Impaired vigilance networks in temporal lobe epilepsy: Mechanisms and clinical implications.

Englot DJ, Morgan VL, Chang C
Epilepsia. 2020 61 (2): 189-202

PMID: 31901182 · PMCID: PMC7033006 · DOI:10.1111/epi.16423

Mesial temporal lobe epilepsy (mTLE) is a neurological disorder in which patients suffer from frequent consciousness-impairing seizures, broad neurocognitive deficits, and diminished quality of life. Although seizures in mTLE originate focally in the hippocampus or amygdala, mTLE patients demonstrate cognitive deficits that extend beyond temporal lobe function-such as decline in executive function, cognitive processing speed, and attention-as well as diffuse decreases in neocortical metabolism and functional connectivity. Given prior observations that mTLE patients exhibit impairments in vigilance, and that seizures may disrupt the activity and long-range connectivity of subcortical brain structures involved in vigilance regulation, we propose that subcortical activating networks underlying vigilance play a critical role in mediating the widespread neural and cognitive effects of focal mTLE. Here, we review evidence for impaired vigilance in mTLE, examine clinical implications and potential network underpinnings, and suggest neuroimaging strategies for determining the relationship between vigilance, brain connectivity, and neurocognition in patients and healthy controls.

Wiley Periodicals, Inc. © 2020 International League Against Epilepsy.

MeSH Terms (6)

Arousal Brain Mapping Epilepsy, Temporal Lobe Humans Nerve Net Neuroimaging

Connections (1)

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