Brain functional connectivity in sleep-related hypermotor epilepsy

Stefania Evangelisti, Claudia Testa, Lorenzo Ferri, Laura Ludovica Gramegna, David Neil Manners, Giovanni Rizzo, Daniel Remondini, Gastone Castellani, Ilaria Naldi, Francesca Bisulli, Caterina Tonon, Paolo Tinuper, Raffaele Lodi

Research output: Contribution to journalArticlepeer-review


Objectives To evaluate functional connectivity (FC) in patients with sleep-related hypermotor epilepsy (SHE) compared to healthy controls. Methods Resting state fMRI was performed in 13 patients with a clinical diagnosis of SHE (age = 38.3 ± 11.8 years, 6 M) and 13 matched healthy controls (age = 38.5 ± 10.8 years, 6 M). Data were first analysed using probabilistic independent component analysis (ICA), then a graph theoretical approach was applied to assess topological and organizational properties at the whole brain level. We evaluated node degree (ND), betweenness centrality (BC), clustering coefficient (CC), local efficiency (LE) and global efficiency (GE). The differences between the two groups were evaluated non-parametrically. Results At the group level, we distinguished 16 RSNs (Resting State Networks). Patients showed a significantly higher FC in sensorimotor and thalamic regions (p < 0.05 corrected). Compared to controls, SHE patients showed no significant differences in network global efficiency, while ND and BC were higher in regions of the limbic system and lower in the occipital cortex, while CC and LE were higher in regions of basal ganglia and lower in limbic areas (p < 0.05 uncorrected). Discussion and conclusions The higher FC of the sensorimotor cortex and thalamus might be in agreement with the hypothesis of a peculiar excitability of the motor cortex during thalamic K-complexes. This sensorimotor-thalamic hyperconnection might be regarded as a consequence of an alteration of the arousal regulatory system in SHE. An altered topology has been found in structures like basal ganglia and limbic system, hypothesized to be involved in the pathophysiology of the disease as suggested by the dystonic-dyskinetic features and primitive behaviours observed during the seizures.

Original languageEnglish
Pages (from-to)873-881
Number of pages9
JournalNeuroImage: Clinical
Publication statusPublished - Jan 1 2018


  • Functional connectivity
  • Graph theory
  • Independent component analysis
  • Nocturnal frontal lobe epilepsy
  • Sleep-related hypermotor epilepsy

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Neurology
  • Clinical Neurology
  • Cognitive Neuroscience


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