Excessively increased thalamocortical connectivity and poor initial antiseizure medication response in epilepsy patients

作者全名："Zhong, Jiyuan; Tan, Ge; Wang, Haijiao; Chen, Yangmei"

作者地址："[Zhong, Jiyuan] Chongqing Med Univ, Int Med Coll, Chongqing, Peoples R China; [Tan, Ge; Wang, Haijiao] Sichuan Univ, West China Hosp, Epilepsy Ctr, Dept Neurol, Chengdu, Peoples R China; [Wang, Haijiao] Cent South Univ, Xiangya Hosp 3, Dept Neurol, Changsha, Peoples R China; [Chen, Yangmei] Chongqing Med Univ, Dept Neurol, Affiliated Hosp 2, Chongqing, Peoples R China"

通信作者："Chen, YM (通讯作者)，Chongqing Med Univ, Dept Neurol, Affiliated Hosp 2, Chongqing, Peoples R China."

来源：FRONTIERS IN NEUROLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001016568300001

JCR分区：Q2

影响因子：2.7

年份：2023

卷号：14

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：epilepsy; antiseizure medication response; thalamus; functional connectivity; effective connectivity

摘要："ObjectivesThe network mechanism underlying the initial response to antiseizure medication in epilepsy has not been revealed yet. Given the central role of the thalamus in the brain network, we conducted a case-control study to investigate the association between thalamic connectivity and medication response. MethodsWe recruited 39 patients with newly diagnosed and medication-naive epilepsy of genetic or unknown etiology, including 26 with a good response (GR group) and 13 with a poor response (PR group), and 26 matched healthy participants (control group). We measured the gray matter density (GMD) and the amplitude of low-frequency fluctuation (ALFF) of bilateral thalami. We then set each thalamus as the seed region of interest (ROI) to calculate voxel-wise functional connectivity (FC) and assessed ROI-wise effective connectivity (EC) between the thalamus and targeted regions. ResultsWe found no significant difference between groups in the GMD or ALFF of bilateral thalami. However, we observed that the FC values of several circuits connecting the left thalamus and the cortical areas, including the bilateral Rolandic operculum, the left insula, the left postcentral gyrus, the left supramarginal gyrus, and the left superior temporal gyrus, differed among groups (False Discovery Rate correction, P < 0.05), with a higher value in the PR group than in the GR group and/or the control group (Bonferroni correction, P < 0.05). Similarly, both the outflow and the inflow EC in each thalamocortical circuit were higher in the PR group than in the GR group and the control group, although these differences did not remain statistically significant after applying the Bonferroni correction (P < 0.05). The FC showed a positive correlation with the corresponding outflow and inflow ECs for each circuit. ConclusionOur finding suggested that patients with stronger thalamocortical connectivity, potentially driven by both thalamic outflowing and inflowing information, may be more likely to respond poorly to initial antiseizure medication."

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