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Baer, Jr. Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001479","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005331","name":"American Brain Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005331","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Many forms of epilepsy are associated with aberrant neuronal connections, but the relationship between such pathological connectivity and the underlying physiological predisposition to seizures is unclear. We sought to characterize the cortical excitability profile of a developmental form of epilepsy known to have structural and functional connectivity abnormalities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We employed transcranial magnetic stimulation (TMS) with simultaneous electroencephalographic (EEG) recording in 8 patients with epilepsy from periventricular nodular heterotopia and matched healthy controls. We used connectivity imaging findings to guide TMS targeting and compared the evoked responses to single\u2010pulse stimulation from different cortical regions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Heterotopia patients with active epilepsy demonstrated a relatively augmented late cortical response that was greater than that of matched controls. This abnormality was specific to cortical regions with connectivity to subcortical heterotopic gray matter. Topographic mapping of the late response differences showed distributed cortical networks that were not limited to the stimulation site, and source analysis in 1 subject revealed that the generator of abnormal TMS\u2010evoked activity overlapped with the spike and seizure onset zone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>Our findings indicate that patients with epilepsy from gray matter heterotopia have altered cortical physiology consistent with hyperexcitability, and that this abnormality is specifically linked to the presence of aberrant connectivity. These results support the idea that TMS\u2010EEG could be a useful biomarker in epilepsy in gray matter heterotopia, expand our understanding of circuit mechanisms of epileptogenesis, and have potential implications for therapeutic neuromodulation in similar epileptic conditions associated with deep lesions. Ann Neurol 2015;77:487\u2013503<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ana.24343","type":"journal-article","created":{"date-parts":[[2015,1,14]],"date-time":"2015-01-14T10:09:49Z","timestamp":1421230189000},"page":"487-503","source":"Crossref","is-referenced-by-count":70,"title":["Physiological consequences of abnormal connectivity in a developmental epilepsy"],"prefix":"10.1002","volume":"77","author":[{"given":"Mouhsin M.","family":"Shafi","sequence":"first","affiliation":[{"name":"Berenson\u2013Allen Center for Noninvasive Brain Stimulation Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School Boston MA"},{"name":"Comprehensive Epilepsy Center Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marine","family":"Vernet","sequence":"additional","affiliation":[{"name":"Berenson\u2013Allen Center for Noninvasive Brain Stimulation Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debby","family":"Klooster","sequence":"additional","affiliation":[{"name":"Kempenhaeghe, Academic Center for Epileptology Heeze the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine J.","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of Neurology Massachusetts General Hospital and Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katica","family":"Boric","sequence":"additional","affiliation":[{"name":"Department of Neurology Massachusetts General Hospital and Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mollie E.","family":"Barnard","sequence":"additional","affiliation":[{"name":"Harvard School of Public Health Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelsey","family":"Romatoski","sequence":"additional","affiliation":[{"name":"Comprehensive Epilepsy Center Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. 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