Introduction. Epilepsy is a disease characterized by abnormal paroxysmal bioelectrical activity in the brain cortex and subcortical structures. Seizures per se change brain metabolism in epileptic focus and in distal parts of the brain. However, interictal phenomena can also affect functional connectivity (FC) and brain metabolism in other parts of the brain. Aim of study. We hypothesised that epilepsy affects functional connectivity not only among cortical, but also between subcortical, structures of the brain in a resting state condition. Clinical rationale for study. Investigating functional connectivity in patients with epilepsy could provide insights into the underlying pathophysiological mechanisms. Better understanding may lead to more effective treatment strategies. Material and methods. Functional connectivity was analysed in 35 patients with epilepsy and in 28 healthy volunteers. The group of patients was divided into generalised and focal epilepsy (temporal and extratemporal subgroups). Each patient and healthy volunteer underwent an fMRI resting-state session. During the study, EEG signals were simultaneously recorded with fMRI to facilitate the subsequent detection of potential interictal epileptiform discharges (IEDs). Their potential impact on BOLD signals was mitigated through linear regression. The data was processed and correlation coefficients (FC values) between the BOLD signal from selected structures of the central nervous system were determined and compared between study groups. The results were presented as significant differences in correlation coefficients between brain/subcortical structures in the epilepsy and control groups. Results. Lower FC values for the epilepsy group compared to the control group were shown for connections related to the MPFC, hippocampus, thalamus, amygdala, and the parahippocampal gyrus. Conclusions. Epilepsy alters the functional connectivity of resting state subcortical networks. Patterns of pathological changes of FC differ between epilepsy subtypes, with predominant lower FC between the hippocampus, parahippocampal gyrus, amygdala and thalamus in patients with epilepsy. Clinical implications. This study suggests that epilepsy affects subcortical structures. Identifying distinct patterns of altered FC in epilepsy subtypes may help to tailor treatment strategies. Changes in FC detected by fMRI may precede clinical symptoms, aiding in the early diagnosis of cognitive and emotional disorders in focal epilepsy.

Simultaneous EEG-fMRI measurements are used to study epileptic patients in order to localize brain regions associated with interictal epileptiform discharges (IEDs). The common approach to this analysis uses the generalized linear model (GLM) with a canonical hemodynamic response function (HRF) to relate EEG activity to predicted BOLD responses. The study aimed to determine whether the canonical HRF is optimal for IED-induced hotspot fMRI analysis and develop optimized HRFs. The optimization of four HRF models was performed on BOLD responses derived from SPM activation clusters from 36 epileptic patients. The results showed that the optimized HRF models improved the sensitivity of the EEG-fMRI analysis of IED events in epilepsy patients compared to standard HRFs. This was evidenced by an increase in the size, number, and maximum t-score values of activated areas.

In recent years the association between video games, cognition, and the brain has been actively investigated. However, it is still unclear how individual predispositions, such as brain structure characteristics, play a role in the process of acquiring new skills, such as video games. The aim of this preliminary study was to investigate whether acquisition of cognitive-motor skills from the real-time strategy video game (StarCraft II) is associated with pre-training measures of brain white matter integrity. Results show that higher white matter integrity in regions (anterior limb of internal capsule, cingulum/hippocampus) and tracts (inferior longitudinal fasciculus) related with motoric functions, set shifting and visual decision making was associated with better Star Craft II performance. The presented findings inline with previous results and suggest that structural brain predispositions of individuals are related to the video game skill acquisition. Our study highlights the importance of neuroimaging studies that focus on white matter in predicting the outcomes of intervention studies and has implications for understanding the neural basis of the skill learning process.

It is unclear why some people learn faster than others. We performed two independent studies in which we investigated the neural basis of real-time strategy (RTS) gaming and neural predictors of RTS games skill-acquisition. In the first (cross-sectional) study we found that experts in the RTS game StarCraft II (SC2) had a larger lenticular nucleus volume than non-RTS players. We followed a cross validation procedure where we used the volume of regions identified in the first study to predict the quality of learning a new, complex skill (SC2) in a sample of individuals who were naïve to RTS games (second training study). Our findings provide new insights into how the volume of lenticular nucleus, which is associated with motor as well as cognitive functions, can be utilized to predict successful skill-learning, and be applied to a much broader context than just video games, e.g. contributing to optimizing cognitive training interventions.