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Thalamic functional connectivity predicts seizure laterality in individual TLE patients: application of a biomarker development strategy.

Abstract：

:Noninvasive markers of brain function could yield biomarkers in many neurological disorders. Disease models constrained by coordinate-based meta-analysis are likely to increase this yield. Here, we evaluate a thalamic model of temporal lobe epilepsy that we proposed in a coordinate-based meta-analysis and extended in a diffusion tractography study of an independent patient population. Specifically, we evaluated whether thalamic functional connectivity (resting-state fMRI-BOLD) with temporal lobe areas can predict seizure onset laterality, as established with intracranial EEG. Twenty-four lesional and non-lesional temporal lobe epilepsy patients were studied. No significant differences in functional connection strength in patient and control groups were observed with Mann-Whitney Tests (corrected for multiple comparisons). Notwithstanding the lack of group differences, individual patient difference scores (from control mean connection strength) successfully predicted seizure onset zone as shown in ROC curves: discriminant analysis (two-dimensional) predicted seizure onset zone with 85% sensitivity and 91% specificity; logistic regression (four-dimensional) achieved 86% sensitivity and 100% specificity. The strongest markers in both analyses were left thalamo-hippocampal and right thalamo-entorhinal cortex functional connection strength. Thus, this study shows that thalamic functional connections are sensitive and specific markers of seizure onset laterality in individual temporal lobe epilepsy patients. This study also advances an overall strategy for the programmatic development of neuroimaging biomarkers in clinical and genetic populations: a disease model informed by coordinate-based meta-analysis was used to anatomically constrain individual patient analyses.

journal_name

Neuroimage Clin

journal_title

NeuroImage. Clinical

authors

Barron DS,Fox PT,Pardoe H,Lancaster J,Price LR,Blackmon K,Berry K,Cavazos JE,Kuzniecky R,Devinsky O,Thesen T

doi

10.1016/j.nicl.2014.08.002

subject

Has Abstract

pub_date

2014-08-07 00:00:00

pages

273-80

issn

2213-1582

pii

S2213-1582(14)00111-9

journal_volume

7

pub_type

杂志文章

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