Multidimensional Associations between Cognition and Connectome Organization in Temporal Lobe Epilepsy

ObjectiveTemporal lobe epilepsy (TLE) is known to affect large-scale structural networks and cognitive function in multiple domains. The study of complex relations between structural network organization and cognition requires comprehensive analytical methods and a shift towards multivariate techniques. The current work sought to identify multidimensional associations between cognitive performance and structural network topology in TLE.MethodsWe studied 34 drug-resistant TLE patients and 25 age- and sex-matched healthy controls. All participants underwent a comprehensive neurocognitive battery and multimodal MRI, allowing for large-scale connectomics, and morphological evaluation of subcortical and neocortical regions. Using canonical correlation analysis, we identified a multivariate mode that links cognitive performance to a brain structural network. Our approach was complemented by bootstrap-based clustering to derive cognitive subtypes and associated patterns of macroscale connectome anomalies.ResultsBoth methodologies provided converging evidence for a close coupling between cognitive impairments across multiple domains and large-scale structural network compromise. Cognitive classes presented with an increasing gradient of abnormalities (increasing cortical and subcortical atrophy and less efficient white matter connectome organization in patients with increasing degrees of cognitive impairments). Notably, network topology characterized better the cognitive performance than morphometric measures. Thus, connectome characteristics featured as important markers of network reorganization and loss of inter-regional connectivity.ConclusionsThe multivariate approach emphasized the close interplay between cognitive impairment and large-scale network anomalies in TLE. Our findings contribute to understand the complexity of structural connectivity regulating the heterogeneous cognitive deficits found in epilepsy