Evaluation of the functional connectivity in brain networks through graph theory analysis and investigation of anxiety and depression in patients with idiopathic generalized epilepsy controlled and refractory to drug treatment

Abstract

Epilepsy is a neurological disease that arises from a group of cerebral dysfunctions. Idiopathic generalized epilepsy (IGE) includes a group of age-related syndromes with genetic background with typical clinical features and abnormal patterns in the electroencephalogram (EGG). Usually, most of IGE patients have normal magnetic resonance imaging (MRI). However, several studies have reported significant structural and functional abnormalities. Despite the majority of these patients respond well (60-70%) to antiepileptic drugs (AEDs), the refractory patients still represent an important portion. In general, neuroimaging studies with IGE make no clear distinction between patients with poorly controlled seizures from those whom are seizure-free. Furthermore, psychiatric disorders such as depression and anxiety have not been widely exploited in these patients. Therefore, the aims of this study are to evaluate patients with IGE and to identify possible biomarkers that could potentially help in a more individualized treatment, taking into consideration changes in mood, anxiety and functional brain networks. All patients will be recruited in the Epilepsy Outpatient Clinics at HC/Campinas - Unicamp, according to the inclusion/exclusion criteria, which were established. Three study groups will be evaluated (responders, refractory and healthy controls). These three groups will undergo a resting state functional MRI (rsfMRI) and they will answer to both Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). Further, we will investigate functional connectivity and apply Graph theoretical network analysis to carry out the investigation of topological properties of brain networks. Finally, the data will be tabulated, analyzed and correlated with clinical data. (AU)