Structural Connectivity Alterations in Operculo-Insular Epilepsy

Operculo-insular epilepsy (OIE) is an under-recognized condition that can mimic temporal and extratemporal epilepsies. Previous studies have revealed structural connectivity changes in the epileptic network of focal epilepsy. However, most reports use the debated streamline-count to quantify ‘connec...

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Bibliographic Details
Published in:Brain sciences 2021-08, Vol.11 (8), p.1041
Main Authors: Obaid, Sami, Rheault, François, Edde, Manon, Guberman, Guido I., St-Onge, Etienne, Sidhu, Jasmeen, Bouthillier, Alain, Daducci, Alessandro, Ghaziri, Jimmy, Bojanowski, Michel W., Nguyen, Dang K., Descoteaux, Maxime
Format: Article
Language:English
Subjects:
connectome
Convulsions & seizures
diffusion magnetic resonance imaging
Electroencephalography
Epilepsy
insula
Localization
Magnetic resonance imaging
operculum
Patients
Temporal lobe
tractography
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Summary:Operculo-insular epilepsy (OIE) is an under-recognized condition that can mimic temporal and extratemporal epilepsies. Previous studies have revealed structural connectivity changes in the epileptic network of focal epilepsy. However, most reports use the debated streamline-count to quantify ‘connectivity strength’ and rely on standard tracking algorithms. We propose a sophisticated cutting-edge method that is robust to crossing fibers, optimizes cortical coverage, and assigns an accurate microstructure-reflecting quantitative conectivity marker, namely the COMMIT (Convex Optimization Modeling for Microstructure Informed Tractography)-weight. Using our pipeline, we report the connectivity alterations in OIE. COMMIT-weighted matrices were created in all participants (nine patients with OIE, eight patients with temporal lobe epilepsy (TLE), and 22 healthy controls (HC)). In the OIE group, widespread increases in ‘connectivity strength’ were observed bilaterally. In OIE patients, ‘hyperconnections’ were observed between the insula and the pregenual cingulate gyrus (OIE group vs. HC group) and between insular subregions (OIE vs. TLE). Graph theoretic analyses revealed higher connectivity within insular subregions of OIE patients (OIE vs. TLE). We reveal, for the first time, the structural connectivity distribution in OIE. The observed pattern of connectivity in OIE likely reflects a diffuse epileptic network incorporating insular-connected regions and may represent a structural signature and diagnostic biomarker.
ISSN:2076-3425
2076-3425
DOI:10.3390/brainsci11081041