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Feng X, Piper RJ, Prentice F, Clayden JD, Baldeweg T. Functional brain connectivity in children with focal epilepsy: A systematic review of functional MRI studies. Seizure 2024; 117:164-173. [PMID: 38432080 DOI: 10.1016/j.seizure.2024.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 03/05/2024] Open
Abstract
Epilepsy is increasingly recognised as a brain network disorder and many studies have investigated functional connectivity (FC) in children with epilepsy using functional MRI (fMRI). This systematic review of fMRI studies, published up to November 2023, investigated profiles of FC changes and their clinical relevance in children with focal epilepsy compared to healthy controls. A literature search in PubMed and Web of Science yielded 62 articles. We categorised the results into three groups: 1) differences in correlation-based FC between patients and controls; 2) differences in other FC measures between patients and controls; and 3) associations between FC and disease variables (for example, age of onset), cognitive and seizure outcomes. Studies revealed either increased or decreased FC across multiple brain regions in children with focal epilepsy. However, findings lacked consistency: conflicting FC alterations (decreased and increased FC) co-existed within or between brain regions across all focal epilepsy groups. The studies demonstrated overall that 1) interhemispheric connections often displayed abnormal connectivity and 2) connectivity within and between canonical functional networks was decreased, particularly for the default mode network. Focal epilepsy disrupted FC in children both locally (e.g., seizure-onset zones, or within-brain subnetworks) and globally (e.g., whole-brain network architecture). The wide variety of FC study methodologies limits clinical application of the results. Future research should employ longitudinal designs to understand the evolution of brain networks during the disease course and explore the potential of FC biomarkers for predicting cognitive and postsurgical seizure outcomes.
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Affiliation(s)
- Xiyu Feng
- Developmental Neurosciences Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, 30 Guilford, London WC1N 1EH, United Kingdom
| | - Rory J Piper
- Developmental Neurosciences Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, 30 Guilford, London WC1N 1EH, United Kingdom; Department of Neurosurgery, Great Ormond Street Hospital, London, United Kingdom
| | - Freya Prentice
- Developmental Neurosciences Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, 30 Guilford, London WC1N 1EH, United Kingdom
| | - Jonathan D Clayden
- Developmental Neurosciences Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, 30 Guilford, London WC1N 1EH, United Kingdom
| | - Torsten Baldeweg
- Developmental Neurosciences Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, 30 Guilford, London WC1N 1EH, United Kingdom.
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Hüsser AM, Vannasing P, Tremblay J, Osterman B, Lortie A, Diadori P, Major P, Rossignol E, Roger K, Fourdain S, Provost S, Maalouf Y, Nguyen DK, Gallagher A. Brain language networks and cognitive outcomes in children with frontotemporal lobe epilepsy. Front Hum Neurosci 2023; 17:1253529. [PMID: 37964801 PMCID: PMC10641510 DOI: 10.3389/fnhum.2023.1253529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 10/11/2023] [Indexed: 11/16/2023] Open
Abstract
Introduction Pediatric frontal and temporal lobe epilepsies (FLE, TLE) have been associated with language impairments and structural and functional brain alterations. However, there is no clear consensus regarding the specific patterns of cerebral reorganization of language networks in these patients. The current study aims at characterizing the cerebral language networks in children with FLE or TLE, and the association between brain network characteristics and cognitive abilities. Methods Twenty (20) children with FLE or TLE aged between 6 and 18 years and 29 age- and sex-matched healthy controls underwent a neuropsychological evaluation and a simultaneous functional near-infrared spectroscopy and electroencephalography (fNIRS-EEG) recording at rest and during a receptive language task. EEG was used to identify potential subclinical seizures in patients. We removed these time intervals from the fNIRS signal to investigate language brain networks and not epileptogenic networks. Functional connectivity matrices on fNIRS oxy-hemoglobin concentration changes were computed using cross-correlations between all channels. Results and discussion Group comparisons of residual matrices (=individual task-based matrix minus individual resting-state matrix) revealed significantly reduced connectivity within the left and between hemispheres, increased connectivity within the right hemisphere and higher right hemispheric local efficiency for the epilepsy group compared to the control group. The epilepsy group had significantly lower cognitive performance in all domains compared to their healthy peers. Epilepsy patients' local network efficiency in the left hemisphere was negatively associated with the estimated IQ (p = 0.014), suggesting that brain reorganization in response to FLE and TLE does not allow for an optimal cognitive development.
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Affiliation(s)
- Alejandra M. Hüsser
- Neurodevelopmental Optical Imaging Laboratory (LIONlab), Research Center, Sainte-Justine Mother and Child University Hospital Center, Montreal, QC, Canada
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
| | - Phetsamone Vannasing
- Neurodevelopmental Optical Imaging Laboratory (LIONlab), Research Center, Sainte-Justine Mother and Child University Hospital Center, Montreal, QC, Canada
| | - Julie Tremblay
- Neurodevelopmental Optical Imaging Laboratory (LIONlab), Research Center, Sainte-Justine Mother and Child University Hospital Center, Montreal, QC, Canada
| | - Bradley Osterman
- Division of Neurology, Sainte-Justine Mother and Child University Hospital Center, Montreal, QC, Canada
- Division of Pediatric Neurology, Montreal Children’s Hospital, McGill University Health Centre, Montreal, QC, Canada
| | - Anne Lortie
- Division of Neurology, Sainte-Justine Mother and Child University Hospital Center, Montreal, QC, Canada
- Department of Neuroscience, Université de Montréal, Montreal, QC, Canada
- Department of Pediatrics, Université de Montréal, Montreal, QC, Canada
| | - Paola Diadori
- Division of Neurology, Sainte-Justine Mother and Child University Hospital Center, Montreal, QC, Canada
- Department of Pediatrics, Université de Montréal, Montreal, QC, Canada
| | - Philippe Major
- Division of Neurology, Sainte-Justine Mother and Child University Hospital Center, Montreal, QC, Canada
- Department of Neuroscience, Université de Montréal, Montreal, QC, Canada
- Department of Pediatrics, Université de Montréal, Montreal, QC, Canada
| | - Elsa Rossignol
- Division of Neurology, Sainte-Justine Mother and Child University Hospital Center, Montreal, QC, Canada
- Department of Neuroscience, Université de Montréal, Montreal, QC, Canada
- Department of Pediatrics, Université de Montréal, Montreal, QC, Canada
| | - Kassandra Roger
- Neurodevelopmental Optical Imaging Laboratory (LIONlab), Research Center, Sainte-Justine Mother and Child University Hospital Center, Montreal, QC, Canada
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
| | - Solène Fourdain
- Neurodevelopmental Optical Imaging Laboratory (LIONlab), Research Center, Sainte-Justine Mother and Child University Hospital Center, Montreal, QC, Canada
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
| | - Sarah Provost
- Neurodevelopmental Optical Imaging Laboratory (LIONlab), Research Center, Sainte-Justine Mother and Child University Hospital Center, Montreal, QC, Canada
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
| | - Yara Maalouf
- Neurodevelopmental Optical Imaging Laboratory (LIONlab), Research Center, Sainte-Justine Mother and Child University Hospital Center, Montreal, QC, Canada
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
| | - Dang Khoa Nguyen
- Department of Neuroscience, Université de Montréal, Montreal, QC, Canada
- CHUM Research Center, Université de Montréal, Montreal, QC, Canada
| | - Anne Gallagher
- Neurodevelopmental Optical Imaging Laboratory (LIONlab), Research Center, Sainte-Justine Mother and Child University Hospital Center, Montreal, QC, Canada
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
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Marcelle M, You X, Fanto EJ, Sepeta LN, Gaillard WD, Berl MM. Impact of development and recent-onset epilepsy on language dominance. Epilepsia 2022; 63:2637-2649. [PMID: 36222084 PMCID: PMC9574909 DOI: 10.1111/epi.17383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 07/20/2022] [Accepted: 08/02/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Reorganization of the language network from typically left-lateralized frontotemporal regions to bilaterally distributed or right-lateralized networks occurs in anywhere from 25%-30% of patients with focal epilepsy. In patients who have been recently diagnosed with epilepsy, an important question remains as to whether it is the presence of seizures or the underlying epilepsy etiology that leads to atypical language representations. This question becomes even more interesting in pediatric samples, where the typical developmental processes of the language network may confer more variability and plasticity in the language network. We assessed a carefully selected cohort of children with recent-onset epilepsy to examine whether it is the effects of seizures or their underlying cause that leads to atypical language lateralization. METHODS We used functional magnetic resonance imaging (fMRI) to compare language laterality in children with recently diagnosed focal unaware epilepsy and age-matched controls. Age at epilepsy onset (age 4 to 6 years vs age 7 to 12 years) was also examined to determine if age at onset influenced laterality. RESULTS The majority of recent-onset patients and controls exhibited left-lateralized language. There was a significant interaction such that the relationship between epilepsy duration and laterality differed by age at onset. In children with onset after age 6, a longer duration of epilepsy was associated with less left-lateralized language dominance. In contrast, in children with onset between 4 and 6 years of age, a longer duration of epilepsy was not associated with less left language dominance. SIGNIFICANCE Our results demonstrate that although language remained largely left-lateralized in children recently diagnosed with epilepsy, the impact of seizure duration depended on age at onset, indicating that the timing of developmental and disease factors are important in determining language dominance.
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Affiliation(s)
- Madeline Marcelle
- Children’s National Hospital, 111 Michigan Avenue NW, Washington, DC 20010, United States
- Interdisciplinary Program in Neuroscience, Georgetown University, 4000 Reservoir Road NW, Washington DC 20057, United States
| | - Xiaozhen You
- Children’s National Hospital, 111 Michigan Avenue NW, Washington, DC 20010, United States
| | - Eleanor J. Fanto
- Children’s National Hospital, 111 Michigan Avenue NW, Washington, DC 20010, United States
| | - Leigh N. Sepeta
- Children’s National Hospital, 111 Michigan Avenue NW, Washington, DC 20010, United States
- George Washington University, 2300 I Street NW, Washington, DC 20037, United States
| | - William Davis Gaillard
- Children’s National Hospital, 111 Michigan Avenue NW, Washington, DC 20010, United States
- George Washington University, 2300 I Street NW, Washington, DC 20037, United States
| | - Madison M. Berl
- Children’s National Hospital, 111 Michigan Avenue NW, Washington, DC 20010, United States
- George Washington University, 2300 I Street NW, Washington, DC 20037, United States
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Bailey K, McAdam-Wong D, Im-Bolter N. Language measurement in childhood epilepsy: A review. BRAIN AND LANGUAGE 2021; 217:104940. [PMID: 33819772 DOI: 10.1016/j.bandl.2021.104940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 03/12/2021] [Accepted: 03/13/2021] [Indexed: 06/12/2023]
Abstract
The psychosocial well-being of children and adolescents with epilepsy is affected by comorbid language deficits. Little is known about the focus of current research in language and epilepsy. A systematic review of research was conducted to identify gaps in knowledge regarding language and epilepsy. In total, 83 published articles were eligible for inclusion. More studies included samples presenting with focal seizures (k = 39) compared to generalized seizures (k = 10), few included measures of morphology (k = 4). Most studies (k = 66) included samples of participants across a wide age range. Our review indicated t-hat future research should include a greater focus on participants with more diversity in epilepsy etiology (e.g., symptomatic epilepsy), and seizure type (e.g., generalized seizures), assessment of additional areas of language (e.g., morphology), increased focus on early childhood, focused examination of specific developmental stages, and greater use of comparison groups with an alternate epilepsy diagnosis.
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Affiliation(s)
- Katharine Bailey
- Department of Psychology, Queen's University, Kingston, ON, Canada; Department of Psychology, Trent University, Peterborough, ON, Canada.
| | | | - Nancie Im-Bolter
- Department of Psychology, Trent University, Peterborough, ON, Canada
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Pur DR, Eagleson R, Lo M, Jurkiewicz MT, Andrade A, de Ribaupierre S. Presurgical brain mapping of the language network in pediatric patients with epilepsy using resting-state fMRI. J Neurosurg Pediatr 2021; 27:259-268. [PMID: 33418528 DOI: 10.3171/2020.8.peds20517] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 08/17/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Epilepsy affects neural processing and often causes intra- or interhemispheric language reorganization, rendering localization solely based on anatomical landmarks (e.g., Broca's area) unreliable. Preoperative brain mapping is necessary to weigh the risk of resection with the risk of postoperative deficit. However, the use of conventional mapping methods (e.g., somatosensory stimulation, task-based functional MRI [fMRI]) in pediatric patients is technically difficult due to low compliance and their unique neurophysiology. Resting-state fMRI (rs-fMRI), a "task-free" technique based on the neural activity of the brain at rest, has the potential to overcome these limitations. The authors hypothesized that language networks can be identified from rs-fMRI by applying functional connectivity analyses. METHODS Cases in which both task-based fMRI and rs-fMRI were acquired as part of the preoperative clinical protocol for epilepsy surgery were reviewed. Task-based fMRI consisted of 2 language tasks and 1 motor task. Resting-state fMRI data were acquired while the patients watched an animated movie and were analyzed using independent component analysis (i.e., data-driven method). The authors extracted language networks from rs-fMRI data by performing a similarity analysis with functionally defined language network templates via a template-matching procedure. The Dice coefficient was used to quantify the overlap. RESULTS Thirteen children underwent conventional task-based fMRI (e.g., verb generation, object naming), rs-fMRI, and structural imaging at 1.5T. The language components with the highest overlap with the language templates were identified for each patient. Language lateralization results from task-based fMRI and rs-fMRI mapping were comparable, with good concordance in most cases. Resting-state fMRI-derived language maps indicated that language was on the left in 4 patients (31%), on the right in 5 patients (38%), and bilateral in 4 patients (31%). In some cases, rs-fMRI indicated a more extensive language representation. CONCLUSIONS Resting-state fMRI-derived language network data were identified at the patient level using a template-matching method. More than half of the patients in this study presented with atypical language lateralization, emphasizing the need for mapping. Overall, these data suggest that this technique may be used to preoperatively identify language networks in pediatric patients. It may also optimize presurgical planning of electrode placement and thereby guide the surgeon's approach to the epileptogenic zone.
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Affiliation(s)
| | - Roy Eagleson
- 2Department of Electrical and Computer Engineering, Brain and Mind Institute, University of Western Ontario, London
| | - Marcus Lo
- 3Lawson Health Research Institute, London
| | - Michael T Jurkiewicz
- 4Department of Medical Imaging, Children's Hospital at London Health Sciences Centre, London; and
| | | | - Sandrine de Ribaupierre
- 6Clinical Neurological Sciences, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada
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Yuan Q, Ma F, Zhang M, Chen M, Zhang Z, Wu J, Lu C, Guo T. Neural interaction between language control and cognitive control: Evidence from cross-task adaptation. Behav Brain Res 2020; 401:113086. [PMID: 33359369 DOI: 10.1016/j.bbr.2020.113086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 12/13/2020] [Accepted: 12/16/2020] [Indexed: 01/28/2023]
Abstract
It has been documented that conflict adaptation (conflict resolution in a task enhanced by that in a previous task) exists not only in the same domain but also across different domains with shared cognitive control mechanisms. For the first time, the present study adopted a cross-task adaptive blocked design to examine the relationship between bilingual language control and cognitive control from the perspective of the immediately adjacent, mutual influence on the neural connectivity level. The results showed that the conflict setting induced by previous tasks changed the nodal degrees of the anterior cingulate cortex/presupplementary motor area and the right thalamus, and connectivity strength of shared links between adjacent language and cognitive control tasks. In addition, pre-activation of the cognitive control network affected the transitivity of the successive use of the language control network. These findings not only indicate a cross-task adaptation effect on the neural connectivity level, but also provide evidence for similarities in conflict detection and inhibition control between language-specific control and domain-general cognitive control. In addition, our results also suggest that there is only partial overlap between bilingual language control and domain-general cognitive control.
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Affiliation(s)
- Qiming Yuan
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Fengyang Ma
- School of Education, University of Cincinnati, Cincinnati, USA
| | - Man Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Mo Chen
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Zhaoqi Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Junjie Wu
- Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin, China
| | - Chunming Lu
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China; IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Taomei Guo
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China; IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China.
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Foley E, Wood AG, Furlong PL, Walsh AR, Kearney S, Bill P, Hillebrand A, Seri S. Mapping language networks and their association with verbal abilities in paediatric epilepsy using MEG and graph analysis. Neuroimage Clin 2020; 27:102265. [PMID: 32413809 PMCID: PMC7226893 DOI: 10.1016/j.nicl.2020.102265] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 03/26/2020] [Accepted: 03/26/2020] [Indexed: 10/26/2022]
Abstract
Recent theoretical models of language have emphasised the importance of integration within distributed networks during language processing. This is particularly relevant to young patients with epilepsy, as the topology of the functional network and its dynamics may be altered by the disease, resulting in reorganisation of functional language networks. Thus, understanding connectivity within the language network in patients with epilepsy could provide valuable insights into healthy and pathological brain function, particularly when combined with clinical correlates. The objective of this study was to investigate interactions within the language network in a paediatric population of epilepsy patients using measures of MEG phase synchronisation and graph-theoretical analysis, and to examine their association with language abilities. Task dependent increases in connectivity were observed in fronto-temporal networks during verb generation across a group of 22 paediatric patients (9 males and 13 females; mean age 14 years). Differences in network connectivity were observed between patients with typical and atypical language representation and between patients with good and poor language abilities. In addition, node centrality in left frontal and temporal regions was significantly associated with language abilities, where patients with good language abilities had significantly higher node centrality within inferior frontal and superior temporal regions of the left hemisphere, compared to patients with poor language abilities. Our study is one of the first to apply task-based measures of MEG network synchronisation in paediatric epilepsy, and we propose that these measures of functional connectivity and node centrality could be used as tools to identify critical regions of the language network prior to epilepsy surgery.
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Affiliation(s)
- Elaine Foley
- School of Life and Health Sciences, Aston Brain Centre, Aston University, Birmingham, UK.
| | - Amanda G Wood
- School of Life and Health Sciences, Aston Brain Centre, Aston University, Birmingham, UK; School of Psychology, Faculty of Health, Melbourne Burwood Campus, Deakin University, Geelong, Victoria, Australia
| | - Paul L Furlong
- School of Life and Health Sciences, Aston Brain Centre, Aston University, Birmingham, UK
| | - A Richard Walsh
- Children's Epilepsy Surgery Service, Birmingham Women's and Children's Hospital, Birmingham, UK
| | - Shauna Kearney
- Children's Epilepsy Surgery Service, Birmingham Women's and Children's Hospital, Birmingham, UK
| | - Peter Bill
- Children's Epilepsy Surgery Service, Birmingham Women's and Children's Hospital, Birmingham, UK
| | - Arjan Hillebrand
- Department of Clinical Neurophysiology and MEG Center, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands
| | - Stefano Seri
- School of Life and Health Sciences, Aston Brain Centre, Aston University, Birmingham, UK; Children's Epilepsy Surgery Service, Birmingham Women's and Children's Hospital, Birmingham, UK
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Bear JJ, Chapman KE, Tregellas JR. The epileptic network and cognition: What functional connectivity is teaching us about the childhood epilepsies. Epilepsia 2019; 60:1491-1507. [PMID: 31247129 PMCID: PMC7175745 DOI: 10.1111/epi.16098] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 05/09/2019] [Accepted: 06/05/2019] [Indexed: 12/13/2022]
Abstract
Our objective was to summarize and evaluate the rapidly expanding body of literature studying functional connectivity in childhood epilepsy. In the self-limited childhood epilepsies, awareness of cognitive comorbidities has been steadily increasing, and recent advances in our understanding of the network effects of these disorders promise insights into the underlying neurobiology. We reviewed publications addressing functional connectivity in children with epilepsy with an emphasis on studies of children with self-limited childhood epilepsies. The majority of studies have been published in the past 10 years and predominantly examine childhood epilepsy with centrotemporal spikes and childhood absence epilepsy. Cognitive network alterations are commonly observed across the childhood epilepsies. Some of these effects appear to be nonspecific to epilepsy syndrome or even to category of neurological disorder. Other patterns, such as changes in the connectivity of cortical language areas in childhood epilepsy with centrotemporal spikes, provide clues to the underlying cognitive deficits seen in affected children. The literature to date is dominated by general observations of connectivity patterns without a priori hypotheses. These data-driven studies build an important foundation for hypothesis generation and are already providing useful insights into the neuropathology of the childhood epilepsies. Future work should emphasize hypothesis-driven approaches and rigorous clinical correlations to better understand how the knowledge of network alterations can be applied to guidance and treatment for the children in our clinics.
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Affiliation(s)
- Joshua J Bear
- Department of Pediatrics, Section of Neurology, Children’s Hospital Colorado
- Department of Pediatrics, University of Colorado Anschutz Medical Campus
| | - Kevin E Chapman
- Department of Pediatrics, Section of Neurology, Children’s Hospital Colorado
- Department of Pediatrics, University of Colorado Anschutz Medical Campus
| | - Jason R Tregellas
- Department of Psychiatry, University of Colorado Anschutz Medical Campus
- Research Service, Rocky Mountain Regional VA Medical Center
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Bartha‐Doering L, Kollndorfer K, Kasprian G, Novak A, Schuler A, Fischmeister FPS, Alexopoulos J, Gaillard WD, Prayer D, Seidl R, Berl MM. Weaker semantic language lateralization associated with better semantic language performance in healthy right-handed children. Brain Behav 2018; 8:e01072. [PMID: 30298640 PMCID: PMC6236252 DOI: 10.1002/brb3.1072] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 06/22/2018] [Accepted: 06/26/2018] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION The relationship between language abilities and language lateralization in the developing brain is important for our understanding of the neural architecture of language development. METHODS We investigated 35 right-handed children and adolescents aged 7-16 years with a functional magnetic resonance imaging language paradigm and a comprehensive language and verbal memory examination. RESULTS We found that less lateralized language was significantly correlated with better language performance across areas of the brain and across different language tasks. Less lateralized language in the overall brain was associated with better in-scanner task accuracy on a semantic language decision task and out-of-scanner vocabulary and verbal fluency. Specifically, less lateralized frontal lobe language dominance was associated with better in-scanner task accuracy and out-of-scanner verbal fluency. Furthermore, less lateralized parietal language was associated with better out-of-scanner verbal memory across learning, short- and long-delay trials. In contrast, we did not find any relationship between temporal lobe language laterality and verbal performance. CONCLUSIONS This study suggests that semantic language performance is better with some involvement of the nondominant hemisphere.
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Affiliation(s)
- Lisa Bartha‐Doering
- Department of Pediatrics and Adolescent MedicineMedical University of ViennaViennaAustria
| | - Kathrin Kollndorfer
- Department of Biomedical Imaging and Image‐guided TherapyMedical University of ViennaViennaAustria
| | - Gregor Kasprian
- Department of Biomedical Imaging and Image‐guided TherapyMedical University of ViennaViennaAustria
| | - Astrid Novak
- Department of Pediatrics and Adolescent MedicineMedical University of ViennaViennaAustria
| | - Anna‐Lisa Schuler
- Department of Pediatrics and Adolescent MedicineMedical University of ViennaViennaAustria
| | | | - Johanna Alexopoulos
- Department of Psychoanalysis and PsychotherapyMedical University of ViennaViennaAustria
| | - William Davis Gaillard
- Center for Neuroscience and Behavioral HealthChildren's National Health System (CNHS)WashingtonDCUSA
| | - Daniela Prayer
- Department of Biomedical Imaging and Image‐guided TherapyMedical University of ViennaViennaAustria
| | - Rainer Seidl
- Department of Pediatrics and Adolescent MedicineMedical University of ViennaViennaAustria
| | - Madison M. Berl
- Center for Neuroscience and Behavioral HealthChildren's National Health System (CNHS)WashingtonDCUSA
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Chou N, Serafini S, Muh CR. Cortical Language Areas and Plasticity in Pediatric Patients With Epilepsy: A Review. Pediatr Neurol 2018; 78:3-12. [PMID: 29191650 DOI: 10.1016/j.pediatrneurol.2017.10.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Revised: 08/28/2017] [Accepted: 10/02/2017] [Indexed: 12/12/2022]
Abstract
Chronic injury to the brain from seizure activity is associated with decreased language skills in pediatric patients, as measured on neuropsychological tests for language function and academic achievement. This makes the study of language in patients with epilepsy clinically necessary. Functional magnetic resonance imaging and direct electrical cortical stimulation have been used to evaluate aspects of cortical language processing in healthy adults and in adults with epilepsy or other neurological insults. Results of these studies help to locate cortical language areas that are involved with modality-specific language processing (visual naming, auditory naming, sentence-completion, and repetition) and the neuroplasticity of language areas in the setting of neurological injury and reorganization. A better understanding of language processing contributes to a more efficient and efficacious electrical cortical stimulation mapping of language areas for patients with intractable epilepsy who are undergoing preresection evaluation. Most of the current literature on localization and reorganization of cortical language areas in the setting of epilepsy concerns the adult patient population, whereas the literature on pediatric patients is substantially lacking in comparison. This article reviews the conclusions drawn thus far from Wada, magnetoencephalography, functional magnetic resonance imaging, and electrical cortical stimulation language studies on types of language reorganization seen in pediatric patients with intractable temporal lobe epilepsy and the clinical factors associated with reorganization, and proposes future directions of research to further the academic and clinical understanding of language processing in pediatric patients.
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Affiliation(s)
- Naomi Chou
- Duke University School of Medicine, Durham, North Carolina
| | - Sandra Serafini
- Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina
| | - Carrie R Muh
- Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina.
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Garcia-Ramos C, Lin JJ, Bonilha L, Jones JE, Jackson DC, Prabhakaran V, Hermann BP. Disruptions in cortico-subcortical covariance networks associated with anxiety in new-onset childhood epilepsy. NEUROIMAGE-CLINICAL 2016; 12:815-824. [PMID: 27830114 PMCID: PMC5094270 DOI: 10.1016/j.nicl.2016.10.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Revised: 09/17/2016] [Accepted: 10/21/2016] [Indexed: 01/26/2023]
Abstract
Anxiety disorders represent a prevalent psychiatric comorbidity in both adults and children with epilepsy for which the etiology remains controversial. Neurobiological contributions have been suggested, but only limited evidence suggests abnormal brain volumes particularly in children with epilepsy and anxiety. Since the brain develops in an organized fashion, covariance analyses between different brain regions can be investigated as a network and analyzed using graph theory methods. We examined 46 healthy children (HC) and youth with recent onset idiopathic epilepsies with (n = 24) and without (n = 62) anxiety disorders. Graph theory (GT) analyses based on the covariance between the volumes of 85 cortical/subcortical regions were investigated. Both groups with epilepsy demonstrated less inter-modular relationships in the synchronization of cortical/subcortical volumes compared to controls, with the epilepsy and anxiety group presenting the strongest modular organization. Frontal and occipital regions in non-anxious epilepsy, and areas throughout the brain in children with epilepsy and anxiety, showed the highest centrality compared to controls. Furthermore, most of the nodes correlating to amygdala volumes were subcortical structures, with the exception of the left insula and the right frontal pole, which presented high betweenness centrality (BC); therefore, their influence in the network is not necessarily local but potentially influencing other more distant regions. In conclusion, children with recent onset epilepsy and anxiety demonstrate large scale disruptions in cortical and subcortical brain regions. Network science may not only provide insight into the possible neurobiological correlates of important comorbidities of epilepsy, but also the ways that cortical and subcortical disruption occurs.
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Affiliation(s)
- Camille Garcia-Ramos
- Department of Medical Physics, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Jack J Lin
- Department of Neurology, University of California-Irvine, Irvine, CA 92697, USA
| | - Leonardo Bonilha
- Neurosciences Department, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Jana E Jones
- Department of Neurology, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Daren C Jackson
- Department of Neurology, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Vivek Prabhakaran
- Department of Medical Physics, University of Wisconsin-Madison, Madison, WI 53705, USA; Department of Radiology, University of Wisconsin-Madison, Madison, WI 53792, USA
| | - Bruce P Hermann
- Department of Neurology, University of Wisconsin-Madison, Madison, WI 53705, USA
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Berl MM, Terwilliger V, Scheller A, Sepeta L, Walkowiak J, Gaillard WD. Speed and complexity characterize attention problems in children with localization-related epilepsy. Epilepsia 2015; 56:833-40. [PMID: 25940056 DOI: 10.1111/epi.12985] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Children with epilepsy (EPI) have a higher rate of attention-deficit/hyperactivity disorder (ADHD; 28-70%) than typically developing (TD) children (5-10%); however, attention is multidimensional. Thus, we aimed to characterize the profile of attention difficulties in children with epilepsy. METHODS Seventy-five children with localization-related epilepsy ages 6-16 years and 75 age-matched controls were evaluated using multimodal, multidimensional measures of attention including direct performance and parent ratings of attention as well as intelligence testing. We assessed group differences across attention measures, determined if parent rating predicted performance on attention measures, and examined if epilepsy characteristics were associated with attention skills. RESULTS The EPI group performed worse than the TD group on timed and complex attention aspects of attention (p < 0.05), whereas performance on simple visual and simple auditory attention tasks was comparable. Children with EPI were 12 times as likely as TD children to have clinically elevated symptoms of inattention as rated by parents, but ratings were a weak predictor of attention performance. Earlier age of onset was associated with slower motor speed (p < 0.01), but no other epilepsy-related clinical characteristics were associated with attention skills. SIGNIFICANCE This study clarifies the nature of the attention problems in pediatric epilepsy, which may be under-recognized. Children with EPI had difficulty with complex attention and rapid response, not simple attention. As such, they may not exhibit difficulty until later in primary school when demands increase. Parent report with standard ADHD screening tools may under-detect these higher-order attention difficulties. Thus, monitoring through direct neuropsychological performance is recommended.
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Affiliation(s)
- Madison M Berl
- Children's National Health System (CNHS), Washington, District of Columbia, U.S.A.,George Washington University, Washington, District of Columbia, U.S.A
| | - Virginia Terwilliger
- Children's National Health System (CNHS), Washington, District of Columbia, U.S.A
| | - Alexandra Scheller
- Children's National Health System (CNHS), Washington, District of Columbia, U.S.A
| | - Leigh Sepeta
- Children's National Health System (CNHS), Washington, District of Columbia, U.S.A
| | | | - William D Gaillard
- Children's National Health System (CNHS), Washington, District of Columbia, U.S.A.,George Washington University, Washington, District of Columbia, U.S.A
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