ArticleEuropean journal of neurology2025
Relationship of left piriform cortex network centrality with temporal lobe epilepsy duration and drug resistance.
Article in European journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- No link between piriform cortex subregion resection and seizure freedom in two cohorts with temporal lobe epilepsy.Journal of neurology · 2026Article
- Intermittent ketogenic fasting with medium-chain triglycerides improves ataxia in COQ8A-related coenzyme Q10 deficiency: A case report.Molecular genetics and metabolism reports · 2026Article
- Relationship of left piriform cortex network centrality with temporal lobe epilepsy duration and drug resistance.European journal of neurology · 2025Article
- Evaluation of degree centrality and neurological outcomes in patients with herpes simplex encephalitis.Frontiers in neurology · 2025Article
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10 authors.
Funding
Abstract
backgroundWe investigated the relationship of piriform cortex (PC) structural network centrality with drug resistance and epilepsy duration as markers of sustained epileptic activity.
methodsPCs were manually delineated on retrospectively collected 3D-T1-MRI images of patients with temporal lobe epilepsy (TLE). Connectomes were computed from diffusion MRI scans, including the PC as network nodes. Betweenness centrality (BC) and node degree were computed and compared across drug-resistant versus drug-sensitive patients. Correlations of centrality metrics with the duration of epilepsy were calculated.
resultsSixty-two patients (36 females, 43/62 drug-resistant) were included in the main analysis. Greater centrality of the left PC was associated with drug resistance (degree: p = 0.00696, d = 0.85; BC: p = 0.00859, d = 0.59; alpha = 0.0125). Furthermore, left PC centrality was correlated with epilepsy duration (degree: rho = 0.39, p = 0.00181; BC: rho = 0.35, p = 0.0047; alpha = 0.0125). Results were robust to analysis of different parcellation schemes. Exploratory whole-network analysis yielded the largest effects in the left PC. Finer parcellations showed stronger effects for both analyses in the left olfactory cortex rostral to PC. In 28 subjects who had received epilepsy surgery, a trend of smaller centrality in patients with ILAE I outcome was observed in this area.
conclusionsWe demonstrated an increased centrality of the left PC in patients with drug-resistant TLE, which was also associated with the epilepsy duration. Recurring seizures over long periods may lead to changes of network properties of the PC. Large effects immediately rostral to our delineated PC region suggest a role of olfactory cortex anterior to the limen insulae in epileptogenic networks.
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