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  1. Article ; Online: Brain connectivity in status epilepticus as a predictor of outcome: A diffusion tensor imaging study.

    Lee, Dong Ah / Lee, Ho-Joon / Park, Kang Min

    Journal of neuroimaging : official journal of the American Society of Neuroimaging

    2024  Volume 34, Issue 3, Page(s) 393–401

    Abstract: Background and purpose: We aimed to explore structural connectivity in status epilepticus.: Methods: We enrolled participants who underwent diffusion tensor imaging. We applied graph theory to investigate structural connectivity. We compared the ... ...

    Abstract Background and purpose: We aimed to explore structural connectivity in status epilepticus.
    Methods: We enrolled participants who underwent diffusion tensor imaging. We applied graph theory to investigate structural connectivity. We compared the structural connectivity measures between patients and healthy controls and between patients with poor (modified Rankin Scale [mRS] >3) and good (mRS ≤3) admission outcomes.
    Results: We enrolled 28 patients and 31 healthy controls (age 65.5 vs.62.0 years, p = .438). Of these patients, 16 and 12 showed poor and good admission outcome (age 65.5 vs.62.0 years, p = .438). The assortative coefficient (-0.113 vs. -0.121, p = .021), mean clustering coefficient (0.007 vs.0.006, p = .009), global efficiency (0.023 vs.0.020, p = .009), transitivity (0.007 vs.0.006, p = .009), and small-worldness index (0.006 vs.0.005, p = .021) were higher in patients with status epilepticus than in healthy controls. The assortative coefficient (-0.108 vs. -0.119, p = .042), mean clustering coefficient (0.007 vs.0.006, p = .042), and transitivity (0.008 vs.0.007, p = .042) were higher in patients with poor admission outcome than in those with good admission outcome. MRS score was positively correlated with structural connectivity measures, including the assortative coefficient (r = 0.615, p = .003), mean clustering coefficient (r = 0.544, p = .005), global efficiency (r = 0.515, p = .007), transitivity (r = 0.547, p = .007), and small-worldness index (r = 0.435, p = .024).
    Conclusion: We revealed alterations in structural connectivity, showing increased integration and segregation in status epilepticus, which might be related with neuronal synchronization. This effect was more pronounced in patients with a poor admission outcome, potentially reshaping our understanding for comprehension of status epilepticus mechanisms and the development of more targeted treatments.
    MeSH term(s) Humans ; Status Epilepticus/diagnostic imaging ; Status Epilepticus/physiopathology ; Female ; Male ; Diffusion Tensor Imaging/methods ; Middle Aged ; Aged ; Brain/diagnostic imaging ; Prognosis ; Nerve Net/diagnostic imaging ; Nerve Net/physiopathology
    Language English
    Publishing date 2024-03-18
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1071724-9
    ISSN 1552-6569 ; 1051-2284
    ISSN (online) 1552-6569
    ISSN 1051-2284
    DOI 10.1111/jon.13196
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  2. Article ; Online: Increased Thalamic Connectivity in Juvenile Myoclonic Epilepsy Based on Electroencephalography Source-Level Analysis.

    Lee, Dong Ah / Kim, Sung Eun / Park, Kang Min

    Brain connectivity

    2024  Volume 14, Issue 3, Page(s) 182–188

    Abstract: Background: ...

    Abstract Background:
    MeSH term(s) Humans ; Myoclonic Epilepsy, Juvenile/physiopathology ; Myoclonic Epilepsy, Juvenile/diagnostic imaging ; Thalamus/physiopathology ; Thalamus/diagnostic imaging ; Male ; Female ; Electroencephalography/methods ; Adult ; Young Adult ; Nerve Net/physiopathology ; Nerve Net/diagnostic imaging ; Neural Pathways/physiopathology ; Adolescent ; Brain Mapping/methods ; Magnetic Resonance Imaging/methods
    Language English
    Publishing date 2024-03-21
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2609017-X
    ISSN 2158-0022 ; 2158-0014
    ISSN (online) 2158-0022
    ISSN 2158-0014
    DOI 10.1089/brain.2023.0084
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  3. Article ; Online: Alteration of multilayer network perspective on gray and white matter connectivity in obstructive sleep apnea.

    Lee, Dong Ah / Lee, Ho-Joon / Park, Kang Min

    Sleep & breathing = Schlaf & Atmung

    2024  

    Abstract: Purpose: The objective of this research was to examine changes in the neural networks of both gray and white matter in individuals with obstructive sleep apnea (OSA) in comparison to those without the condition, employing a comprehensive multilayer ... ...

    Abstract Purpose: The objective of this research was to examine changes in the neural networks of both gray and white matter in individuals with obstructive sleep apnea (OSA) in comparison to those without the condition, employing a comprehensive multilayer network analysis.
    Methods: Patients meeting the criteria for OSA were recruited through polysomnography, while a control group of healthy individuals matched for age and sex was also assembled. Utilizing T1-weighted imaging, a morphometric similarity network was crafted to represent gray matter, while diffusion tensor imaging provided structural connectivity for constructing a white matter network. A multilayer network analysis was then performed, employing graph theory methodologies.
    Results: We included 40 individuals diagnosed with OSA and 40 healthy participants in our study. Analysis revealed significant differences in various global network metrics between the two groups. Specifically, patients with OSA exhibited higher average degree overlap and average multilayer clustering coefficient (28.081 vs. 23.407, p < 0.001; 0.459 vs. 0.412, p = 0.004), but lower multilayer modularity (0.150 vs. 0.175, p = 0.001) compared to healthy controls. However, no significant differences were observed in average multiplex participation, average overlapping strength, or average weighted multiplex participation between the patients with OSA and healthy controls. Moreover, several brain regions displayed notable differences in degree overlap at the nodal level between patients with OSA and healthy controls.
    Conclusion: Remarkable alterations in the multilayer network, indicating shifts in both gray and white matter, were detected in patients with OSA in contrast to their healthy counterparts. Further examination at the nodal level unveiled notable changes in regions associated with cognition, underscoring the effectiveness of multilayer network analysis in exploring interactions across brain layers.
    Language English
    Publishing date 2024-05-11
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1500381-4
    ISSN 1522-1709 ; 1520-9512
    ISSN (online) 1522-1709
    ISSN 1520-9512
    DOI 10.1007/s11325-024-03059-4
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  4. Article ; Online: Structural connectivity as a predictive factor for perampanel response in patients with epilepsy.

    Lee, Dong Ah / Lee, Ho-Joon / Park, Kang Min

    Seizure

    2024  Volume 118, Page(s) 125–131

    Abstract: Objectives: This study aimed to identify clinical characteristics that could predict the response to perampanel (PER) and determine whether structural connectivity is a predictive factor.: Methods: We enrolled patients with epilepsy who received PER ... ...

    Abstract Objectives: This study aimed to identify clinical characteristics that could predict the response to perampanel (PER) and determine whether structural connectivity is a predictive factor.
    Methods: We enrolled patients with epilepsy who received PER and were followed-up for a minimum of 12 months. Good PER responders, who were seizure-free or presented with more than 50 % seizure reduction, were classified separately from poor PER responders who had seizure reduction of less than 50 % or non-responders. A graph theoretical analysis was conducted based on diffusion tensor imaging to calculate network measures of structural connectivity among patients with epilepsy.
    Results: 106 patients with epilepsy were enrolled, including 26 good PER responders and 80 poor PER responders. Good PER responders used fewer anti-seizure medications before PER administration compared to those by poor PER responders (3 vs. 4; p = 0.042). Early PER treatment was more common in good PER responders than poor PER responders (46.2 vs. 21.3 %, p = 0.014). Regarding cortical structural connectivity, the global efficiency was higher and characteristic path length was lower in good PER responders than in poor PER responders (0.647 vs. 0.635, p = 0.006; 1.726 vs. 1,759, p = 0.008, respectively). For subcortical structural connectivity, the mean clustering coefficient and small-worldness index were higher in good PER responders than in poor PER responders (0.821 vs. 0.791, p = 0.009; 0.597 vs. 0.560, p = 0.009, respectively).
    Conclusion: This study demonstrated that early PER administration can predict a good PER response in patients with epilepsy, and structural connectivity could potentially offer clinical utility in predicting PER response.
    Language English
    Publishing date 2024-04-29
    Publishing country England
    Document type Journal Article
    ZDB-ID 1137610-7
    ISSN 1532-2688 ; 1059-1311
    ISSN (online) 1532-2688
    ISSN 1059-1311
    DOI 10.1016/j.seizure.2024.04.026
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  5. Article ; Online: Sarcopenia and anti-seizure medication response in juvenile myoclonic epilepsy.

    Kim, Jinseung / Lee, Ho-Joon / Lee, Dong Ah / Park, Kang Min

    Brain and behavior

    2024  Volume 14, Issue 3, Page(s) e3464

    Abstract: Introduction: This study aimed to investigate the presence of sarcopenia in patients with juvenile myoclonic epilepsy (JME) and the association between sarcopenia and response to anti-seizure medication (ASM) in patients with JME.: Methods: We ... ...

    Abstract Introduction: This study aimed to investigate the presence of sarcopenia in patients with juvenile myoclonic epilepsy (JME) and the association between sarcopenia and response to anti-seizure medication (ASM) in patients with JME.
    Methods: We enrolled 42 patients with JME and 42 healthy controls who underwent brain magnetic resonance imaging with three-dimensional T1-weighted imaging. We measured the temporal muscle thickness (TMT), a radiographic marker for sarcopenia, using T1-weighted imaging. We compared the TMT between patients with JME and healthy controls and analyzed it according to the ASM response in patients with JME. We also performed a receiver operating characteristic (ROC) curve analysis to evaluate how well the TMT differentiated the groups.
    Results: The TMT in patients with JME did not differ from that in healthy controls (9.630 vs. 9.956 mm, p = .306); however, ASM poor responders had a lower TMT than ASM good responders (9.109 vs. 10.104 mm, p = .023). ROC curve analysis revealed that the TMT exhibited a poor performance in differentiating patients with JME from healthy controls, with an area under the ROC curve of .570 (p = .270), but good performance in differentiating between ASM good and poor responders, with an area under the ROC curve of .700 (p = .015).
    Conclusion: The TMT did not differ between patients with JME and healthy controls; however, it was reduced in ASM poor responders compared to ASM good responders, suggesting a link between ASM response and sarcopenia in patients with JME. TMT can be used to investigate sarcopenia in various neurological disorders.
    MeSH term(s) Humans ; Myoclonic Epilepsy, Juvenile/complications ; Myoclonic Epilepsy, Juvenile/diagnostic imaging ; Myoclonic Epilepsy, Juvenile/drug therapy ; Sarcopenia/diagnostic imaging ; Brain ; Magnetic Resonance Imaging/methods ; Head
    Language English
    Publishing date 2024-03-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2623587-0
    ISSN 2162-3279 ; 2162-3279
    ISSN (online) 2162-3279
    ISSN 2162-3279
    DOI 10.1002/brb3.3464
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  6. Article ; Online: Sarcopenia in patients with isolated rapid eye movement sleep behavior disorder.

    Kim, Jinseung / Lee, Ho-Joon / Lee, Dong Ah / Park, Kang Min

    Sleep medicine

    2024  Volume 114, Page(s) 189–193

    Abstract: Objectives: Evaluating of sarcopenia is important for promoting healthy aging, preventing functional decline, reducing the risk of falls and fractures, and improving overall quality of life. This study aimed to investigate sarcopenia in patients with ... ...

    Abstract Objectives: Evaluating of sarcopenia is important for promoting healthy aging, preventing functional decline, reducing the risk of falls and fractures, and improving overall quality of life. This study aimed to investigate sarcopenia in patients with isolated rapid eye movement sleep behavior disorder (RBD) using temporal muscle thickness (TMT) measurement.
    Methods: This investigation was retrospectively conducted at a single tertiary hospital. We recruited patients diagnosed with isolated RBD confirmed by polysomnography and clinical history and healthy participants as controls. Patients with isolated RBD and healthy controls underwent brain MRI scans, including three-dimensional T1-weighted imaging. We measured TMT, a radiographic marker of sarcopenia, based on the T1-weighted imaging. We compared the TMT between the groups and performed receiver operating characteristic (ROC) curve analysis to evaluate how well the TMT differentiated patients with isolated RBD from healthy controls. We also conducted a correlation analysis between the TMT and clinical factors.
    Results: Our study included 28 patients with isolated RBD and 30 healthy controls. There was a significant difference in the TMT of both groups. The TMT was reduced in patients with isolated RBD than in healthy controls (11.843 vs. 10.420 mm, p = 0.002). In the ROC curve analysis, the TMT exhibited good performance in differentiating patients with isolated RBD from healthy controls, with an area under the curve of 0.708. Furthermore, age was negatively correlated with TMT in patients with isolated RBD (r = -0.453, p = 0.015).
    Conclusion: We demonstrate that TMT is reduced in patients with isolated RBD compared with healthy controls, confirming sarcopenia in patients with isolated RBD. The result suggests an association between neurodegeneration and sarcopenia. TMT can be used to evaluate sarcopenia in sleep disorders.
    MeSH term(s) Humans ; REM Sleep Behavior Disorder ; Retrospective Studies ; Sarcopenia ; Quality of Life ; Brain
    Language English
    Publishing date 2024-01-06
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2012041-2
    ISSN 1878-5506 ; 1389-9457
    ISSN (online) 1878-5506
    ISSN 1389-9457
    DOI 10.1016/j.sleep.2024.01.004
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  7. Article ; Online: Alterations in the multilayer network in patients with rapid eye movement sleep behaviour disorder.

    Lee, Dong Ah / Lee, Won Hee / Lee, Ho-Joon / Park, Kang Min

    Journal of sleep research

    2024  , Page(s) e14182

    Abstract: This study aimed to reveal the pathophysiology of isolated rapid eye movement sleep behaviour disorder (RBD) in patients using multilayer network analysis. Participants eligible for isolated RBD were included and verified via polysomnography. Both iRBD ... ...

    Abstract This study aimed to reveal the pathophysiology of isolated rapid eye movement sleep behaviour disorder (RBD) in patients using multilayer network analysis. Participants eligible for isolated RBD were included and verified via polysomnography. Both iRBD patients and healthy controls underwent brain MRI, including T1-weighted imaging and diffusion tensor imaging. Grey matter matrix was derived from T1-weighted images using a morphometric similarity network. White matter matrix was formed from diffusion tensor imaging-based structural connectivity. Multilayer network analysis of grey and white matter was performed using graph theory. We studied 29 isolated RBD patients and 30 healthy controls. Patients exhibited a higher average overlap degree (27.921 vs. 23.734, p = 0.002) and average multilayer clustering coefficient (0.474 vs. 0.413, p = 0.002) compared with controls. Additionally, several regions showed significant differences in the degree of overlap and multilayer clustering coefficient between patients with isolated RBD and healthy controls at the nodal level. The degree of overlap in the left medial orbitofrontal, left posterior cingulate, and right paracentral nodes and the multilayer clustering coefficients in the left lateral occipital, left rostral middle frontal, right fusiform, right inferior posterior parietal, and right parahippocampal nodes were higher in patients with isolated RBD than in healthy controls. We found alterations in the multilayer network at the global and nodal levels in patients with isolated RBD, and these changes may be associated with the pathophysiology of isolated RBD. Multilayer network analysis can be used widely to explore the mechanisms underlying various neurological disorders.
    Language English
    Publishing date 2024-02-22
    Publishing country England
    Document type Journal Article
    ZDB-ID 1122722-9
    ISSN 1365-2869 ; 0962-1105
    ISSN (online) 1365-2869
    ISSN 0962-1105
    DOI 10.1111/jsr.14182
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  8. Article ; Online: Thalamic nuclei volumes and intrinsic thalamic network in patients with occipital lobe epilepsy.

    Lee, Dong Ah / Lee, Ho-Joon / Park, Kang Min

    Brain and behavior

    2023  Volume 13, Issue 4, Page(s) e2968

    Abstract: Introduction: This study aimed to investigate the alterations in individual thalamic nuclei volumes in patients with occipital lobe epilepsy (OLE) compared with those of healthy controls, and to analyze the intrinsic thalamic network based on these ... ...

    Abstract Introduction: This study aimed to investigate the alterations in individual thalamic nuclei volumes in patients with occipital lobe epilepsy (OLE) compared with those of healthy controls, and to analyze the intrinsic thalamic network based on these volumes using graph theory.
    Methods: Thirty adult patients with newly diagnosed OLE and 42 healthy controls were retrospectively enrolled (mean age, 33.8 ± 17.0 and 32.2 ± 6.6 years, respectively). The study participants underwent brain magnetic resonance imaging with three-dimensional T1-weighted imaging. The right and left total thalamic and individual thalamic nuclei volumes were obtained using the FreeSurfer program. Then, the intrinsic thalamic network was calculated based on the individual thalamic nuclei volumes and graph theory using a BRAPH program.
    Results: There were no differences in the right and left whole-thalamic volumes between the two groups (0.445% vs. 0.469%, p = .142 and 0.481% vs. 0.490%, p = .575, respectively). However, significant differences were observed in the volumes of several thalamic nuclei between the two groups. The right medial geniculate and right suprageniculate nuclei volumes were increased (0.0077% vs. 0.0064%, p = .0003 and 0.0013% vs. 0.0010%, p = .0004, respectively), whereas the right and left parafascicular nuclei volumes were decreased in patients with OLE compared with those in healthy controls (0.0038% vs. 0.0048%, p < .0001 and 0.0037% vs. 0.0045%, p = .0001, respectively). There were no differences in the network measures regarding intrinsic thalamic network between the two groups.
    Conclusion: We successfully demonstrated the alterations in individual thalamic nuclei volumes, especially the increased medial geniculate and suprageniculate, and decreased parafascicular nuclei volumes in patients with OLE compared with those of healthy controls despite no changes in the whole-thalamic volumes. These findings suggest an important role of the thalamus in the epileptic network of OLE.
    MeSH term(s) Adult ; Humans ; Adolescent ; Young Adult ; Middle Aged ; Retrospective Studies ; Thalamus/diagnostic imaging ; Thalamus/pathology ; Thalamic Nuclei/diagnostic imaging ; Thalamic Nuclei/pathology ; Epilepsies, Partial/pathology ; Brain ; Magnetic Resonance Imaging/methods
    Language English
    Publishing date 2023-03-16
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2623587-0
    ISSN 2162-3279 ; 2162-3279
    ISSN (online) 2162-3279
    ISSN 2162-3279
    DOI 10.1002/brb3.2968
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  9. Article: Can Artificial Intelligence Diagnose Transient Global Amnesia Using Electroencephalography Data?

    Seo, Young Deok / Lee, Dong Ah / Park, Kang Min

    Journal of clinical neurology (Seoul, Korea)

    2023  Volume 19, Issue 1, Page(s) 36–43

    Abstract: Background and purpose: This study aimed to determine the ability of deep learning using convolutional neural networks (CNNs) to diagnose transient global amnesia (TGA) based on electroencephalography (EEG) data, and to differentiate between patients ... ...

    Abstract Background and purpose: This study aimed to determine the ability of deep learning using convolutional neural networks (CNNs) to diagnose transient global amnesia (TGA) based on electroencephalography (EEG) data, and to differentiate between patients with recurrent TGA events and those with a single TGA event.
    Methods: We retrospectively enrolled newly diagnosed patients with TGA and healthy controls. All patients with TGA and the healthy controls underwent EEG. The EEG signals were converted into images using time-frequency analysis with short-time Fourier transforms. We employed two CNN models (AlexNet and VGG19) to classify the patients with TGA and the healthy controls, and for further classification of patients with recurrent TGA events and those with a single TGA event.
    Results: We enrolled 171 patients with TGA and 68 healthy controls. The accuracy and area under the curve (AUC) of the AlexNet and VGG19 models in classifying patients with TGA and healthy controls were 70.4% and 71.8%, and 0.718 and 0.743, respectively. In addition, the accuracy and AUC of the AlexNet and VGG19 models in classifying patients with recurrent TGA events and those with a single TGA event were 71.1% and 88.4%, and 0.773 and 0.873, respectively.
    Conclusions: We have successfully demonstrated the feasibility of deep learning in diagnosing TGA based on EEG data, and used two different CNN models to distinguish between patients with recurrent TGA events and those with a single TGA event.
    Language English
    Publishing date 2023-01-05
    Publishing country Korea (South)
    Document type Journal Article
    ZDB-ID 2500489-X
    ISSN 2005-5013 ; 1738-6586
    ISSN (online) 2005-5013
    ISSN 1738-6586
    DOI 10.3988/jcn.2023.19.1.36
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  10. Article ; Online: Involvement of the default mode network in patients with transient global amnesia: multilayer network.

    Lee, Dong Ah / Lee, Ho-Joon / Park, Kang Min

    Neuroradiology

    2023  Volume 65, Issue 12, Page(s) 1729–1736

    Abstract: Introduction: We aimed to investigate the alterations in the multilayer network in patients with transient global amnesia (TGA).: Methods: We enrolled 124 patients with TGA and 80 healthy controls. Both patients with TGA and healthy controls ... ...

    Abstract Introduction: We aimed to investigate the alterations in the multilayer network in patients with transient global amnesia (TGA).
    Methods: We enrolled 124 patients with TGA and 80 healthy controls. Both patients with TGA and healthy controls underwent a three-teslar brain magnetic resonance imaging (MRI). A gray matter layer matrix was created using a morphometric similarity network derived from the T1-weighted imaging, and a white matter layer matrix was constructed using structural connectivity based on the diffusion tensor imaging. A multilayer network analysis was performed by applying graph theoretical analysis.
    Results: There were no significant differences in global network measures between the groups. However, several regions, related to the default mode network, showed significant differences in nodal network measures between the groups. Multi-richness in the left pars opercularis, multi-rich-club degree in the right posterior cingulate gyrus, and weighted multiplex participation in the right posterior cingulate gyrus were higher in patients with TGA compared with healthy controls (15.47 vs. 12.26, p = 0.0005; 41.68 vs. 37.16, p = 0.0005; 0.90 vs. 0.80, p = 0.0005; respectively). The multiplex core-periphery in the left precuneus was higher (0.96 vs. 0.84, p = 0.0005), whereas that in the transverse temporal gyrus was lower in patients with TGA compared with healthy controls (0.00 vs. 0.02, p = 0.0005).
    Conclusion: We newly find the alterations in the multilayer network in patients with TGA compared with healthy controls, which shows the involvement of the default mode network. These changes may be related to the pathophysiology of TGA.
    MeSH term(s) Humans ; Diffusion Tensor Imaging/methods ; Amnesia, Transient Global/diagnostic imaging ; Amnesia, Transient Global/pathology ; Default Mode Network ; Brain/pathology ; Magnetic Resonance Imaging/methods
    Language English
    Publishing date 2023-10-17
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 123305-1
    ISSN 1432-1920 ; 0028-3940
    ISSN (online) 1432-1920
    ISSN 0028-3940
    DOI 10.1007/s00234-023-03241-7
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