| Summary: | Background: Temporal lobe is the most frequent site of origin of partial seizures. Patients with
Temporal Lobe Epilepsy (TLE) represent approximately two thirds of the intractable seizure
population.
Objectives: This study aims to compare the area of activation in between healthy subjects and
TLE patients as a result of increase in blood oxygen level in different parts of the brain during
self-paced unilateral and bilateral finger tapping. In addition, this study also aims to compare
the effective connectivity in between region of interest in Healthy subjects and TLE patients
during self-paced unilateral and bilateral finger tapping.
Methodology: This study involves 12 healthy subjects and 12 TLE patients. All of them
undergone functional magnetic resonance imaging (fMRI) where they performed self-paced
unilateral and bilateral finger tapping. The images were then pre-processed and underwent first
level analysis using Statistical Parametric Mapping (SPM). Second level analysis were then
performed to compare the area of activation in healthy subjects and TLE patients. For effective
connectivity, two regions of interest were chosen which represent visual and motor regions.
Three models tested in between each region of interest which were bidirectional, visual to
motor and motor to visual. These tests were conducted in each brain hemispheres of both
healthy subjects and TLE patients.
Results: In both healthy subjects and TLE patients, first level analysis showed intense
activation at the visual area. Second level analysis was performed comparing the two group of
samples, using two samples t-test, familywise error rate (FWE) p < 0.05, healthy subjects
showed more areas of significant activation. For effective connectivity, in healthy subjects,
visual to motor was the dominant model with average value of 0.03Hz bilaterally. In TLE subjects, on the right hemisphere, a contrary result was observed whereby motor to visual area
was the dominant model. On the left hemisphere, the same model as healthy subjects was the
dominant model, visual to motor, but with higher average value of 0.1Hz.
Conclusion: This study found that there were less area of brain that has significant activation
in TLE patients during motor activity. TLE brains also exhibit different effective connectivity
whereby in the right hemisphere, motor area exerts more influence on the visual area and in
the left hemisphere, visual area exerts significantly more influence on the motor area. These
findings suggest that there is alteration of the motor networks in TLE patients.
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