PPubMed26 Jun 2020Cited 37×

Network reorganisation following anterior temporal lobe resection and relation with post-surgery seizure relapse: A longitudinal study

Nádia Moreira da Silva, Rob Forsyth, Andrew McEvoy, Anna Miserocchi, Jane de Tisi, Sjoerd B. Vos, Gavin P. Winston, John Duncan, Yujiang Wang, Peter N. Taylor

Abstract

'Jane de Tisi' 'Sjoerd B. Vos' 'Gavin P. Winston' 'John Duncan' 'Yujiang Wang' 'Peter N. Taylor'] Title: Highlights 1. • Diffusion changes assessed at two time points following epilepsy surgery. 2. • Graph theory and connectometry revealed substantial longitudinal diffusion changes. 3. • Changes were found beyond the site of resection. 4. • Postoperative seizure freedom associated with longitudinal structural changes.

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Our results confirm widespread alterations after epilepsy surgery beyond resection, with changes linked to seizure freedom, using longitudinal diffusion MRI and network analysis.

What’s new

i.Characterized longitudinal white‑matter changes in 48 anterior temporal lobe resection patients
ii.Combined diffusion connectometry and graph‑theory to assess structural and network topology alterations
iii.Demonstrated that greater reductions in quantitative anisotropy were associated with postoperative seizure freedom in left TLE
iv.Developed a null model to separate effects of resection from post‑surgical plasticity

How they did it

A longitudinal cohort of 48 TLE patients (26 left, 22 right) and 17 controls underwent diffusion MRI before surgery and 3–4 months after (with a subset at 12 months). Connectometry (using quantitative anisotropy) identified focal tract changes, while graph‑theory metrics on AAL‑parcellated networks quantified global and local topology. Statistical comparisons used Wilcoxon rank‑sum tests with FDR correction (q=0.05).

What they found

Significant local changes in strength, clustering coefficient, eigenvector and betweenness centrality between patients and controls within 3–4 months (FDR p < 0.005)
Greater reductions in QA were related to postoperative seizure freedom in left TLE
No longitudinal network‑topology differences were found between seizure‑free and recurrence groups
Sample comprised 48 patients (26 left TLE, 22 right TLE) and 17 controls

Caveats

✕Only longitudinal changes were analyzed; cross‑sectional pre‑/post‑operative comparisons were not performed
✕Outcome subgroup sizes were small (left TLE: 11 seizure‑free vs 11 recurrence; right TLE: 5 seizure‑free vs 12 recurrence)
✕Only 13 patients had 12‑month scans, limiting longer‑term analysis

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