Janson A, Sainburg L, Akbarian B, Johnson GW, Rogers BP, Chang C, Englot DJ, Morgan VL. Indirect structural changes and reduced controllability after temporal lobe epilepsy resection. Epilepsia. 2024 Mar;65(3):675-686. doi: 10.1111/epi.17889. Epub 2024 Jan 19. PMID: 38240699; PMCID: PMC10948308.
The study investigates the network-wide functional changes in the brain of patients with temporal lobe epilepsy (TLE) before and after mesial temporal resection surgery, using a measure called average regional controllability (ARC). This measure evaluates the capacity of specific brain nodes to influence overall network dynamics. The research involved 27 patients with drug-resistant unilateral mesial TLE who underwent a surgical procedure known as selective amygdalohippocampectomy. By comparing pre-surgical and post-surgical brain scans and using whole-brain tractography to map connections, significant changes were observed not only in the directly affected areas but also in remote regions like the ipsilateral occipital lobe. These changes, which include both direct and indirectly affected network edges, were associated with the broader network’s dynamic properties, involving key “hub” nodes such as the thalamus and insula. The findings highlight that the ARC can reveal extensive structural and functional brain alterations post-surgery, potentially influencing outcomes like seizure recurrence and cognitive or behavioral changes, thus offering a nuanced understanding of brain network dynamics following epileptic focus resection.
