Gaelle Eve Doucet

Brain activity at rest: A multiscale hierarchical functional organization.

Spontaneous brain activity was mapped with functional MRI (fMRI) in a sample of 180 subjects while in a conscious resting-state condition. With the use of independent component analysis (ICA) of each individual fMRI signal and classification of the ICA-defined components across subjects, a set of 23 resting-state networks (RNs) was identified. Functional connectivity between each pair of RNs was assessed using temporal correlation analyses in the 0.01- to 0.1-Hz frequency band, and the corresponding set of correlation coefficients was used to obtain a hierarchical clustering of the 23 RNs. At the highest hierarchical level, we found two anticorrelated systems in charge of intrinsic and extrinsic processing, respectively. At a lower level, the intrinsic system appears to be partitioned in three modules that subserve generation of spontaneous thoughts (M1a; default mode), inner maintenance and manipulation of information (M1b), and cognitive control and switching activity (M1c), respectively. The extrinsic system was found to be made of two distinct modules: one including primary somatosensory and auditory areas and the dorsal attentional network (M2a) and the other encompassing the visual areas (M2b). Functional connectivity analyses revealed that M1b played a central role in the functioning of the intrinsic system, whereas M1c seems to mediate exchange of information between the intrinsic and extrinsic systems.

The resting state questionnaire: An introspective questionnaire for evaluation of inner experience during the conscious resting state

We designed a semi-structured questionnaire for the introspective evaluation of inner experience of participants undergoing functional magnetic resonance imaging (fMRI) in the resting state. This resting state questionnaire (ReSQ) consists of 62 items organized by five main types of mental activity: visual mental imagery (IMAG); inner language (LANG), split into two subtypes, inner speech (SPEE) and auditory mental imagery (AUDI); somatosensory awareness (SOMA); inner musical experience (MUSI); and mental manipulation of numbers (NUMB). For IMAG and LANG, additional questions estimated association of such activities with ongoing learning, retrospective memories, or prospective thoughts. Using a 0-100% scale, the participant quantitatively rated the proportion of time spent in each mental activity during the resting state fMRI acquisition. A total of 180 healthy volunteers completed the ReSQ immediately after being scanned with fMRI while at rest. Of these, 66% exhibited dominance of a type of mental activity at rest (IMAG: 35%; LANG: 17%; SOMA: 7%; MUSI: 6%; NUMB: 1%). A majority of participants reported either retrospective memories (82%) or prospective thoughts (78%), with 58% of participants reporting both in at least one type of mental activity. Thoughts related to ongoing learning were low (37% of participants). The present results are consistent with those of previous studies investigating inner experience in a natural environment. In conclusion, we provide a robust and easy-to-implement tool for the exploration of mental activities during rest of healthy participants undergoing fMRI. This tool relies on normative data acquired from a 180-participant sample balanced for sex and handedness.

Extratemporal functional connectivity impairments at rest are related to memory performance in mesial temporal epilepsy

Mesial temporal lobe epilepsy (MTLE) is the most frequent form of focal epilepsy. At rest, there is evidence that brain abnormalities in MTLE are not limited to the epileptogenic region, but extend throughout the whole brain. It is also well established that MTLE patients suffer from episodic memory deficits. Thus, we investigated the relation between the functional connectivity seen at rest in fMRI and episodic memory impairments in MTLE. We focused on resting state BOLD activity and evaluated whether functional connectivity (FC) differences emerge from MTL seeds in left and right MTLE groups, compared with healthy controls. Results revealed significant FC reductions in both patient groups, localized in angular gyri, thalami, posterior cingulum and medial frontal cortex. We found that the FC between the left non‐pathologic MTL and the medial frontal cortex was positively correlated with the delayed recall score of a non‐verbal memory test in right MTLE patients, suggesting potential adaptive changes to preserve this memory function. In contrast, we observed a negative correlation between a verbal memory test and the FC between the left pathologic MTL and posterior cingulum in left MTLE patients, suggesting potential functional maladaptative changes in the pathologic hemisphere. Overall, the present study provides some indication that left MTLE may be more impairing than right MTLE patients to normative functional connectivity. Our data also indicates that the pattern of extra‐temporal FC may vary as a function of episodic memory material and each hemispheres capacity for cognitive reorganization. Hum Brain Mapp 34:2202–2216, 2013.

Presurgery resting‐state local graph‐theory measures predict neurocognitive outcomes after brain surgery in temporal lobe epilepsy

This study determined the ability of resting‐state functional connectivity (rsFC) graph‐theory measures to predict neurocognitive status postsurgery in patients with temporal lobe epilepsy (TLE) who underwent anterior temporal lobectomy (ATL).

Early and Late Age of Seizure Onset have a Differential Impact on Brain Resting-State Organization in Temporal Lobe Epilepsy

Temporal lobe epilepsy (TLE) is associated with abnormalities which extend into the entire brain. While the age of seizure onset (SO) has a large impact on brain plasticity, its effect on brain connectivity at rest remains unclear, especially, in interaction with factors such as the presence of mesial temporal sclerosis (MTS). In this context, we investigated whole-brain and regional functional connectivity (FC) organization in 50 TLE patients who underwent a resting-state fMRI scan, in comparison to healthy controls, using graph-theory measures. We first classified TLE patients according to the presence of MTS or not. Then, we categorized the patients based on their age of SO into two subgroups (early or late age of SO). Results revealed whole-brain differences with both reduced functional segregation and increased integration in the patients, regardless of the age of SO and MTS, relative to the controls. At a local level, we revealed that the connectivity of the ictal hippocampus remains the most impaired for an early SO, even in the absence of MTS. Importantly, we showed that the impact of age of SO on whole-brain and regional resting-state FC depends on the presence of MTS. Overall, our results highlight the importance of investigating the effect of age of SO when examining resting-state activity in TLE, as this factor leads different perturbations of network modularity and connectivity at the global and local level, with different implications for regional plasticity and adaptive organization.

Resting-State Functional Connectivity Predicts the Strength of Hemispheric Lateralization for Language Processing in Temporal Lobe Epilepsy and Normals

In temporal lobe epilepsy (TLE), determining the hemispheric specialization for language before surgery is critical to preserving a patients cognitive abilities post‐surgery. To date, the major techniques utilized are limited by the capacity of patients to efficiently realize the task. We determined whether resting‐state functional connectivity (rsFC) is a reliable predictor of language hemispheric dominance in right and left TLE patients, relative to controls. We chose three subregions of the inferior frontal cortex (pars orbitalis, pars triangularis, and pars opercularis) as the seed regions. All participants performed both a verb generation task and a resting‐state fMRI procedure. Based on the language task, we computed a laterality index (LI) for the resulting network. This revealed that 96% of the participants were left‐hemisphere dominant, although there remained a large degree of variability in the strength of left lateralization. We tested whether LI correlated with rsFC values emerging from each seed. We revealed a set of regions that was specific to each group. Unique correlations involving the epileptic mesial temporal lobe were revealed for the right and left TLE patients, but not for the controls. Importantly, for both TLE groups, the rsFC emerging from a contralateral seed was the most predictive of LI. Overall, our data depict the broad patterns of rsFC that support strong versus weak left hemisphere language laterality. This project provides the first evidence that rsFC data may potentially be used on its own to verify the strength of hemispheric dominance for language in impaired or pathologic populations. Hum Brain Mapp, 36:288–303, 2015.

Resting-state functional connectivity in epilepsy: growing relevance for clinical decision making.

PURPOSE OF REVIEW Seizures produce dysfunctional, maladaptive networks, making functional connectivity an ideal technique for identifying complex brain effects of epilepsy. We review the current status of resting-state functional connectivity (rsFC) research, highlighting its potential added value to epilepsy surgery programs. RECENT FINDINGS RsFC research has demonstrated that the brain impact of seizures goes beyond the epileptogenic zone, changing connectivity patterns in widespread cortical regions. There is evidence for abnormal connectivity, but the degree to which these represent adaptive or maladaptive plasticity responses is unclear. Empirical associations with cognitive performance and psychiatric symptoms have helped understand deleterious impacts of seizures outside the epileptogenic zone. Studies in the prediction of outcome suggest that there are identifiable presurgical patterns of functional connectivity associated with a greater likelihood of positive cognitive or seizure outcomes. SUMMARY The role of rsFC remains limited in most clinical settings, but shows great promise for identifying epileptic circuits and foci, predicting outcomes following surgery, and explaining cognitive deficits and psychiatric symptoms of epilepsy. RsFC has demonstrated that even focal epilepsies constitute a network and brain systems disorder. By providing a tool to both identify and characterize the brain network impact of epileptiform activity, rsFC can make a strong contribution to presurgical algorithms in epilepsy.

Functional connectivity evidence of cortico-cortico inhibition in temporal lobe epilepsy.

Epileptic seizures can initiate a neural circuit and lead to aberrant neural communication with brain areas outside the epileptogenic region. We focus on interictal activity in focal temporal lobe epilepsy and evaluate functional connectivity (FC) differences that emerge as function of bilateral versus strictly unilateral epileptiform activity. We assess the strength of FC at rest between the ictal and non‐ictal temporal lobes, in addition to whole brain connectivity with the ictal temporal lobe. Results revealed strong connectivity between the temporal lobes for both patient groups, but this did not vary as a function of unilateral versus bilateral interictal status. Both the left and right unilateral temporal lobe groups showed significant anti‐correlated activity in regions outside the epileptogenic temporal lobe, primarily involving the contralateral (non‐ictal/non‐pathologic) hemisphere, with precuneus involvement prominent. The bilateral groups did not show this contralateral anti‐correlated activity. This anti‐correlated connectivity may represent a form of protective and adaptive inhibition, helping to constrain epileptiform activity to the pathologic temporal lobe. The absence of this activity in the bilateral groups may be indicative of flawed inhibitory mechanisms, helping to explain their more widespread epileptiform activity. Our data suggest that the location and build up of epilepsy networks in the brain are not truly random, and are not limited to the formation of strictly epileptogenic networks. Functional networks may develop to take advantage of the regulatory function of structures such as the precuneus to instantiate an anti‐correlated network, generating protective cortico–cortico inhibition for the purpose of limiting seizure spread or epileptogenesis. Hum Brain Mapp 35:353–366, 2014.

Hippocampal functional connectivity patterns during spatial working memory differ in right versus left temporal lobe epilepsy.

Temporal lobe epilepsy (TLE), affecting the medial temporal lobe, is a disorder that affects not just episodic memory but also working memory (WM). However, the exact nature of hippocampal-related network activity in visuospatial WM remains unclear. To clarify this, we utilized a functional connectivity (FC) methodology to investigate hippocampal network involvement during the encoding phase of a functional magnetic resonance imaging (fMRI) visuospatial WM task in right and left TLE patients. Specifically, we assessed the relation between FC within right and left hippocampus-seeded networks, and patient performance (rate of correct responses) during the encoding phase of a block span WM task. Results revealed that both TLE groups displayed a negative relation between WM performance and FC between the left hippocampus and ipsilateral parahippocampal gyrus. We also found a positive relationship between performance and FC between the left hippocampus seed and the precuneus, in the right TLE group. Lastly, the left TLE specifically demonstrated a negative relationship between performance and FC between both hippocampi and ipsilateral cerebellar clusters. Our findings indicate that right and left TLE groups may develop different patterns of FC to implement visuospatial WM. Indeed, the present result suggests that FC provides a unique means of identifying abnormalities in brain networks, which cannot be discerned at the level of behavioral output through neuropsychological testing. More broadly, our findings demonstrate that FC methods applied to task-based fMRI provide the opportunity to define specific task-related networks.

Functional connectivity abnormalities vary by amygdala subdivision and are associated with psychiatric symptoms in unilateral temporal epilepsy

The amygdala has been described as a structure affected by mesial temporal lobe epilepsy (MTLE). Indeed, it is suggested that amygdala abnormalities are related to the co-morbid depression and anxiety reported in MTLE. In this context, we investigated the relation between functional connectivity (FC) emerging from this structure in fMRI and depression and anxiety levels reported in MTLE patients. We focused on resting-state BOLD activity and evaluated whether FC differences emerge from each of three amygdala subdivisions (laterobasal, centromedial and superficial) in left and right MTLE groups, compared with healthy controls. Results revealed significant differences between patient groups and controls. Specifically, the left MTLE group showed abnormal FC for the left-sided seeds only. Furthermore, regardless of the seed, we observed more reliable differences between the right MTLE group and controls. Further analysis of these results revealed correlations between these impaired connectivities and psychiatric symptoms in both MTLE groups. Opposite relations, however, were highlighted: the more depressed or anxious the right MTLE patients, the closer their FC values approached controls; whereas the less anxious the left MTLE patients, the closer their FC values were normative. These results highlight how MTLE alter FC emerging from the limbic system. Overall, our data demonstrate that right TLE has a more maladaptive impact on emotion-related networks, in ways specific to the amygdala region, and the emotion symptom involved, than left TLE.