The changes in brain network functional gradients and dynamic functional connectivity in SeLECTS patients revealing disruptive and compensatory mechanisms in brain networks

Background Self-limited epilepsy with centrotemporal spikes (SeLECTS), a common childhood focal epilepsy syndrome, is linked to cognitive impairments and poorly understood neuropathological mechanisms.Methods This study explored dynamic functional connectivity (dFC) and functional gradients (FG) alterations in key brain networks using resting-state MRI (rs-MRI) data from 34 SeLECTS patients and 32 healthy controls (HCs).Results The results revealed significant dFC changes between the Default Mode Network (DMN) and Sensorimotor Network (SMN) in SeLECTS patients compared to HCs. Specifically, the first gradient of the DMN showed decreased gradient scores in the bilateral dorsolateral superior frontal gyrus and increased scores in the left inferior temporal gyrus. In the first gradient of the SMN, increased scores were found in the bilateral supplementary motor area, while decreases occurred in the right precentral gyrus. Support vector machine (SVM) analysis showed that FG-based features could effectively identify abnormalities in specific brain networks of SeLECTS (AUC = 0.819). Further correlation analysis linked FG alterations in the DMN to cognitive measures (working memory, processing speed, and full-scale IQ) and in the SMN to disease duration and language comprehension.Conclusion These findings suggest that significant changes in FG and dFC of DMN- and SMN-related brain regions in SeLECTS may reflect both disruptions and compensatory mechanisms in brain networks, offering new insights into the neuropathological basis of the disorder and potential diagnostic biomarkers.