{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T17:17:03Z","timestamp":1784999823102,"version":"3.55.0"},"reference-count":43,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,1,31]],"date-time":"2024-01-31T00:00:00Z","timestamp":1706659200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000005","name":"U.S. Department of Defense","doi-asserted-by":"publisher","award":["W81XWH\u201017\u20100619"],"award-info":[{"award-number":["W81XWH\u201017\u20100619"]}],"id":[{"id":"10.13039\/100000005","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The uncinate fasciculus (UF) has been implicated previously in contributing to the pathophysiology of functional (nonepileptic) seizures (FS). FS are frequently preceded by adverse life events (ALEs) and present with comorbid psychiatric symptoms, yet neurobiological correlates of these factors remain unclear. To address this gap, using advanced diffusion magnetic resonance imaging (dMRI), UF tracts in a large cohort of patients with FS and pre\u2010existing traumatic brain injury (TBI\u2009+\u2009FS) were compared to those in patients with TBI without FS (TBI\u2010only). We hypothesized that dMRI measures in UF structural connectivity would reveal UF differences when controlling for TBI status. Partial correlation tests assessed the potential relationships with psychiatric symptom severity measures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Participants with TBI\u2010only (<jats:italic>N<\/jats:italic>\u2009=\u200946) and TBI\u2009+\u2009FS (<jats:italic>N<\/jats:italic>\u2009=\u200955) completed a series of symptom questionnaires and MRI scanning. Deterministic tractography via diffusion spectrum imaging (DSI) was implemented in DSI studio (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/dsi-studio.labsolver.org\">https:\/\/dsi\u2010studio.labsolver.org<\/jats:ext-link>) with q\u2010space diffeomorphic reconstruction (QSDR), streamline production, and manual segmentation to assess bilateral UF integrity. Fractional anisotropy (FA), radial diffusivity (RD), streamline counts, and their respective asymmetry indices (AIs) served as estimates of white matter integrity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared to TBI\u2010only, TBI\u2009+\u2009FS participants demonstrated decreased left hemisphere FA and RD asymmetry index (AI) for UF tracts (both <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05, false discovery rate [FDR] corrected). Additionally, TBI\u2009+\u2009FS reported higher symptom severity in depression, anxiety, and PTSD measures (all <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01). Correlation tests comparing UF white matter integrity differences to psychiatric symptom severity failed to reach criteria for significance (all <jats:italic>p<\/jats:italic>\u2009&gt;\u2009.05, FDR corrected).<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>In a large, well\u2010characterized sample, participants with FS had decreased white matter health after controlling for the history of TBI. Planned follow\u2010up analysis found no evidence to suggest that UF connectivity measures are a feature of group differences in mood or anxiety comorbidities for FS. These findings suggest that frontolimbic structural connectivity may play a role in FS symptomology, after accounting for prior ALEs and comorbid psychopathology severity.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.17896","type":"journal-article","created":{"date-parts":[[2024,1,31]],"date-time":"2024-01-31T12:09:56Z","timestamp":1706702996000},"page":"1060-1071","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Decreased uncinate fasciculus integrity in functional seizures following traumatic brain injury"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-7805-6938","authenticated-orcid":false,"given":"Caroline G.","family":"Byington","sequence":"first","affiliation":[{"name":"Department of Neurology, UAB Epilepsy Center University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7550-679X","authenticated-orcid":false,"given":"Adam M.","family":"Goodman","sequence":"additional","affiliation":[{"name":"Department of Neurology, UAB Epilepsy Center University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6888-9000","authenticated-orcid":false,"given":"Jane B.","family":"Allendorfer","sequence":"additional","affiliation":[{"name":"Department of Neurology, UAB Epilepsy Center University of Alabama at Birmingham  Birmingham Alabama USA"},{"name":"Department of Neurobiology University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Correia","sequence":"additional","affiliation":[{"name":"Departments of Psychiatry and Neurology, Veterans Affairs Providence Healthcare System, Rhode Island Hospital Brown University  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4901-3852","authenticated-orcid":false,"suffix":"Jr.","given":"W. Curt","family":"LaFrance","sequence":"additional","affiliation":[{"name":"Departments of Psychiatry and Neurology, Veterans Affairs Providence Healthcare System, Rhode Island Hospital Brown University  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5936-6627","authenticated-orcid":false,"given":"Jerzy P.","family":"Szaflarski","sequence":"additional","affiliation":[{"name":"Department of Neurology, UAB Epilepsy Center University of Alabama at Birmingham  Birmingham Alabama USA"},{"name":"Departments of Neurobiology and Neurosurgery University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,31]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.12356"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2016.01.003"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1059\u20101311(05)80119\u20100"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/PSY.0b013e3181d96550"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2009.06.006"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ncl.2009.06.004"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nicl.2021.102623"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.51198"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.12053"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1684\/epd.2019.1107"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2018.04.009"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11682\u2010018\u20109906\u20100"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.16758"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.5698\/1535\u20107597.18.4.211"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dcn.2015.06.003"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awq283"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1037\/bne0000305"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psyneuen.2009.02.016"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2017.11.021"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tics.2005.03.010"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2015.02.022"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2020.116673"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brainres.2015.04.050"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1207\/s15327752jpa6703_13"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.61.2.194"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02116837"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0063850"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1155\/2000\/421719"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2015.10.019"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2004.07.051"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2011.06.021"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0080713"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2010.03.035"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/nbm.781"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2008.03.036"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nicl.2013.06.014"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroscience.2021.05.012"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2017.00720"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2017.07.010"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2018.12.027"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2011.07.001"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.2147\/NDT.S235159"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebr.2021.100496"}],"container-title":["Epilepsia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/epi.17896","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/epi.17896","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,29]],"date-time":"2024-11-29T10:53:42Z","timestamp":1732877622000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/epi.17896"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,31]]},"references-count":43,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1111\/epi.17896"],"URL":"https:\/\/doi.org\/10.1111\/epi.17896","archive":["Portico"],"relation":{},"ISSN":["0013-9580","1528-1167"],"issn-type":[{"value":"0013-9580","type":"print"},{"value":"1528-1167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,31]]},"assertion":[{"value":"2023-08-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-31","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}