title: The Brain Activity in Brodmann Area 17: A Potential Bio-Marker to Predict Patient Responses to Antiepileptic Drugs.
abstract: In this study, we aimed to predict newly diagnosed patient responses to antiepileptic drugs (AEDs) using resting-state functional magnetic resonance imaging tools to explore changes in spontaneous brain activity. We recruited 21 newly diagnosed epileptic patients, 8 drug-resistant (DR) patients, 11 well-healed (WH) patients, and 13 healthy controls. After a 12-month follow-up, 11 newly diagnosed epileptic patients who showed a poor response to AEDs were placed into the seizures uncontrolled (SUC) group, while 10 patients were enrolled in the seizure-controlled (SC) group. By calculating the amplitude of fractional low-frequency fluctuations (fALFF) of blood oxygen level-dependent signals to measure brain activity during rest, we found that the SUC patients showed increased activity in the bilateral occipital lobe, particularly in the cuneus and lingual gyrus compared with the SC group and healthy controls. Interestingly, DR patients also showed increased activity in the identical cuneus and lingual gyrus regions, which comprise Brodmann's area 17 (BA17), compared with the SUC patients; however, these abnormalities were not observed in SC and WH patients. The receiver operating characteristic (ROC) curves indicated that the fALFF value of BA17 could differentiate SUC patients from SC patients and healthy controls with sufficient sensitivity and specificity prior to the administration of medication. Functional connectivity analysis was subsequently performed to evaluate the difference in connectivity between BA17 and other brain regions in the SUC, SC and control groups. Regions nearby the cuneus and lingual gyrus were found positive connectivity increased changes or positive connectivity changes with BA17 in the SUC patients, while remarkably negative connectivity increased changes or positive connectivity decreased changes were found in the SC patients. Additionally, default mode network (DMN) regions showed negative connectivity increased changes or negative changes with BA17 in the SUC patients. The abnormal increased in BA17 activity may be a key point that plays a substantial role in facilitating seizure onset.
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
authors.forename: Yida
authors.initials: Y
authors.lastname: Hu
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
authors.forename: Xiujuan
authors.initials: X
authors.lastname: Mi
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
authors.forename: Xin
authors.initials: X
authors.lastname: Xu
authors.affiliation: Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
authors.forename: Weidong
authors.initials: W
authors.lastname: Fang
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
authors.forename: Kebin
authors.initials: K
authors.lastname: Zeng
authors.affiliation: Department of Pediatrics, Chongqing City Hospital of Traditional Chinese Medicine, Chongqing, People's Republic of China.
authors.forename: Mingming
authors.initials: M
authors.lastname: Yang
authors.affiliation: Department of Neurology, Chongqing City Hospital of Traditional Chinese Medicine, Chongqing, People's Republic of China.
authors.forename: Chenyu
authors.initials: C
authors.lastname: Li
authors.affiliation: The Nursing Department, Chongqing Three Gorges Central Hospital, Chongqing, People's Republic of China.
authors.forename: Shasha
authors.initials: S
authors.lastname: Wang
authors.affiliation: The Nursing Department, First Hospital of Shanxi Medical University, Taiyuan, People's Republic of China.
authors.forename: Minghui
authors.initials: M
authors.lastname: Li
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
authors.forename: Xuefeng
authors.initials: X
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000494:pharmacology / Q000627:therapeutic use*; D015415:Biomarkers; D001921:Brain / Q000187:drug effects / Q000503:physiopathology*; D001931:Brain Mapping; D000069279:Drug Resistant Epilepsy / Q000188:drug therapy / Q000503:physiopathology*; D004827:Epilepsy / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012146:Rest; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D015415:Biomarkers