BACKGROUND AND OBJECTIVES Despite their temporal lobe pathology, a significant subgroup of patients with temporal lobe epilepsy (TLE) is able to maintain normative cognitive functioning. In this study, we identify patients with TLE with intact vs impaired neurocognitive profiles and interrogate for the presence of both normative and highly individual intrinsic connectivity networks (ICNs)-all toward understanding the transition from impaired to intact neurocognitive status. METHODS This retrospective cross-sectional study included patients with TLE and matched healthy controls (HCs) from the Thomas Jefferson Comprehensive Epilepsy Center. Functional MRI data were decomposed using independent component analysis to obtain individualized ICNs. In this article, we calculated the degree of match between individualized ICNs and canonical ICNs (e.g., 17 resting-state networks by Yeo et al.) and divided each participant's ICNs into normative or non-normative status based on the degree of match. RESULTS 100 patients with TLE (mean age 42.0 [SD: 13.7] years, 47 women) and 92 HCs were included in this study. We found that the individualized networks matched to the canonical networks less well in the cognitively impaired (n = 24) compared with the cognitively intact (n = 63) patients with TLE by 2-way mixed-measures analysis of variance (impaired vs intact mean difference [MD] -0.165 [-0.317, -0.013], p = 0.028). The cognitively impaired patients showed significant abnormalities in the profiles of both normative (impaired vs intact MD -0.537 [-0.998, -0.076], p = 0.017, intact vs HC MD -0.221 [-0.536, 0.924], p = 0.220, and impaired vs HC MD -0.759 [-1.200, -0.319], p < 0.001) and non-normative networks (impaired vs intact MD 0.484 [0.030, 0.937], p = 0.033, intact vs HC MD 0.369 [0.059, 0.678], p = 0.014, and impaired vs HC MD 0.853 [0.419, 1.286], p < 0.001) while the intact patients showed abnormalities only in non-normative networks. At the same time, we found that normative networks held a strong, positive association with the neuropsychological measures, with this association negative in non-normative networks. DISCUSSION Our data demonstrated that significant cognitive deficits are associated with the status of both canonical and highly individual ICNs, making clear that the transition from intact to impaired cognitive status is not simply the result of disruption to normative brain networks.

中文翻译：

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规范和非规范脑网络与颞叶癫痫患者认知功能的关联。


背景和目标 尽管存在颞叶病理，但颞叶癫痫 (TLE) 患者的一个重要亚组能够维持正常的认知功能。在这项研究中，我们识别了具有完整和受损神经认知特征的 TLE 患者，并询问是否存在正常和高度个体的内在连接网络 (ICN)，所有这些都是为了了解从受损到完整神经认知状态的转变。方法 这项回顾性横断面研究纳入了来自 Thomas Jefferson 综合癫痫中心的 TLE 患者和匹配的健康对照 (HC)。使用独立成分分析对功能性 MRI 数据进行分解，以获得个性化的 ICN。在本文中，我们计算了个性化ICN和规范ICN（例如Yeo等人的17个静息状态网络）之间的匹配程度，并根据匹配程度将每个参与者的ICN分为规范或非规范状态。结果 本研究纳入了 100 名 TLE 患者（平均年龄 42.0 [SD：13.7] 岁，47 名女性）和 92 名 HC。通过 2 路混合测量方差分析（受损均值与完整均值），我们发现，与认知完整 (n = 63) 的 TLE 患者相比，认知受损 (n = 24) 的个体化网络与规范网络的匹配较差差异 [MD] -0.165 [-0.317，-0.013]，p = 0.028）。认知障碍患者的两种正常情况均表现出显着异常（受损与完整MD -0.537 [-0.998，-0.076]，p = 0.017，完整与HC MD -0.221 [-0.536，0.924]，p = 0.220，和受损与 HC MD -0.759 [-1.200, -0.319], p < 0.001) 和非规范网络（受损与完整 MD 0.484 [0.030, 0.937]，p = 0.033，完整与 HC MD 0。369 [0.059, 0.678]，p = 0.014，受损 vs HC MD 0.853 [0.419, 1.286]，p < 0.001），而完整患者仅在非规范网络中表现出异常。与此同时，我们发现规范网络与神经心理学测量之间存在强烈的正相关关系，而这种关联在非规范网络中呈负相关。讨论我们的数据表明，显着的认知缺陷与规范的和高度个体化的ICN的状态有关，这清楚地表明，从完整的认知状态到受损的认知状态的转变不仅仅是规范大脑网络破坏的结果。