title: Resting functional connectivity between the hemispheres in childhood absence epilepsy.
abstract: OBJECTIVE
  The fundamental mechanisms by which childhood absence epilepsy (CAE) changes neural networks even between seizures remain poorly understood. During seizures, cortical and subcortical networks exhibit bihemspheric synchronous activity based on prior EEG-fMRI studies. Our aim was to investigate whether this abnormal bisynchrony may extend to the interictal period, using a blood oxygen level-dependent (BOLD) resting functional connectivity approach.
  
  
  METHODS
  EEG-fMRI data were recorded from 16 patients with CAE and 16 age- and gender-matched controls. Three analyses were performed. 1) Using 16 pairs of seizure-related regions of interest (ROI), we compared the between-hemisphere interictal resting functional connectivity of patients and controls. 2) For regions showing significantly increased interhemispheric connectivity in CAE, we then calculated connectivity to the entire brain. 3) A paired-voxel approach was performed to calculate resting functional connectivity between hemispheres without the constraint of predefined ROIs.
  
  
  RESULTS
  We found significantly increased resting functional connectivity between hemispheres in the lateral orbitofrontal cortex of patients with CAE compared to normal controls. Enhanced between-hemisphere connectivity localized to the lateral orbitofrontal cortex was confirmed by all 3 analysis methods.
  
  
  CONCLUSIONS
  Our results demonstrate abnormal increased connectivity between the hemispheres in patients with CAE in seizure-related regions, even when seizures were not occurring. These findings suggest that the lateral orbitofrontal cortex may play an important role in CAE pathophysiology, warranting further investigation. In addition, resting functional connectivity analysis may provide a promising biomarker to improve our understanding of altered brain function in CAE during the interictal period.
authors.affiliation: Department of Neurology, Yale University School of Medicine, New Haven, CT 06520-8018, USA.
authors.forename: X
authors.initials: X
authors.lastname: Bai
authors.forename: J
authors.initials: J
authors.lastname: Guo
authors.forename: B
authors.initials: B
authors.lastname: Killory
authors.forename: M
authors.initials: M
authors.lastname: Vestal
authors.forename: R
authors.initials: R
authors.lastname: Berman
authors.forename: M
authors.initials: M
authors.lastname: Negishi
authors.forename: N
authors.initials: N
authors.lastname: Danielson
authors.forename: E J
authors.initials: EJ
authors.lastname: Novotny
authors.forename: R T
authors.initials: RT
authors.lastname: Constable
authors.forename: H
authors.initials: H
authors.lastname: Blumenfeld
mesh_terms: D000293:Adolescent; D054022:Cerebrum / Q000503:physiopathology*; D002648:Child; D004832:Epilepsy, Absence / Q000175:diagnosis* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D009415:Nerve Net / Q000503:physiopathology*; D009434:Neural Pathways / Q000503:physiopathology*; D017397:Prefrontal Cortex / Q000503:physiopathology*