Functional Connectivity Patterns Of Executive Control Network And Alertness Related Network In Patients With Right Temporal Lobe Epilepsy

Objective Temporal lobe epilepsy(TLE)is a common multi-factor chronic disease of the nervous system,which is one of the most common type of epilepsy.There is a consensus that patients with temporal lobe epilepsy have cognitive impairment,among which executive function and alertness are more vulnerable.At present,there have been many reports on the research about the executive function or alertness function of TLE patients alone,but there are no reports on the research about the executive control network and alertness network of TLE patients at the same time.In our study,attention network test(ANT)was used to evaluate the behavioral performance,afterwards Combined with the resting state functional magnetic resonance imaging(rs-fmri)and Independent component analysis(ICA),to investigate the functional connectivity patterns of executive control network and alertness related network within and between networks as well as its relationship with behavior in patients with right temporal lobe epilepsy(rTLE).The interaction between the two networks is alsodiscussed at last.Methods 20 rTLE patients and 20 normal controls were studied.The attention network test(ANT)was used to evaluate behavioral performance and compare executive control efficiency and alertness efficiency.Then rs-fmri scanning was performed and ICA was used to extract the executive control network and alertness related network.The functional connection of resting state within and between the two networks was analyzed,and the correlation between the behavior and Z value which was extracted of functional connection in brain regions with differences between the two groups.The functional connectivity between the two networks has been tentatively explored.Results The executive control effect of the patients was significantly lower than that of the control group(P<0.01).Compared with control,the intrinsic and phasic alertness performances of the patients were impaired(P<0.01);rTLE patients presented lower functional connectivity of the executive control network in right middle frontal gyrus、superior frontal gyrus、medial superior frontal gyrus 、 supplementary motor area 、 precuneus,left inferior parietal lobule.There was no statistically significant difference in functional connectivity between the two networks;rTLE patients presented lower functional connectivity of the alertness related network in right middle frontal gyrus、the pars opercularis of inferior frontal gyrus、the triangle of inferior frontal gyrus、Orbital inferior frontal gyrus、insula、inferior parietal lobule,left medial superior frontal gyrus、Cerebellum Posterior Lobe.No brain regions with enhanced functional connectivity were found in either network.The Z value of the right Precuneus was correlated with the executive control effect in the rTLE patients(P<0.05).The functional connection between the two networks was significantly weaker than that of the control group(P<0.05).Conclusion These results suggest that patients with rTLE have the impairment in executive function and alert function,and the functional connection patterns of executive control network and alertness related network were changed.The relationship between the right precuneus and executive function was clarified,and the functional connection between the two networks is weakened.The changes of the results above may be related to the pathological mechanism of epilepsy.