title: Connectome Reorganization Associated With Surgical Outcome in Temporal Lobe Epilepsy.
abstract: To identify the distinct pattern of anatomical network reorganization in surgically refractory mesial temporal lobe epilepsy (MTLE) patients using a longitudinal design. We collected longitudinal diffusion-weighted images of 19 MTLE patients before and after anterior temporal lobectomy. Patients were classified as seizure-free (SF) or nonseizure-free (NSF) at least 1 year after surgery. We constructed whole-brain anatomical networks derived from white matter tractography and evaluated network connectivity measures by graph theoretical analysis. The reorganization trajectories of network measures in SF and NSF patients were investigated by two-way mixed analysis of variance, with factors "group" (SF vs NSF) and "treatment" (presurgery vs postsurgery). Widespread brain structures showed opposite reorganization trajectories in FS and NSF groups (interaction effect). Most of them showed group difference before surgery and then converge after surgery, suggesting that surgery remodeled these structures into a similar status. Conversly, contralateral amygdala-planum-temporale and thalamic-parietal tracts showed higher connectivity strength in NSF than in SF patients after surgery, indicating maladaptive neuroplastic responses to surgery in NSF patients. Our findings suggest that surgical outcomes are associated not only with the preoperative pattern of anatomical connectivity, but also with connectome reconfiguration following surgery. The reorganization of contralateral temporal lobe and corticothalamic tracts may be particularly important for seizure control in MTLE.
authors.affiliation: From the Laboratory of Cognitive Neuropsychology, Department of Medical Psychology, Anhui Medical University, Hefei (G-JJ); Center for Cognition and Brain Disorders and the Affiliated Hospital, Hangzhou Normal University (G-JJ, JW, WL); Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou (G-JJ, JW, WL); Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine (ZZ, QX, WW, GL); Department of Medical Imaging, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School (ZW); Department of Neurology, Jinling Hospital (FY); Department of Neurosurgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing (KS); Department of Radiology, Taishan Medical University, Tai'an (QJ); and Key Laboratory for Neuroinformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China (WL).
authors.forename: Gong-Jun
authors.initials: GJ
authors.lastname: Ji
authors.forename: Zhiqiang
authors.initials: Z
authors.lastname: Zhang
authors.forename: Qiang
authors.initials: Q
authors.lastname: Xu
authors.forename: Wei
authors.initials: W
authors.lastname: Wei
authors.forename: Jue
authors.initials: J
authors.lastname: Wang
authors.forename: Zhengge
authors.initials: Z
authors.lastname: Wang
authors.forename: Fang
authors.initials: F
authors.lastname: Yang
authors.forename: Kangjian
authors.initials: K
authors.lastname: Sun
authors.forename: Qing
authors.initials: Q
authors.lastname: Jiao
authors.forename: Wei
authors.initials: W
authors.lastname: Liao
authors.forename: Guangming
authors.initials: G
authors.lastname: Lu
mesh_terms: D000328:Adult; D000679:Amygdala / Q000378:metabolism; D038481:Anterior Temporal Lobectomy / Q000379:methods*; D001921:Brain / Q000378:metabolism*; D038524:Diffusion Magnetic Resonance Imaging; D004833:Epilepsy, Temporal Lobe / Q000601:surgery*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010296:Parietal Lobe / Q000378:metabolism; D013788:Thalamus / Q000378:metabolism