TY - JOUR
T1 - Characterizing the role of the structural connectome in seizure dynamics
AU - Shah, Preya
AU - Ashourvan, Arian
AU - Mikhail, Fadi
AU - Pines, Adam
AU - Kini, Lohith
AU - Oechsel, Kelly
AU - Das, Sandhitsu R.
AU - Stein, Joel M.
AU - Shinohara, Russell T.
AU - Bassett, Danielle S.
AU - Litt, Brian
AU - Davis, Kathryn A.
N1 - Funding Information:
This work was supported by National Institutes of Health grants 1R01NS099348, K23-NS073801, 1R01NS085211, and 1R01MH112847. We also acknowledge support by the Thornton Foundation, the Mirowski Family Foundation, the ISI Foundation, the John D. and Catherine T. MacArthur Foundation, the Sloan Foundation, and the Paul Allen Foundation.
Publisher Copyright:
© 2019 The Author(s). All rights reserved.
PY - 2019/7
Y1 - 2019/7
N2 - 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.
AB - 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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U2 - 10.1093/brain/awz125
DO - 10.1093/brain/awz125
M3 - Article
C2 - 31099821
AN - SCOPUS:85068463351
VL - 142
SP - 1955
EP - 1972
JO - Brain
JF - Brain
SN - 0006-8950
IS - 7
ER -