PT  - JOURNAL ARTICLE
AU  - Thomas Blauwblomme
AU  - Athena Demertzi
AU  - Jean-Marc Tacchela
AU  - Ludovic Fillon
AU  - Marie Bourgeois
AU  - Emma Lositto
AU  - Monika Eisermann
AU  - Daniele Marinazzo
AU  - Federico Raimondo
AU  - Sarael Alcauter
AU  - Frederik Van De Steen
AU  - Nigel Colenbier
AU  - Steven Laureys
AU  - Volodia Dangouloff-Ros
AU  - Lionel Naccache
AU  - Nathalie Boddaert
AU  - Rima Nabbout
TI  - Functional cortico-subcortical reorganization after complete hemispheric disconnection for intractable epilepsy
AID  - 10.1101/707539
DP  - 2019 Jan 01
TA  - bioRxiv
PG  - 707539
4099  - http://biorxiv.org/content/early/2019/07/19/707539.short
4100  - http://biorxiv.org/content/early/2019/07/19/707539.full
AB  - Hemispherotomy is a treatment for drug-resistant epilepsy with the whole hemisphere involved in seizure onset. As recovery mechanisms are still debated, we characterize functional reorganization with multimodal MRI in two children operated on the right hemisphere (RH). We found that interhemispheric functional connectivity was abolished in both patients. The healthy left hemispheres (LH) displayed focal hyperperfusion in motor and limbic areas, and preserved network-level organization. The disconnected RHs were hypoperfused despite sustained network-level organization. Functional connectivity was increased in the left thalamo-cortical loop and between the cerebelli. The classification probability of the RH corresponding to a minimally conscious state was smaller than for the LH. We conclude that after hemispherotomy, neurological rehabilitation is sustained by cortical disinhibition and reinforcement of connectivity driven by subcortical structures in the remaining hemisphere. Our results highlight the effect of vascularization on functional connectivity and raise inquiries about the conscious state of the isolated hemisphere.