Reduced default mode network connectivity in treatment-resistant idiopathic generalized epilepsy

Benjamin P. Kay, Mark W. Difrancesco, Michael D. Privitera, Jean Gotman, Scott K. Holland, Jerzy P. Szaflarski

Research output: Contribution to journalArticlepeer-review

72 Scopus citations


Summary Purpose Idiopathic generalized epilepsy (IGE) resistant to treatment is common, but its neuronal correlates are not entirely understood. Therefore, the aim of this study was to examine resting-state default mode network (DMN) functional connectivity in patients with treatment-resistant IGE. Methods Treatment resistance was defined as continuing seizures despite an adequate dose of valproic acid (valproate, VPA). Data from 60 epilepsy patients and 38 healthy controls who underwent simultaneous electroencephalography (EEG) and resting-state functional magnetic resonance imaging (fMRI) were included (EEG/fMRI). Independent component analysis (ICA) and dual regression were used to quantify DMN connectivity. Confirmatory analysis using seed-based voxel correlation was performed. Key Findings There was a significant reduction of DMN connectivity in patients with treatment-resistant epilepsy when compared to patients who were treatment responsive and healthy controls. Connectivity was negatively correlated with duration of epilepsy. Significance Our findings in this large sample of patients with IGE indicate the presence of reduced DMN connectivity in IGE and show that connectivity is further reduced in treatment-resistant epilepsy. DMN connectivity may be useful as a biomarker for treatment resistance.

Original languageEnglish
Pages (from-to)461-470
Number of pages10
Issue number3
StatePublished - Mar 2013


  • Dual regression
  • Independent component analysis
  • Primary generalized epilepsy
  • Resting-state functional connectivity
  • Seed-based voxel correlation
  • Valproic acid


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