Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/19061
Title: Cognitive network reorganization following surgical control of seizures in Lennox-Gastaut syndrome.
Austin Authors: Warren, Aaron E L;Harvey, A Simon;Abbott, David F ;Vogrin, Simon J;Bailey, Catherine;Davidson, Andrew;Jackson, Graeme D ;Archer, John S 
Affiliation: Department of Neurology, Austin Health, Heidelberg, Victoria, Australia
The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Heidelberg, Victoria, Australia
Department of Neurology, The Royal Children's Hospital, Parkville, Victoria, Australia
Department of Paediatrics, The University of Melbourne, Heidelberg, Victoria, Australia
Department of Medicine, The University of Melbourne, Heidelberg, Victoria, Australia
Department of Anaesthesia and Pain Management, The Royal Children's Hospital, Parkville, Victoria, Australia
Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
Issue Date: May-2017
metadata.dc.date: 2017-03-11
Publication information: Epilepsia 2017; 58(5): e75-e81
Abstract: We previously observed that adults with Lennox-Gastaut syndrome (LGS) show abnormal functional connectivity among cognitive networks, suggesting that this may contribute to impaired cognition. Herein we report network reorganization following seizure remission in a child with LGS who underwent functional magnetic resonance imaging (fMRI) before and after resection of a cortical dysplasia. Concurrent electroencephalography (EEG) was acquired during presurgical fMRI. Presurgical and postsurgical functional connectivity were compared using (1) graph theoretical analyses of small-world network organization and node-wise strength; and (2) seed-based analyses of connectivity within and between five functional networks. To explore the specificity of these postsurgical network changes, connectivity was further compared to nine children with LGS who did not undergo surgery. The presurgical EEG-fMRI revealed diffuse activation of association cortex during interictal discharges. Following surgery and seizure control, functional connectivity showed increased small-world organization, stronger connectivity in subcortical structures, and greater within-network integration/between-network segregation. These changes suggest network improvement, and diverged sharply from the comparison group of nonoperated children. Following surgery, this child with LGS achieved seizure control and showed extensive reorganization of networks that underpin cognition. This case illustrates that the epileptic process of LGS can directly contribute to abnormal network organization, and that this network disruption may be reversible.
URI: http://ahro.austin.org.au/austinjspui/handle/1/19061
DOI: 10.1111/epi.13720
ORCID: 0000-0002-7259-8238
PubMed URL: 28295228
Type: Journal Article
Subjects: Epileptic encephalopathy
Functional MRI
Graph theory
Lennox-Gastaut syndrome
Surgery
Appears in Collections:Journal articles

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