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The Brain Activity in Brodmann Area 17: A Potential Bio-Marker to Predict Patient Responses to Antiepileptic Drugs.

Hu Y, Mi X, Xu X, Fang W, Zeng K, Yang M, Li C, Wang S, Li M, Wang X - PLoS ONE (2015)

Bottom Line: By calculating the amplitude of fractional low-frequency fluctuations (fALFF) of blood oxygen level-dependent signals to measure brain activity during rest, we found that the SUC patients showed increased activity in the bilateral occipital lobe, particularly in the cuneus and lingual gyrus compared with the SC group and healthy controls.Interestingly, DR patients also showed increased activity in the identical cuneus and lingual gyrus regions, which comprise Brodmann's area 17 (BA17), compared with the SUC patients; however, these abnormalities were not observed in SC and WH patients.Regions nearby the cuneus and lingual gyrus were found positive connectivity increased changes or positive connectivity changes with BA17 in the SUC patients, while remarkably negative connectivity increased changes or positive connectivity decreased changes were found in the SC patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.

ABSTRACT
In this study, we aimed to predict newly diagnosed patient responses to antiepileptic drugs (AEDs) using resting-state functional magnetic resonance imaging tools to explore changes in spontaneous brain activity. We recruited 21 newly diagnosed epileptic patients, 8 drug-resistant (DR) patients, 11 well-healed (WH) patients, and 13 healthy controls. After a 12-month follow-up, 11 newly diagnosed epileptic patients who showed a poor response to AEDs were placed into the seizures uncontrolled (SUC) group, while 10 patients were enrolled in the seizure-controlled (SC) group. By calculating the amplitude of fractional low-frequency fluctuations (fALFF) of blood oxygen level-dependent signals to measure brain activity during rest, we found that the SUC patients showed increased activity in the bilateral occipital lobe, particularly in the cuneus and lingual gyrus compared with the SC group and healthy controls. Interestingly, DR patients also showed increased activity in the identical cuneus and lingual gyrus regions, which comprise Brodmann's area 17 (BA17), compared with the SUC patients; however, these abnormalities were not observed in SC and WH patients. The receiver operating characteristic (ROC) curves indicated that the fALFF value of BA17 could differentiate SUC patients from SC patients and healthy controls with sufficient sensitivity and specificity prior to the administration of medication. Functional connectivity analysis was subsequently performed to evaluate the difference in connectivity between BA17 and other brain regions in the SUC, SC and control groups. Regions nearby the cuneus and lingual gyrus were found positive connectivity increased changes or positive connectivity changes with BA17 in the SUC patients, while remarkably negative connectivity increased changes or positive connectivity decreased changes were found in the SC patients. Additionally, default mode network (DMN) regions showed negative connectivity increased changes or negative changes with BA17 in the SUC patients. The abnormal increased in BA17 activity may be a key point that plays a substantial role in facilitating seizure onset.

No MeSH data available.


Related in: MedlinePlus

The fALFF values of BA17 and ROC curves.A: BA17 mask. B: A scatter plot showing fALFF values within BA17 mask in the SUC, SC, DR, WH patients and healthy controls. The error bar represents the standard deviation. * P = 0.01, ** P = 0.026. C: An ROC curve for the SUC patients and healthy controls. The cut-off point of the fALFF value for this curve was 1.15. Using this cut-off point, 9 out of 11 SUC patients and 10 out of 13 healthy controls were correctly identified, with a sensitivity of 81.8% and a specificity of 76.9%. D: An ROC curve for the SUC and SC patients with a fALFF cut-off point of 1.20. Using this cut-off point, the fALFF of BA17 could classify 8 out of 11 SUC patients and 7 out of 10 SC patients, yielding a sensitivity of 72.7% and a specificity of 70.0%.
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pone.0139819.g004: The fALFF values of BA17 and ROC curves.A: BA17 mask. B: A scatter plot showing fALFF values within BA17 mask in the SUC, SC, DR, WH patients and healthy controls. The error bar represents the standard deviation. * P = 0.01, ** P = 0.026. C: An ROC curve for the SUC patients and healthy controls. The cut-off point of the fALFF value for this curve was 1.15. Using this cut-off point, 9 out of 11 SUC patients and 10 out of 13 healthy controls were correctly identified, with a sensitivity of 81.8% and a specificity of 76.9%. D: An ROC curve for the SUC and SC patients with a fALFF cut-off point of 1.20. Using this cut-off point, the fALFF of BA17 could classify 8 out of 11 SUC patients and 7 out of 10 SC patients, yielding a sensitivity of 72.7% and a specificity of 70.0%.

Mentions: Previous results showed both the SUC and DR patients had significantly increased fALFF values in the bilateral cuneus and lingual gyrus while neither the SC nor the WH patients had the same fALFF abnormalities. These findings suggested that the fALFF values for the cuneus and lingual gyrus might serve as markers to detect patients who would have poor responses to AED therapy. Because both the cuneus and the lingual gyrus are located in BA17, we calculated the mean fALFF value of each participant within a BA17 mask (Fig 4A) using the Brodmann area template [32]. ANOVA result indicated there was BA17 fALFF difference among the SUC, SC, DR, WH, and control groups (P = 0.042). Independent two sample t-tests (Fig 4B) showed BA17 fALFF differences were found in SUC vs. CON (P = 0.001) and SUC vs. SC (P = 0.026). No difference was found in DR vs. CON (P = 0.068) and DR vs. WH (P = 0.265). Fig 4C shows the sensitivity and specificity of the fALFF of BA17 for differentiating SUC patients and controls. The area under the ROC curve was 0.85 (P = 0.004, 95% confidence interval [0.690–1.002]). The cut-off point of the fALFF value for this ROC was 1.15. Using this cut-off point, the fALFF of BA17 distinguished 9 out of 11 SUC patients and 10 out of 13 controls, with a sensitivity of 81.8% and a specificity of 76.9%. Notably, the fALFF value of BA17 could also differentiate SUC from SC patients. Fig 4D shows the sensitivity and specificity of the fALFF of BA17 for differentiating SUC and SC patients. The area under the curve was 0.78 (P = 0.029, 95% CI [0.585–0.979]), with a fALFF cut-off point of 1.20. Using this cut-off point, the fALFF of BA17 could classify 8 out of 11 SUC patients and 7 out of 10 SC patients, with a sensitivity of 72.7% and a specificity of 70.0%.


The Brain Activity in Brodmann Area 17: A Potential Bio-Marker to Predict Patient Responses to Antiepileptic Drugs.

Hu Y, Mi X, Xu X, Fang W, Zeng K, Yang M, Li C, Wang S, Li M, Wang X - PLoS ONE (2015)

The fALFF values of BA17 and ROC curves.A: BA17 mask. B: A scatter plot showing fALFF values within BA17 mask in the SUC, SC, DR, WH patients and healthy controls. The error bar represents the standard deviation. * P = 0.01, ** P = 0.026. C: An ROC curve for the SUC patients and healthy controls. The cut-off point of the fALFF value for this curve was 1.15. Using this cut-off point, 9 out of 11 SUC patients and 10 out of 13 healthy controls were correctly identified, with a sensitivity of 81.8% and a specificity of 76.9%. D: An ROC curve for the SUC and SC patients with a fALFF cut-off point of 1.20. Using this cut-off point, the fALFF of BA17 could classify 8 out of 11 SUC patients and 7 out of 10 SC patients, yielding a sensitivity of 72.7% and a specificity of 70.0%.
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pone.0139819.g004: The fALFF values of BA17 and ROC curves.A: BA17 mask. B: A scatter plot showing fALFF values within BA17 mask in the SUC, SC, DR, WH patients and healthy controls. The error bar represents the standard deviation. * P = 0.01, ** P = 0.026. C: An ROC curve for the SUC patients and healthy controls. The cut-off point of the fALFF value for this curve was 1.15. Using this cut-off point, 9 out of 11 SUC patients and 10 out of 13 healthy controls were correctly identified, with a sensitivity of 81.8% and a specificity of 76.9%. D: An ROC curve for the SUC and SC patients with a fALFF cut-off point of 1.20. Using this cut-off point, the fALFF of BA17 could classify 8 out of 11 SUC patients and 7 out of 10 SC patients, yielding a sensitivity of 72.7% and a specificity of 70.0%.
Mentions: Previous results showed both the SUC and DR patients had significantly increased fALFF values in the bilateral cuneus and lingual gyrus while neither the SC nor the WH patients had the same fALFF abnormalities. These findings suggested that the fALFF values for the cuneus and lingual gyrus might serve as markers to detect patients who would have poor responses to AED therapy. Because both the cuneus and the lingual gyrus are located in BA17, we calculated the mean fALFF value of each participant within a BA17 mask (Fig 4A) using the Brodmann area template [32]. ANOVA result indicated there was BA17 fALFF difference among the SUC, SC, DR, WH, and control groups (P = 0.042). Independent two sample t-tests (Fig 4B) showed BA17 fALFF differences were found in SUC vs. CON (P = 0.001) and SUC vs. SC (P = 0.026). No difference was found in DR vs. CON (P = 0.068) and DR vs. WH (P = 0.265). Fig 4C shows the sensitivity and specificity of the fALFF of BA17 for differentiating SUC patients and controls. The area under the ROC curve was 0.85 (P = 0.004, 95% confidence interval [0.690–1.002]). The cut-off point of the fALFF value for this ROC was 1.15. Using this cut-off point, the fALFF of BA17 distinguished 9 out of 11 SUC patients and 10 out of 13 controls, with a sensitivity of 81.8% and a specificity of 76.9%. Notably, the fALFF value of BA17 could also differentiate SUC from SC patients. Fig 4D shows the sensitivity and specificity of the fALFF of BA17 for differentiating SUC and SC patients. The area under the curve was 0.78 (P = 0.029, 95% CI [0.585–0.979]), with a fALFF cut-off point of 1.20. Using this cut-off point, the fALFF of BA17 could classify 8 out of 11 SUC patients and 7 out of 10 SC patients, with a sensitivity of 72.7% and a specificity of 70.0%.

Bottom Line: By calculating the amplitude of fractional low-frequency fluctuations (fALFF) of blood oxygen level-dependent signals to measure brain activity during rest, we found that the SUC patients showed increased activity in the bilateral occipital lobe, particularly in the cuneus and lingual gyrus compared with the SC group and healthy controls.Interestingly, DR patients also showed increased activity in the identical cuneus and lingual gyrus regions, which comprise Brodmann's area 17 (BA17), compared with the SUC patients; however, these abnormalities were not observed in SC and WH patients.Regions nearby the cuneus and lingual gyrus were found positive connectivity increased changes or positive connectivity changes with BA17 in the SUC patients, while remarkably negative connectivity increased changes or positive connectivity decreased changes were found in the SC patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.

ABSTRACT
In this study, we aimed to predict newly diagnosed patient responses to antiepileptic drugs (AEDs) using resting-state functional magnetic resonance imaging tools to explore changes in spontaneous brain activity. We recruited 21 newly diagnosed epileptic patients, 8 drug-resistant (DR) patients, 11 well-healed (WH) patients, and 13 healthy controls. After a 12-month follow-up, 11 newly diagnosed epileptic patients who showed a poor response to AEDs were placed into the seizures uncontrolled (SUC) group, while 10 patients were enrolled in the seizure-controlled (SC) group. By calculating the amplitude of fractional low-frequency fluctuations (fALFF) of blood oxygen level-dependent signals to measure brain activity during rest, we found that the SUC patients showed increased activity in the bilateral occipital lobe, particularly in the cuneus and lingual gyrus compared with the SC group and healthy controls. Interestingly, DR patients also showed increased activity in the identical cuneus and lingual gyrus regions, which comprise Brodmann's area 17 (BA17), compared with the SUC patients; however, these abnormalities were not observed in SC and WH patients. The receiver operating characteristic (ROC) curves indicated that the fALFF value of BA17 could differentiate SUC patients from SC patients and healthy controls with sufficient sensitivity and specificity prior to the administration of medication. Functional connectivity analysis was subsequently performed to evaluate the difference in connectivity between BA17 and other brain regions in the SUC, SC and control groups. Regions nearby the cuneus and lingual gyrus were found positive connectivity increased changes or positive connectivity changes with BA17 in the SUC patients, while remarkably negative connectivity increased changes or positive connectivity decreased changes were found in the SC patients. Additionally, default mode network (DMN) regions showed negative connectivity increased changes or negative changes with BA17 in the SUC patients. The abnormal increased in BA17 activity may be a key point that plays a substantial role in facilitating seizure onset.

No MeSH data available.


Related in: MedlinePlus