extrahippocampal structural changes, suggestive of seizure spread along stereotypic, functional connections. Our group previously incorporated the atrophic medial dorsal nucleus (MDN) of the thalamus into a resting-state functional connectivity model of MTLE that accurately predicted seizure-onset laterality. We have since expanded the atrophy network to include the putamen, caudate, and pulvinar.

Design/Methods To prepare a coordinate-based meta-analysis, a comprehensive search for peer-reviewed, resting-state MTLE literature was carried out. Manuscripts were required to use standard space coordinates to report significant voxels identified through whole-brain imaging contrasts between MTLE patients and healthy subjects at rest. Thirteen manuscripts passed screening, providing 255 foci from 38 resting-state contrasts, representing 355 MTLE and 334 healthy control subjects. BrainMap Tools (https://www.brainmap.org/) were used to store (Scribe3.6.2b), collate (Sleuth3.0.4), and analyze (GingerALE3.0.2) the foci using activation likelihood estimation.

Results The abnormally functioning regions identified in MTLE overlap entirely with the atrophy network and implicate additional pathophysiologic involvement. Coordinates are reported in MNI space with labels from the Talairach Daemon: The main cluster was comprised of the MDN (8,-16,8), ventral lateral (-16,-10,8), and anterior nuclei of the thalamus as well as the pulvinar (-8,-26,12). Significant peaks in this cluster were also found in the caudate body (6,12,4) and head (-4,8,0), putamen (-14,2,4; -24,6,8), and lateral globus pallidus (-16,2,-12).

Conclusions Structural and functional changes in MTLE are spatially convergent in the caudate, putamen, and pulvinar. These regions should be included in resting-state functional connectivity-based predictors of laterality and models of network propagation of seizures in MTLE.

Authors/Disclosures
Jonathan M. Towne (Research Imaging Institute) PRESENTER	The institution of Mr. Towne has received research support from the American Epilepsy Society (Predoctoral Research Fellowship) and the National Institutes of Health (F31NS131025, T32TR004545, T32GM113896).
Victor Lami, MD	Dr. Eslami has nothing to disclose.
Jose E. Cavazos, MD, PhD (U Texas Health San Antonio)	Dr. Cavazos has received stock or an ownership interest from Brain Sentinel . The institution of Dr. Cavazos has received research support from NIH.
Peter T. Fox, MD (Univ of TX Health Sci Center)	No disclosure on file

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