Altered regional synchronization in epileptic patients with generalized tonic–clonic seizures

Epilepsy is a common neurological disorder characterized by hyper-synchronous abnormalities of neurons. Resting state brain activity measured by fMRI might evaluate the synchronization of the disorder. To investigate the alteration of the haemodynamic synchronization in epilepsy, resting-state fMRI (RS-fMRI) was performed on 25 patients with primarily generalized tonic-clonic seizures (GTCS), along with 25 age- and sex-matched healthy subjects. Regional homogeneity (ReHo), a measurement of the synchronization of spontaneous RS-fMRI signal oscillations within spatially neighboring voxels, was examined. Compared with the healthy controls, the patients with GTCS showed bilaterally and symmetrically altered ReHo in the cortical and subcortical structures. In addition, a correlation analysis of the ReHo measurement versus the epilepsy duration was performed, and highly negative correlations were observed in thalamus, insula and the regions followed the pattern of 'default' state of brain function. The current findings demonstrate that altered regional synchronization of brain activity exists in the patients with GTCS during interictal period, and there is potential in utilizing the ReHo method in RS-fMRI analyses of epilepsy.