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Previous studies have identified alterations in structural and functional connectivity related to this disorder, but its local functional neural basis has received less attention. The purpose of this study was to combine univariate analysis and a Gaussian process classifier (GPC) to assess local activity and further explore neuropathological mechanisms in PNH\u2010related epilepsy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We used a 3.0\u2010T scanner to acquire resting\u2010state data and measure local regional homogeneity (ReHo) alterations in 38 patients with PNH\u2010related epilepsy and 38 healthy controls (HCs). We first assessed ReHo alterations by comparing the PNH group to the HC group using traditional univariate analysis. Next, we applied a GPC to explore whether ReHo could be used to differentiate PNH patients from healthy patients at an individual level.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared to HCs, PNH\u2010related epilepsy patients exhibited lower ReHo in the left insula extending to the putamen as well as in the subgenual anterior cingulate cortex (sgACC) extending to the orbitofrontal cortex (OFC) [<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05, family\u2010wise error corrected]. Both of these regions were also correlated with epilepsy duration. Furthermore, the ReHo GPC classification yielded a 76.32% accuracy (sensitivity\u00a0=\u00a071.05% and specificity\u00a0=\u00a081.58%) with <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001 after permutation testing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Using the resting\u2010state approach, we identified localized activity alterations in the left insula extending to the putamen and the sgACC extending to the OFC, providing pathophysiological evidence of PNH. These local connectivity patterns may provide a means to differentiate PNH patients from HCs.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cns.14104","type":"journal-article","created":{"date-parts":[[2023,2,6]],"date-time":"2023-02-06T01:45:30Z","timestamp":1675647930000},"page":"1325-1331","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Localized activity alternations in periventricular nodular heterotopia\u2010related epilepsy"],"prefix":"10.1111","volume":"29","author":[{"given":"Wenyu","family":"Liu","sequence":"first","affiliation":[{"name":"Departments of Neurology, West China Hospital Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hesheng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Departments of Neurology, West China Hospital Sichuan University  Chengdu 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