Structural and functional changes of the cerebellum in temporal lobe epilepsy

Ge Wang; Xianghe Liu; Min Zhang; Kangrun Wang; Chaorong Liu; Yayu Chen; Wenyue Wu; Haiting Zhao; Bo Xiao; Lily Wan; Lili Long

doi:10.3389/fneur.2023.1213224

Structural and functional changes of the cerebellum in temporal lobe epilepsy

Front Neurol. 2023 Aug 3:14:1213224. doi: 10.3389/fneur.2023.1213224. eCollection 2023.

Authors

Ge Wang^#^{1

2

3}, Xianghe Liu^#^{1

2

3}, Min Zhang^{1

2

3}, Kangrun Wang^{1

2

3}, Chaorong Liu^{1

2

3}, Yayu Chen^{1

2

4}, Wenyue Wu^{1

5}, Haiting Zhao^{1

2

3}, Bo Xiao^{1

2

3}, Lily Wan⁶, Lili Long^{1

2

3}

Affiliations

¹ Department of Neurology, Xiangya Hospital, Central South University, Changsha, China.
² National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
³ Clinical Research Center for Epileptic Disease of Hunan Province, Central South University, Changsha, China.
⁴ Department of Infectious Diseases, Xiangya Hospital, Central South University, Changsha, China.
⁵ Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
⁶ Department of Anatomy and Neurobiology, Central South University Xiangya Medical School, Changsha, Hunan, China.

^# Contributed equally.

Abstract

Aims: This study aimed to comprehensively explore the cerebellar structural and functional changes in temporal lobe epilepsy (TLE) and its association with clinical information.

Methods: The SUIT toolbox was utilized to perform cerebellar volume and diffusion analysis. In addition, we extracted the average diffusion values of cerebellar peduncle tracts to investigate microstructure alterations. Seed-based whole-brain analysis was used to investigate cerebellar-cerebral functional connectivity (FC). Subgroup analyses were performed to identify the cerebellar participation in TLE with/without hippocampal sclerosis (HS)/focal-to-bilateral tonic-clonic seizure (FBTCS) and TLE with different lateralization.

Results: TLE showed widespread gray matter atrophy in bilateral crusII, VIIb, VIIIb, left crusI, and left VIIIa. Both voxel and tract analysis observed diffusion abnormalities in cerebellar afferent peduncles. Reduced FC between the right crus II and the left parahippocampal cortex was found in TLE. Additionally, TLE showed increased FCs between left lobules VI-VIII and cortical nodes of the dorsal attention and visual networks. Across all patients, decreased FC was associated with poorer cognitive function, while increased FCs appeared to reflect compensatory effects. The cerebellar structural changes were mainly observed in HS and FBTCS subgroups and were regardless of seizure lateralization, while cerebellar-cerebral FC alterations were similar in all subgroups.

Conclusion: TLE exhibited microstructural changes in the cerebellum, mainly related to HS and FBTCS. In addition, altered cerebellar-cerebral functional connectivity is associated with common cognitive alterations in TLE.

Keywords: cerebellar peduncle; cerebellum; functional connectivity; multimodality MRI; temporal lobe epilepsy.

Grants and funding

This study was supported by grants from the National Multidisciplinary Cooperative Diagnosis and Treatment Capacity Project for Major Diseases of Xiangya Hospital, Central South University (z027001) and the National Natural Science Foundation of China (82171454).