TY - JOUR
T1 - Reduced default mode network connectivity in treatment-resistant idiopathic generalized epilepsy
AU - Kay, Benjamin P.
AU - Difrancesco, Mark W.
AU - Privitera, Michael D.
AU - Gotman, Jean
AU - Holland, Scott K.
AU - Szaflarski, Jerzy P.
PY - 2013/3
Y1 - 2013/3
N2 - 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.
AB - 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.
KW - Dual regression
KW - Independent component analysis
KW - Primary generalized epilepsy
KW - Resting-state functional connectivity
KW - Seed-based voxel correlation
KW - Valproic acid
UR - http://www.scopus.com/inward/record.url?scp=84874669970&partnerID=8YFLogxK
U2 - 10.1111/epi.12057
DO - 10.1111/epi.12057
M3 - Article
C2 - 23293853
AN - SCOPUS:84874669970
SN - 0013-9580
VL - 54
SP - 461
EP - 470
JO - Epilepsia
JF - Epilepsia
IS - 3
ER -