Objective To investigate the changes in the complex network of brain functions associated with sodium channel blocker (SCB) treatment and the neural mechanisms underlying the effects on executive control functions. Methods Twenty-one patients with temporal lobe epilepsy taking SCB (TLE-SCB) and 12 patients with temporal lobe epilepsy not taking SCB (TLE-N) were enrolled in the study along with 18 healthy controls (HC). Resting-state functional magnetic resonance imaging (rsfMRI) and attentional network testing (ANT) were completed,and graph theoretic methods were applied to study the changes in the complex networks of brain function in the three groups of subjects,and to investigate the relationship between changes in brain networks and executive function. Results The TLE-SCB and TLE-N groups showed executive function impairment compared to the HC group. Analysis of brain network topological properties showed that multiple node median centrality was reduced in the TLE-SCB group compared to the TLE-N group (all Bonferroni corrected,P<0.017);right amygdala node clustering coefficient,and local efficiency of the left suboccipital gyrus were reduced (t=-2.953,P=0.006;t=-2.597,P=0.0142). The TLE-SCB compared to the HC group had decreased multiple node median centrality (all Bonferroni corrected,P<0.017);increased node clustering coefficients in the left orbital middle frontal gyrus (t=2.861,P=0.007);and decreased localized efficiency in the left inferotemporal gyrus (t=-2.870,P=0.007). The TLE-N group compared to the HC group had decreased right paracentral lobule mediator centrality,local efficiency increased (t=2.644,P=0.013;t=3.464,P=0.002);right amygdala node clustering coefficient increased (t=2.884,P=0.007). Correlation analysis showed that decreased centrality of left suboccipital gyrus mediators was negatively correlated with executive efficiency in the TLE-SCB group (P=0.045,r=-0.441). Conclusion Patients using SCB medication showed impairment of brain functional network topological properties,with the left suboccipital gyrus as an important node;altered brain functional network topological properties may underlie the network of cognitive impairment in SCB.

Objective To investigate the changes in the complex network of brain functions associated with sodium channel blocker (SCB) treatment and the neural mechanisms underlying the effects on executive control functions. Methods Twenty-one patients with temporal lobe epilepsy taking SCB (TLE-SCB) and 12 patients with temporal lobe epilepsy not taking SCB (TLE-N) were enrolled in the study along with 18 healthy controls (HC). Resting-state functional magnetic resonance imaging (rsfMRI) and attentional network testing (ANT) were completed,and graph theoretic methods were applied to study the changes in the complex networks of brain function in the three groups of subjects,and to investigate the relationship between changes in brain networks and executive function. Results The TLE-SCB and TLE-N groups showed executive function impairment compared to the HC group. Analysis of brain network topological properties showed that multiple node median centrality was reduced in the TLE-SCB group compared to the TLE-N group (all Bonferroni corrected,P<0.017);right amygdala node clustering coefficient,and local efficiency of the left suboccipital gyrus were reduced (t=-2.953,P=0.006;t=-2.597,P=0.0142). The TLE-SCB compared to the HC group had decreased multiple node median centrality (all Bonferroni corrected,P<0.017);increased node clustering coefficients in the left orbital middle frontal gyrus (t=2.861,P=0.007);and decreased localized efficiency in the left inferotemporal gyrus (t=-2.870,P=0.007). The TLE-N group compared to the HC group had decreased right paracentral lobule mediator centrality,local efficiency increased (t=2.644,P=0.013;t=3.464,P=0.002);right amygdala node clustering coefficient increased (t=2.884,P=0.007). Correlation analysis showed that decreased centrality of left suboccipital gyrus mediators was negatively correlated with executive efficiency in the TLE-SCB group (P=0.045,r=-0.441). Conclusion Patients using SCB medication showed impairment of brain functional network topological properties,with the left suboccipital gyrus as an important node;altered brain functional network topological properties may underlie the network of cognitive impairment in SCB.

Objective This study aimed to explore the changes of interhemispheric functional homotopy in patients with different course of temporal lobe epilepsy based on voxel-mirrored homotopic connectivity(VMHC).Methods Twenty temporal lobe epilepsy patients with a short disease course(TLE-SD),twenty-seven temporal lobe epilepsy patients with a long disease course(TLE-SD)and thirty healthy controls(HC)matched with demo-graphic data were enrolled.All participants finished functional MRI scans and neuropsychological assessment.Brain regions with significant changes between the TLE-SD/TLE-LD group and the healthy controls group were obtained based on the VMHC analysis,and the two-samples t-test was performed in the different brain regions of VMHC values between the two comparisons.The VMHC values of abnormal brain regions in the patient group were extracted and used for correlation analysis with the scale scores.Results Compared with HC,the VMHC values of the putamen and anterior cingulate gyrus were reduced in the TLE-SD group,while the VMHC values of the putamen,anterior cingulate gyrus,superior temporal gyrus and superior frontal gyrus were reduced in the TLE-LD group.Compared with the TLE-SD group,the VMHC values of the superior temporal gyrus in the TLE-LD group was significantly reduced(t=2.918,P=0.033).Correlation analysis showed that the VMHC values of the putamen was positively correlated with the Montreal Cognitive Assessment(MoCA)scores(r=0.442,P=0.021).Conclusions The interhemispheric functional homotopy was impaired in patients with temporal lobe epilepsy and the impairment may be more severe in patients with a long course of disease.Cognitive impairment in patients with temporal lobe epilepsy may be related to the abnormalities of interhemispheric functional homotopy.