Mapping Lesion-related Hyperkinetic Seizures to a Functional Network
Abstract number :
2.312
Submission category :
5. Neuro Imaging / 5B. Functional Imaging
Year :
2024
Submission ID :
778
Source :
www.aesnet.org
Presentation date :
12/8/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Bowen Yang, MD, PhD – Beijing Tiantan Hospital
Kai Zhang, MD – Beijing Tiantan Hospital
Chao Zhang, MD – Beijing Tiantan Hospital
Xiaoqiu Shao, MD – Beijing Tiantan Hospital
Wenhan Hu, MD – Beijing Tiantan Hospital
Chen Yao, MD, PhD – Shenzhen Second People's Hospital
Xiu Wang, MD, PhD – Beijing Tiantan Hospital
Baotian Zhao, MD – Beijing Tiantan Hospital
Jiajie Mo, MD, PhD – Beijing Tiantan Hospital
Rationale: To determine whether anatomically heterogeneous lesions causing hyperkinetic seizures (HKS) connect to a common functional network.
Methods: We identified 50 cases with HKS as the first ictal semiology from the Beijing Tiantan-Fengtai Epilepsy Center, all had a focal seizure onset zone, referred to as a "lesion" to align with the analysis method. Using a technique termed lesion network mapping, we tested whether these lesions belonged to the same functional network. The network of brain regions functionally connected to each lesion was identified using a connectome dataset from healthy participants (n = 1000) (Figure 1A). Network maps were overlapped to identify any region functionally connected to our set of lesions (Figure 1B). Specificity was evaluated using a case-control design; control cohorts included a group of similar lesions causing automatism (either manual or oral) (n = 47) and a second group of lesions causing elementary motor signs (n = 53) including tonic, clonic, or head or eye version. Therapeutic relevance was assessed using deep brain stimulation sites that improve seizure control.
Results: Lesion locations from 50 patients with HKS (25 [50%] male; age, 21.2±9.8 years), 47 patients with automatism (25 [53%] male; age, 15.3±8.8 years), and 53 patients with elementary motor signs (24 [45%] male; age, 17.5±9.0 years) were included. The most sensitive connectivity was to the anterior cingulate cortex (ACC) ( > 85% overlap). In the specificity analysis, the ACC was the only area with statistical significance in the comparison between HKS and both automatism and elementary motor signs (corrected using Family-wise error (FEW) with a voxel level P < 0.001, and a cluster level P < 0.05) (Figure 1C & 1D). Deep brain stimulation sites’ connectivity to this common network was associated with improved seizure control (r = 0.49, P < 0.01) in 27 patients with drug-resistant epilepsy (19 [70%] male; age, 27.4±9.1 years; the follow-up, 46.2±27.6 years) (Figure 2A-2E). Reversed connectivity patterns between the ACC and the whole brain encompassed most lesion locations causing HKS (48/50, 96%) (Figure 2F).
Neuro Imaging