Statistical parametric map showing the significant differences of functional connectivity between PDD and nD-PD groups.

<p>(a) Differences in functional connectivity for the left middle frontal gyrus seeds between the PDD and nD-PD groups. (b) Differences in functional connectivity for the right inferior frontal gyrus between the PDD and nD-PD groups in the resting state. (c) Differences in functional connectivity for the left amygdala seeds between the PDD and nD-PD groups. (d) Differences in functional connectivity for left lingual gyrus seeds between the PDD and nD-PD groups. (e) Differences in functional connectivity for right lingual gyrus seeds between the PDD and nD-PD groups. T score bars are shown on the right. Green spot: the position of the region of interest.</p

Brain regions exhibiting decreased and increased regional homogeneity among three groups.

<p>Brain regions exhibiting decreased and increased regional homogeneity among three groups.</p

Demographic information for the PDD/nD-PD and control groups.

<p>Demographic information for the PDD/nD-PD and control groups.</p

Differences in ReHo values between the PDD and nD-PD groups. (P<0.05, AlphaSim corrected).

<p>Differences in ReHo values between the PDD and nD-PD groups. (P<0.05, AlphaSim corrected).</p

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

<div><p>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.</p></div

Maps of fALFF differences.

<p><b>A:</b> SUC vs. control. Compared with healthy controls, the SUC patients showed significantly increased fALFF values in the warm color regions, including the bilateral cuneus, bilateral lingual gyrus, bilateral superior/middle/inferior occipital gyrus, and right posterior cingulate. <b>B:</b> SUC vs. SC. Compared with SC patients, the SUC patients showed significantly increased fALFF values in the warm color regions of the bilateral cuneus, bilateral lingual gyrus, bilateral middle temporal-occipital area, and right fusiform gyrus. <b>C:</b> DR vs. controls. The DR patients showed significantly increased fALFF values in the warm color regions of the bilateral cuneus, bilateral middle occipital gyrus, bilateral fusiform, and right middle temporal-occipital area. <b>D:</b> DR vs. WH. Compared with WH patients, the DR patients showed significantly increased fALFF values in the warm color regions of the left cuneus, bilateral fusiform, and right middle occipital gyrus. <b>E:</b> SC vs. CON. Compared with the healthy controls, the SC patients showed significantly increased fALFF values in the warm color region of the left inferior occipital gyrus. In contrast, the cold color regions in the right fusiform gyrus represent the area with decreased fALFF values in SC patients compared with controls. <b>F:</b> WH vs. CON. The WH patients showed only showed decreased fALFF values in the cold color region of the right fusiform gyrus. The statistical threshold was set at P < 0.05 with a cluster size > 351 mm³, which corresponded to a corrected P < 0.05.</p

Map of fALFF differences among the SUC, SC, DR, WH and control groups.

<p>There were significant fALFF differences among the five groups in the bilateral cuneus, lingual gyrus, inferior/middle occipital gyrus, calcarine, middle temporal-occipital area, fusiform, subcortical structure of left occipital lobe, subcortical structure of right temporal lobe, right posterior cingulated, and right cerebellum posterior lobe. The statistical threshold was set at P < 0.05 and a cluster size > 4158 mm³, which corresponded to a corrected P < 0.05.</p

The fALFF values of BA17 and ROC curves.

<p><b>A:</b> BA17 mask. <b>B:</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. <b>C:</b> 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%. <b>D:</b> 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%.</p

Spatial overlapping maps and scatter plots showing fALFF values of overlaps.

<p><b>A:</b> SUC vs. CON and DR vs. CON. Overlap regions account for 20% of SUC <i>vs</i>. controls, 41.7% of DR <i>vs</i>. controls, and 15.9% of total respectively. The yellow parts represents brain regions with common fALFF changes between SUC <i>vs</i>. controls and DR <i>vs</i>. controls including the bilateral lingual gyrus, cuneus, inferior occipital gyrus, middle occipital gyrus, right superior occipital gyrus, subcortical structure of left occipital lobe, subcortical structure of right temporal lobe, and left fusiform. The red parts show regions with fALFF differences from comparison of SUC vs. CON only. The blue parts show regions with fALFF differences from comparison of DR vs. CON only. <b>B:</b> SUC vs. SC and DR vs. WH. Overlap regions account for 27.2% of SUC <i>vs</i>. SC, 24.7% of DR <i>vs</i>. WH, and 14.9% of total respectively. The yellow parts represents brain regions with common fALFF changes between SUC <i>vs</i>. SC and DR <i>vs</i>. WH were found in the bilateral middle occipital gyrus, fusiform, lingual gyrus, the right superior occipital gyrus, cuneus and cerebellum posterior lobe. The red parts show regions with fALFF differences from comparison of SUC vs. SC only. The blue parts show regions with fALFF differences from comparison of DR vs. WH only. All comparisons were restrained in the ANOVA mask. <b>C:</b> fALFF values of overlap with common brain activity changes between SUC vs. CON and DR vs. CON. The error bar represents the standard deviation. * P< 0.001. <b>D:</b> fALFF values of overlap with common brain activity changes between SUC vs. SC and DR vs. WH. The error bar represents the standard deviation. * P = 0.001, * *P< 0.001.</p

Baseline demographic and head motion characteristics for subjects.

<p>^aThe P values for the gender distributions in the five groups were calculated using the chi-squared test.</p><p>^bThe values are represented as mean±standard deviation (SD).</p><p>^cThe P values were calculated by one-way ANOVA tests.</p><p>^dThe head motion characteristics was represented as mean framewise displacement (FD)±SD.</p><p>Baseline demographic and head motion characteristics for subjects.</p