Cognitive impairment in epilepsy : The role of reduced network flexibility

Journal article


Tailby, Chris, Kowalczyk, Magdalena A. and Jackson, Graeme D.. (2018). Cognitive impairment in epilepsy : The role of reduced network flexibility. Annals of Clinical and Translational Neurology. 5(1), pp. 29-40. https://doi.org/10.1002/acn3.503
AuthorsTailby, Chris, Kowalczyk, Magdalena A. and Jackson, Graeme D.
Abstract

Objective
The dominant model of cognitive impairment in focal epilepsy has emphasised structural bases for cognitive deficits. Current theories of cognition in the healthy brain emphasise the importance of the reweighting of brain network interactions in support of task performance. Here, we explore the hypothesis that cognitive deficits in epilepsy arise through abnormalities of dynamic functional network interactions.

Method
We studied 19 healthy controls and 37 temporal lobe epilepsy (TLE) patients, using a behavioural measure of verbal fluency (the Controlled Oral Word Association Test) and an fMRI verbal fluency paradigm (Orthographic Lexical Retrieval).

Results
Behaviourally, verbal fluency was significantly impaired in TLE. Psychophysiological interaction analyses of the fMRI data, which capture state-dependent changes in network connectivity, revealed reduced task-dependent modulations of connectivity from left superior medial frontal cortex to left middle frontal gyrus in TLE patients. Individual differences in verbal fluency among TLE cases was correlated with task-dependent changes in connectivity from left posterior cingulate to left superior medial frontal cortex, and from left superior medial frontal cortex to a range of right predominant brain areas.

Interpretation
These data reveal that the typical pattern of task-driven shifts in network connectivity is not observed in TLE. Our observations go beyond simple structure-function associations and suggest that failure of network flexibility can be an important contributor to cognitive impairment in epilepsy.

Year2018
JournalAnnals of Clinical and Translational Neurology
Journal citation5 (1), pp. 29-40
PublisherWiley-Blackwell
ISSN2328-9503
Digital Object Identifier (DOI)https://doi.org/10.1002/acn3.503
Scopus EID2-s2.0-85035044057
Open accessPublished as ‘gold’ (paid) open access
Research or scholarlyResearch
Page range29-40
FunderNational Health and Medical Research Council (NHMRC)
Publisher's version
License
File Access Level
Open
Output statusPublished
Publication dates
Online24 Nov 2017
Publication process dates
Accepted18 Oct 2017
Deposited14 Jul 2021
Grant IDNHMRC/628952
NHMRC/1081151
NHMRC/1060312
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