Epilepsy & behavior : E&B · 2025
The functional and structural language-associated brain network in patients with temporal lobe epilepsy and atypical language organization.
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Yildirim Mehmet Salih, Nenning Karl-Heinz, Schmidbauer Victor Ulrich, Stepponat Radheshyam, Berger Marc, Koren Johannes, Baumgartner Christoph, Pataraia Ekaterina, Dorfer Christian, Rössler Karl, Bonelli Silvia, Kasprian Gregor
Аннотация
BACKGROUND: Evidence suggests that epilepsy may contribute to both functional and structural brain alterations, with atypical language organization (ALO) being more frequently observed in epilepsy patients compared to healthy controls. This study aimed to investigate structural connectivity differences between left-hemispheric language dominance (LLD) and ALO in patients with temporal lobe epilepsy (TLE) using probabilistic tractography.
METHODS: Twenty-two TLE patients with ALO and 27 age- and sex-matched patients with LLD who underwent pre-surgical language assessment using 3 Tesla functional magnetic resonance imaging (fMRI) were included in this study. Both groups were subdivided further based on the seizure onset hemisphere. SPM12 was used to determine the functional task-based language pattern. Individual structural connectivity network was investigated based on tractography and whole brain segmentation.
RESULTS: In patients with ALO, the structural connectivity of the inferior frontal gyrus (IFG) exhibited stronger lateralization to the right hemisphere compared to LLD patients (ANOVA, pFDR = 0.030). FMRI activations in the IFG and superior temporal gyrus (STG) ipsilateral to seizure onset were negatively associated with epilepsy duration (puncorrected < 0.001) in ALO with right-hemispheric TLE. Furthermore, lateralization index of the STG- (Pearson's correlation: ρ = 0.714, puncorrected = 0.020) and IFG-connectivity (ρ = -0.608, puncorrected = 0.036) correlated with epilepsy duration in ALO.
CONCLUSION: Several similarities regarding structural connectivity were detected across all groups. However, increased right-hemispheric connectivity of the IFG was detected in ALO, showing a correlation with epilepsy duration. Network analysis may enhance the understanding reorganization patterns underlying epilepsy and help to improve neurosurgical outcome.
METHODS: Twenty-two TLE patients with ALO and 27 age- and sex-matched patients with LLD who underwent pre-surgical language assessment using 3 Tesla functional magnetic resonance imaging (fMRI) were included in this study. Both groups were subdivided further based on the seizure onset hemisphere. SPM12 was used to determine the functional task-based language pattern. Individual structural connectivity network was investigated based on tractography and whole brain segmentation.
RESULTS: In patients with ALO, the structural connectivity of the inferior frontal gyrus (IFG) exhibited stronger lateralization to the right hemisphere compared to LLD patients (ANOVA, pFDR = 0.030). FMRI activations in the IFG and superior temporal gyrus (STG) ipsilateral to seizure onset were negatively associated with epilepsy duration (puncorrected < 0.001) in ALO with right-hemispheric TLE. Furthermore, lateralization index of the STG- (Pearson's correlation: ρ = 0.714, puncorrected = 0.020) and IFG-connectivity (ρ = -0.608, puncorrected = 0.036) correlated with epilepsy duration in ALO.
CONCLUSION: Several similarities regarding structural connectivity were detected across all groups. However, increased right-hemispheric connectivity of the IFG was detected in ALO, showing a correlation with epilepsy duration. Network analysis may enhance the understanding reorganization patterns underlying epilepsy and help to improve neurosurgical outcome.