Characterizing the role of the structural connectome in seizure dynamics

How does the human brain's structural scaffold give rise to its intricate functional dynamics? This is a central question in translational neuroscience that is particularly relevant to epilepsy, a disorder affecting over 50 million subjects worldwide. Treatment for medication-resistant focal ep...

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Bibliographic Details
Published in:Brain (London, England : 1878) Vol. 142; no. 7; p. 1955
Main Authors: Shah, Preya, Ashourvan, Arian, Mikhail, Fadi, Pines, Adam, Kini, Lohith, Oechsel, Kelly, Das, Sandhitsu R, Stein, Joel M, Shinohara, Russell T, Bassett, Danielle S, Litt, Brian, Davis, Kathryn A
Format: Journal Article
Language:English
Published: England 01.07.2019
Subjects:
Adult
Brain - physiopathology
Connectome
Diffusion Magnetic Resonance Imaging
Drug Resistance
Electrocorticography
Epilepsies, Partial - physiopathology
Female
Humans
Male
Middle Aged
Neural Pathways - physiopathology
Neuroimaging
Seizures - physiopathology
White Matter - physiopathology
Young Adult
epilepsy
structural connectivity
functional connectivity
high-angular resolution diffusion imaging
intracranial EEG
ISSN:1460-2156, 1460-2156
Online Access:Get more information
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Summary:How does the human brain's structural scaffold give rise to its intricate functional dynamics? This is a central question in translational neuroscience that is particularly relevant to epilepsy, a disorder affecting over 50 million subjects worldwide. Treatment for medication-resistant focal epilepsy is often structural-through surgery or laser ablation-but structural targets, particularly in patients without clear lesions, are largely based on functional mapping via intracranial EEG. Unfortunately, the relationship between structural and functional connectivity in the seizing brain is poorly understood. In this study, we quantify structure-function coupling, specifically between white matter connections and intracranial EEG, across pre-ictal and ictal periods in 45 seizures from nine patients with unilateral drug-resistant focal epilepsy. We use high angular resolution diffusion imaging (HARDI) tractography to construct structural connectivity networks and correlate these networks with time-varying broadband and frequency-specific functional networks derived from coregistered intracranial EEG. Across all frequency bands, we find significant increases in structure-function coupling from pre-ictal to ictal periods. We demonstrate that short-range structural connections are primarily responsible for this increase in coupling. Finally, we find that spatiotemporal patterns of structure-function coupling are highly stereotyped for each patient. These results suggest that seizures harness the underlying structural connectome as they propagate. Mapping the relationship between structural and functional connectivity in epilepsy may inform new therapies to halt seizure spread, and pave the way for targeted patient-specific interventions.
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ISSN:1460-2156
1460-2156
DOI:10.1093/brain/awz125