title: Short-term cerebral activity alterations after surgery in patients with unilateral mesial temporal lobe epilepsy associated with hippocampal sclerosis: A longitudinal resting-state fMRI study.
abstract: OBJECTIVE
  Mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS), as a brain network disorder, has given increased importance to resective surgery. We aimed to examine the short-term postoperative functional network reorganization in patients with unilateral MTLE-HS using resting-state functional magnetic resonance imaging (Rs-fMRI) data with a longitudinal design.
  
  
  METHODS
  Seventeen (10 right-side and 7 left-side) patients with unilateral MTLE-HS were recruited. Rs-fMRI data were recorded from each subject before surgery and at an average of 4.5 months after surgery. Preoperative and postoperative amplitude of low-frequency fluctuations (ALFF) values as well as regions of interesting (ROI)-wise functional connectivity (FC) were compared to characterize the dynamic alterations of cerebral activity.
  
  
  RESULTS
  After surgery, patients with unilateral MTLE-HS presented bilateral diffuse ALFF value changes, which were more widespread in the left-side resection group. Regarding the postoperative Rs-FC alterations, the left MTLE-HS patients presented an interhemispheric FC alteration in a relatively symmetric manner between the bilateral frontal lobe and putamen; the right MTLE-HS patients exhibited an intrahemispheric FC reduction in the basal ganglia-thalamocortical circuit.
  
  
  CONCLUSIONS
  Patients with unilateral MTLE-HS presented bilateral diffuse regional and interregional neural activity alteration after surgery, even over a short period, which exhibited a divergent pattern between the different sides of resection. This finding may contribute to the understanding of the effect and the mechanisms of surgery on the whole brain network in patients with unilateral MTLE-HS.
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Southwestern Medical Center, University of Texas, Dallas, TX, USA.
authors.forename: Yingying
authors.initials: Y
authors.lastname: Tang
authors.affiliation: Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China; Southwestern Medical Center, University of Texas, Dallas, TX, USA.
authors.forename: Wei
authors.initials: W
authors.lastname: Xia
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Southwestern Medical Center, University of Texas, Dallas, TX, USA.
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Yu
authors.affiliation: Department of Psychosomatic Medicine, Sichuan Province People's Hospital, Chengdu, Sichuan, China; Southwestern Medical Center, University of Texas, Dallas, TX, USA.
authors.forename: Bo
authors.initials: B
authors.lastname: Zhou
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Southwestern Medical Center, University of Texas, Dallas, TX, USA.
authors.forename: Chunyan
authors.initials: C
authors.lastname: Luo
authors.affiliation: Huaxi MR Research Center, Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Southwestern Medical Center, University of Texas, Dallas, TX, USA.
authors.forename: Xiaoqi
authors.initials: X
authors.lastname: Huang
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Southwestern Medical Center, University of Texas, Dallas, TX, USA. Electronic address: chenqin8124@gmail.com.
authors.forename: Qin
authors.initials: Q
authors.lastname: Chen
authors.affiliation: Huaxi MR Research Center, Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Southwestern Medical Center, University of Texas, Dallas, TX, USA; Division of Medical Imaging, Faculty of Medicine, University of Liverpool, Liverpool, L69 3BX, United Kingdom. Electronic address: qiyonggong@hmrrc.org.cn.
authors.forename: Qiyong
authors.initials: Q
authors.lastname: Gong
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Southwestern Medical Center, University of Texas, Dallas, TX, USA. Electronic address: zhoudong66@yahoo.de.
authors.forename: Dong
authors.initials: D
authors.lastname: Zhou
mesh_terms: D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000601:surgery; D001931:Brain Mapping; D004833:Epilepsy, Temporal Lobe / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D012146:Rest; D013997:Time Factors; D016896:Treatment Outcome; D014402:Tuberous Sclerosis / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000601:surgery; D055815:Young Adult
keywords: Amplitude of low frequency fluctuations (ALFF); Functional connectivity (FC); Hippocampal sclerosis (HS); Mesial temporal lobe epilepsy (MTLE); Resting-state functional MRI (Rs-MRI); Surgery