Base On Graph Theory To Explore The Progressive Changes In The Brain Network Of Patients With Temporal Lobe Epilepsy:A Three Years Follow-Up Study

PURPOSE: To explore the changes in the complex network of brain functions in patients with temporal lobe epilepsy(TLE)and the mechanism of progressive damage.METHODS: This study enrolled 15 epilepsy patients(TLE baseline)and13 healthy controls(HCs)who underwent resting functional magnetic resonance(rs-f MRI)and attention network test(ANT).The TLE group was followed up for 3 years(TLE follow-up)and underwent rs-f MRI and ANT too,apply graph theory method to study the 3-year longitudinal changes of the complex network of brain function in patients with TLE,and evaluate cognitive function.RESULTS: This study finally included 13 TLE subjects and 13 healthy controls.The cross-sectional study showed that compared with the healthy control group,the TLE baseline had impaired alertness,and the local efficiency of the left inferior temporal gyrus(ITG.L)and the left supplementery motor area(SMA.L)had increased,the hippocampus(HIP.L),the right hippocampus(HIP.R),the left parahippocampal gyrus(PHG.L),the right parahippocampal gyrus(PHG.R),the left amygdala(AMYG.L)and the right amygdala(AMYG.R),the left thalamus(THA.L)and the right thalamus(THA.R)decreased,the right side of the precentral gyrus(Pre CG),the right side of the postcentral gyrus(Po CG)and the right side of the paracentral lobule(PCL.R)increased,the global efficiency of the TLE follow-up group decreased,and the small-world decreased,and the difference in the area under the curve of gamma and sigma,which quantifies the small-world was statistically significant.Longitudinal research results showed that compared with the TLE baseline group,the TLE follow-up group show that degree centrality of the right olfactory cortex(OLF.R),left hippocampus(HIP.L),left amygdala(AMYG.L),and right amygdala(AMYG.R),right caudate nucleus(CAU.R),left lenticular putamen(PUT.L)and left lenticular pallidus(PAL.L)decreased,while the degree centrality of the right superior temporal pole(STG.R)increased,and the overall efficiency of the TLE follow-up group decreased.Correlation analysis showed that the local efficiency of the left supplementery motor area was positively correlated with duration of the disease,the local efficiency of the right thalamus was negatively correlated with its alertness efficiency and orientation function,and the left thalamus was negatively correlated with orientation function.The global efficiency of the TLE follow-up group is negatively correlated with the alertness efficiency,and the small-world is negatively correlated with the alertness efficiency;the degree centrality of the right superior temporal pole is positively correlated with its alertness efficiency and is negatively correlated with its onset time,The degree centrality of the right olfactory cortex is correlated with the onset time.CONCLUSION:This study explored the changes from brain network to brain function,and then to explore the effects of disease progression in patients with TLE on cognitive impairment such as attention,providing new evidence and imaging evidence for the progressive impairment of TLE.Our study demonstrate that the damage of temporal lobe epilepsy is not only limited to the temporal lobe,but also damages the external structure of the temporal lobe.The local efficiency of the bilateral thalamus decreased are considered to be a compensation for alertness and orientation,the local efficiency increase of the right anterior central gyrus,the right central posterior gyrus and the paracentral lobules are considered to be a compensation for executive function.In the progressive damage of TLE,it first appears in the changes in network efficiency and the degree of centrality of nodes,which is concentrated in the overall network efficiency and local network Decline in efficiency and interruption of the network.