title: Identifying Corticothalamic Network Epicenters in Patients with Idiopathic Generalized Epilepsy.
abstract: OBJECTIVE
  Corticothalamic networks are considered core pathologic substrates for idiopathic generalized epilepsy; however, the predominant epileptogenic epicenters within these networks are still largely unknown. The current study aims to identify these epicenters by resting-state functional connectivity.
  
  
  METHODS
  To identify epicenters within the corticothalamic networks in idiopathic generalized epilepsy, we retrospectively studied a large cohort of patients with this condition (n = 97) along with healthy controls (n = 123) by resting-state functional MR imaging. The thalamus was functionally divided into subregions corresponding to distinct cortical lobes for 5 parallel corticothalamic networks. The functional connectivity between each voxel in the cortical lobe and the corresponding thalamic subregion was calculated, and functional connectivity strength was used to evaluate the interconnectivity of voxels in the cortex and thalamus.
  
  
  RESULTS
  The projection of 5 cortical lobes to the thalamus is consistent with previous histologic findings in humans. Compared with controls, patients with idiopathic generalized epilepsy showed increased functional connectivity strength in 4 corticothalamic networks: 1) the supplementary motor area, pulvinar, and ventral anterior nucleus in the prefrontal-thalamic network; 2) the premotor cortex and ventrolateral nucleus in motor/premotor-thalamic networks; 3) the visual cortex, posterior default mode regions, and pulvinar in parietal/occipital-thalamic networks; and 4) the middle temporal gyrus in the temporal-thalamic network.
  
  
  CONCLUSIONS
  Several key nodes were distinguished in 4 corticothalamic networks. The identification of these epicenters refines the corticothalamic network theory and provides insight into the pathophysiology of idiopathic generalized epilepsy.
authors.affiliation: From the Center for Cognition and Brain Disorders and the Affiliated Hospital (G.-J.J., J.W., Y.-F.Z., W.L.), Hangzhou Normal University, Hangzhou, China Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments (G.-J.J., J.W., Y.-F.Z., W.L.), Hangzhou, China.
authors.forename: G-J
authors.initials: GJ
authors.lastname: Ji
authors.affiliation: Departments of Medical Imaging (Z.Z., Q.X., W.L., G.L.).
authors.forename: Z
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Departments of Medical Imaging (Z.Z., Q.X., W.L., G.L.).
authors.forename: Q
authors.initials: Q
authors.lastname: Xu
authors.affiliation: Department of Medical Imaging (Z.W.), Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Wang
authors.affiliation: From the Center for Cognition and Brain Disorders and the Affiliated Hospital (G.-J.J., J.W., Y.-F.Z., W.L.), Hangzhou Normal University, Hangzhou, China Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments (G.-J.J., J.W., Y.-F.Z., W.L.), Hangzhou, China.
authors.forename: J
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Radiology (Q.J.), Taishan Medical University, Tai'an, China.
authors.forename: Q
authors.initials: Q
authors.lastname: Jiao
authors.affiliation: Neurology (F.Y., G.C.).
authors.forename: F
authors.initials: F
authors.lastname: Yang
authors.affiliation: Neurosurgery (Q.T.), Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors.forename: Q
authors.initials: Q
authors.lastname: Tan
authors.affiliation: Neurology (F.Y., G.C.).
authors.forename: G
authors.initials: G
authors.lastname: Chen
authors.affiliation: From the Center for Cognition and Brain Disorders and the Affiliated Hospital (G.-J.J., J.W., Y.-F.Z., W.L.), Hangzhou Normal University, Hangzhou, China Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments (G.-J.J., J.W., Y.-F.Z., W.L.), Hangzhou, China.
authors.forename: Y-F
authors.initials: YF
authors.lastname: Zang
authors.affiliation: From the Center for Cognition and Brain Disorders and the Affiliated Hospital (G.-J.J., J.W., Y.-F.Z., W.L.), Hangzhou Normal University, Hangzhou, China Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments (G.-J.J., J.W., Y.-F.Z., W.L.), Hangzhou, China Departments of Medical Imaging (Z.Z., Q.X., W.L., G.L.) weiliao.wl@gmail.com cjr.luguangming@vip.163.com.
authors.forename: W
authors.initials: W
authors.lastname: Liao
authors.affiliation: Departments of Medical Imaging (Z.Z., Q.X., W.L., G.L.) weiliao.wl@gmail.com cjr.luguangming@vip.163.com.
authors.forename: G
authors.initials: G
authors.lastname: Lu
mesh_terms: D000328:Adult; D002540:Cerebral Cortex / Q000503:physiopathology; D004829:Epilepsy, Generalized / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009434:Neural Pathways / Q000503:physiopathology*; D012189:Retrospective Studies; D013788:Thalamus / Q000503:physiopathology; D055815:Young Adult