Presurgical hyperconnectivity of the ablation volume is associated with seizure-freedom after magnetic resonance-guided laser interstitial thermal therapy

George M. Ibrahim, Alexander G. Weil, Shaina Sedighim, Nathan B. Schoen, Mirriam Mikhail, Priya Sharma, Magno R. Guillen, Benjamin R. Morgan, Simeon Wong, Iahn Cajigas, Walter J. Jermakowicz, Carolina Sandoval-Garcia, Evan C. Lewis, Aria Fallah, Nolan Altman, Santiago Medina, Esperanza Pacheco-Jacome, Prasanna Jayakar, Ann Hyslop, Ian MillerJohn Ragheb, Sanjiv Bhatia, Byron Bernal

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Purpose: Magnetic Resonance-guided Laser Interstitial Thermal Therapy (MRgLITT) is an emerging minimally-invasive alternative to resective surgery for medically-intractable epilepsy. The precise lesioning effect produced by MRgLITT supplies opportunities to glean insights into epileptogenic regions and their interactions with functional brain networks. In this exploratory analysis, we sought to characterize associations between MRgLITT ablation zones and large-scale brain networks that portended seizure outcome using resting-state fMRI. Methods: Presurgical fMRI and intraoperatively volumetric structural imaging were obtained, from which the ablation volume was segmented. The network properties of the ablation volume within the brain's large-scale brain networks were characterized using graph theory and compared between children who were and were not rendered seizure-free. Results: Of the seventeen included children, five achieved seizure freedom following MRgLITT. Greater functional connectivity of the ablation volume to canonical resting-state networks was associated with seizure-freedom (p < 0.05, FDR-corrected). The ablated volume in children who subsequently became seizure-free following MRgLITT had significantly greater strength, and eigenvector centrality within the large-scale brain network. Conclusions: These findings provide novel insights into the interaction between epileptogenic cortex and large-scale brain networks. The association between ablation volume and resting-state networks may supply novel avenues for presurgical planning and patient stratification.

Original languageEnglish (US)
Pages (from-to)89-93
Number of pages5
JournalSeizure
Volume61
DOIs
StatePublished - Oct 2018
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2018 British Epilepsy Association

Keywords

  • Functional connectivity
  • Intrinsic connectivity networks
  • Laser ablation
  • Low frequency neural oscillations
  • Resting-state fMRI
  • Seizures
  • Thermal ablation

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