ABSTRACT
Epilepsy may affect connectivity between the putamen and cortex even during the resting state. Putamen is part of the basal ganglia resting state network (BG-RSN) which is anti-correlated with the default mode network (DMN) in healthy subjects. Therefore, we aimed at studying the functional brain connectivity (FC) of the putamen with the cortical areas engaged in the DMN as well as with the primary somatomotor cortex which is a cortical region engaged in the BG-RSN. We compared the data obtained in patients with epilepsy with that in healthy controls (HC). Functional magnetic resonance imaging (fMRI) was performed in 10 HC and 24 patients with epilepsy: 14 patients with extratemporal epilepsy (PE) and 10 patients with temporal epilepsy (PT). Resting state fMRI data was obtained using the 1.5 T Siemens Symphony scanner. The Group ICA of fMRI Toolbox (GIFT) program was used for independent component analysis. The component representing the DMN was chosen according to a spatial correlation with a mask typical for DMN. The FC between the putamen and the primary somatomotor cortex was studied to assess the connectivity of the putamen within the BG-RSN. A second-level analysis was calculated to evaluate differences among the groups using SPM software. In patients with epilepsy as compared to HC, the magnitude of anti-correlation between the putamen and brain regions engaged in the DMN was significantly lower. In fact, the correlation changed the connectivity direction from negative in HC to positive in PE and PT. The disturbed FC of the BG in patients with epilepsy as compared with HC was further illustrated by a significant decrease in connectivity between the left/right putamen and the left/right somatomotor cortex, i.e. between regions that are engaged in the BG-RSN. The FC between the putamen and the cortex is disturbed in patients with epilepsy. This may reflect an altered function of the BG in epilepsy.
Subject(s)
Basal Ganglia/physiology , Brain/physiology , Epilepsy, Temporal Lobe/physiopathology , Epilepsy/physiopathology , Nerve Net/physiology , Adult , Basal Ganglia/anatomy & histology , Brain/anatomy & histology , Brain/pathology , Brain Mapping , Case-Control Studies , Cerebral Cortex/pathology , Cerebral Cortex/physiopathology , Epilepsy/pathology , Epilepsy, Temporal Lobe/pathology , Female , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Motor Cortex/pathology , Motor Cortex/physiopathology , Nerve Net/anatomy & histology , Putamen/pathology , Putamen/physiopathologyABSTRACT
Miller Fisher syndrome (MFS) is a localized variant of Guillain-Barré syndrome (GBS), characterized by ophthalmoplegia, areflexia, and ataxia. Recent neurophysiological studies have suggested that abnormal terminal axon dysfunction occurs in some cases of Miller Fisher syndrome and Guillain-Barrd syndrome. We present a rare case report of recurrent MFS with abnormal terminal axon dysfunction. To the best of our knowledge, this is the first case report of recurrent MFS with terminal axon dysfunction that persisted up to nine months after the initial presentation of the second attack with positive antiganglioside antibodies and full clinical recovery.
Subject(s)
Axons/pathology , Miller Fisher Syndrome/pathology , Miller Fisher Syndrome/physiopathology , Adult , Autoantibodies , Electromyography , Gangliosides/immunology , Humans , Male , Miller Fisher Syndrome/immunology , Neural Conduction , RecurrenceABSTRACT
PURPOSE: The rationale for this case report is to assess the degree of congruency between the results of several advanced functional, metabolic, and structural neuroimaging techniques used in patients with MRI-negative focal epilepsy. METHODS: We investigated the presurgical evaluation and post-operative outcome of a patient with intractable, extratemporal epilepsy. Because the habitual seizures in this patient could be easily induced, six, advanced, neurodiagnostic techniques were successively applied (SISCOM, ictal FDG-PET, ictal fMRI, postictal diffusion-weighted imaging, voxel-based morphometry, and MRS imaging). RESULTS: The findings for the neuroimaging methods investigated, within the left central region, were fairly congruent. Subsequent, invasive EEG recordings revealed a seizure-onset zone at the site where most of the neuroimaging had shown abnormal findings. The surgical removal of the epileptogenic zone, as defined by concordant neuroimaging and SEEG data, resulted in seizure-free postoperative outcome. Histopathological findings revealed mild focal cortical dysplasia. CONCLUSION: Great efforts should be made to combine most of the advanced neuroimaging methods in the preoperative assessment of non-lesional epilepsy surgery candidates.
