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Guo Y, Lin Z, Fan Z, Tian X. Epileptic brain network mechanisms and neuroimaging techniques for the brain network. Neural Regen Res 2024; 19:2637-2648. [PMID: 38595282 PMCID: PMC11168515 DOI: 10.4103/1673-5374.391307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 09/08/2023] [Accepted: 11/22/2023] [Indexed: 04/11/2024] Open
Abstract
Epilepsy can be defined as a dysfunction of the brain network, and each type of epilepsy involves different brain-network changes that are implicated differently in the control and propagation of interictal or ictal discharges. Gaining more detailed information on brain network alterations can help us to further understand the mechanisms of epilepsy and pave the way for brain network-based precise therapeutic approaches in clinical practice. An increasing number of advanced neuroimaging techniques and electrophysiological techniques such as diffusion tensor imaging-based fiber tractography, diffusion kurtosis imaging-based fiber tractography, fiber ball imaging-based tractography, electroencephalography, functional magnetic resonance imaging, magnetoencephalography, positron emission tomography, molecular imaging, and functional ultrasound imaging have been extensively used to delineate epileptic networks. In this review, we summarize the relevant neuroimaging and neuroelectrophysiological techniques for assessing structural and functional brain networks in patients with epilepsy, and extensively analyze the imaging mechanisms, advantages, limitations, and clinical application ranges of each technique. A greater focus on emerging advanced technologies, new data analysis software, a combination of multiple techniques, and the construction of personalized virtual epilepsy models can provide a theoretical basis to better understand the brain network mechanisms of epilepsy and make surgical decisions.
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Affiliation(s)
- Yi Guo
- Department of Neurology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
| | - Zhonghua Lin
- Sichuan Provincial Center for Mental Health, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
| | - Zhen Fan
- Department of Geriatrics, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
| | - Xin Tian
- Department of Neurology, Chongqing Key Laboratory of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Tsai ML, Wang CC, Wang AYD, Lee FC, Chang H, Liu YL, Wong TT, Peng SJ. Antiseizure Medications Normalize Electroencephalographic Functional Connectivity and Power in Children With Benign Epilepsy With Centrotemporal Spikes. Pediatr Neurol 2024; 156:41-50. [PMID: 38729071 DOI: 10.1016/j.pediatrneurol.2024.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 02/12/2024] [Accepted: 03/17/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND The decision to treat children with benign epilepsy with centrotemporal spikes (BECTS) using antiseizure medications (ASM) is controversial. Our goal is to compare the effect of ASM treatment on the alteration of electroencephalographic (EEG) functional connectivity and power across four frequency bands in children with BECTS. METHODS Children with BECTS with two-year follow-up were retrospectively divided into ASM versus non-ASM groups. The network properties of the EEGs as based on network-based statistic and graph theory were evaluated by the following indices: global efficiency, clustering coefficient, betweenness centrality, and nodal strength in four frequency bands (delta, theta, alpha, and beta). EEG power including absolute power (AP) and relative power (RP) was analyzed in four frequency bands. RESULTS In children with BECTS with ASM treatment, there was no significant change in EEG connectivity across all bands before and after two years of ASM. In children with BECTS without ASM treatment, there was a significant increase of global efficiency, clustering coefficient, and nodal strength but not the betweenness centrality in the delta band after two years of follow-up. A decrease in AP in the delta and theta bands and a decrease in RP in the theta band were found in the ASM group after two years of treatment. CONCLUSIONS Our results suggest that ASM may play a role in modulating the development of increasing overall brain connectivity and in downregulating overt synaptic activity, but not intrinsic focal connectivity, in the early years of BECTS. The changes in the EEG power indicate that ASM significantly normalized slow-wave band power.
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Affiliation(s)
- Min-Lan Tsai
- Division of Pediatric Neurology, Department of Pediatrics, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan; Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chuang-Chin Wang
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Andy Yu-Der Wang
- Department of Neurology, University of California San Francisco, San Francisco, CA
| | - Feng-Chin Lee
- Division of Pediatric Neurology, Department of Pediatrics, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan; Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Hsi Chang
- Division of Pediatric Neurology, Department of Pediatrics, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan; Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yen-Lin Liu
- Division of Pediatric Neurology, Department of Pediatrics, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan; Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Tai-Tong Wong
- Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pediatric Neurosurgery, Department of Neurosurgery, Taipei Medical University Hospital, Taipei, Taiwan; Neuroscience Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Syu-Jyun Peng
- Professional Master Program in Artificial Intelligence in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Clinical Big Data Research Center, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan.
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Neumann H, Daseking M, Thiels C, Köhler C, Lücke T. Cognitive development in children with new-onset Rolandic epilepsy and Rolandic discharges without seizures: Focusing on intelligence, visual perception, working memory and the role of parents' education. Epilepsy Behav 2024; 152:109596. [PMID: 38350362 DOI: 10.1016/j.yebeh.2023.109596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 12/13/2023] [Accepted: 12/21/2023] [Indexed: 02/15/2024]
Abstract
PURPOSE Our aim was to assess intelligence, visual perception and working memory in children with new-onset Rolandic epilepsy (RE) and children with Rolandic discharges without seizures (RD). METHODS The participants in the study were 12 children with RE and 26 children with RD aged 4 to 10 years (all without medication and shortly after diagnosis) and 31 healthy controls. Their cognitive performance was assessed using the German versions of the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-III), the Wechsler Intelligence Scale for Children (WISC-IV), the Developmental Test of Visual Perception-2 (DTVP-2), the Developmental Test of Visual Perception-Adolescent and Adult (DTVP-A) (each according to age) and the Word Order, Hand Movements and Spatial Memory subtests of the German version of the Kaufman Assessment Battery for Children (K-ABC). RESULTS The comparison of the entire group of children with RE/RD and the control group conducted in the first step of our analysis revealed a weaker performance of the children with RE/RD in all cognitive domains. Significant deficits, however, were found exclusively in the RD group. Compared to the controls, they performed significantly weaker regarding IQ (full scale IQ: p < 0.001; verbal IQ: p < 0.001; performance IQ: p = 0.002; processing speed: p = 0.005), visual perception (general visual perception: p = 0.005; visual-motor integration: p = 0.002) and working memory (WISC working memory: p = 0.002 and K-ABC Word Order (p = 0.010) and Hand Movements (p = 0.001) subtests. Also, the children without seizures scored significantly lower than those with seizures on the WISC Working Memory Index (p = 0.010) and on the K-ABC Word Order (p = 0.021) and Hand Movements (p = 0.027) subtests. Further analysis of our data demonstrated the particular importance of the family context for child development. Significant cognitive deficits were found only in children with RD from parents with lower educational levels. This group consistently scored lower compared to the control group regarding IQ (full scale IQ: p < 0.001; verbal IQ: p < 0.001; performance IQ: p = 0.012; processing speed: p = 0.034), visual perception (general visual perception: p = 0.018; visual-motor integration: p = 0.010) and auditory working memory (WISC working memory: p = 0.014). Furthermore, compared to the children with RE, they performed significantly weaker on verbal IQ (p = 0.020), auditory working memory consistently (WISC working memory: p = 0.027; K-ABC: Word Order: p = 0.046) as well as in one of the K-ABC spatial working memory subtests (Hand Movements: p = 0.029). Although we did not find significant deficits in children with new-onset RE compared to healthy controls, the performance of this group tended to be weaker more often. No statistically significant associations were observed between selected clinical markers (focus types: centrotemporal/other foci/laterality of foci and spread of Rolandic discharges) and cognitive test results. Except for spatial working memory, we also found no evidence that the age of our patients at the time of study participation was of significant importance to their cognitive performance. CONCLUSIONS Our study provides some evidence that children with Rolandic discharges, with and without seizures, may be at higher risk of cognitive impairment. In addition to medical care, we emphasise early differentiated psychosocial diagnostics to provide these children and their families with targeted support if developmental problems are present.
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Affiliation(s)
- Helmut Neumann
- University Children's Hospital, Ruhr University Bochum, Department of Neuropediatrics Bochum, Germany.
| | - Monika Daseking
- Department of Educational Psychology, Helmut Schmidt University/University of the Armed Forces Hamburg, Hamburg, Germany
| | - Charlotte Thiels
- University Children's Hospital, Ruhr University Bochum, Department of Neuropediatrics Bochum, Germany
| | - Cornelia Köhler
- University Children's Hospital, Ruhr University Bochum, Department of Neuropediatrics Bochum, Germany
| | - Thomas Lücke
- University Children's Hospital, Ruhr University Bochum, Department of Neuropediatrics Bochum, Germany
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Steinruecke M, Gillespie C, Ahmed N, Bandyopadhyay S, Duklas D, Ghahfarokhi MH, Henshall DE, Khan M, de Koning R, Madden J, Marston JSN, Mohamed RAA, Nischal SA, Norton EJ, Parameswaran G, Vasilica AM, Wei JOY, Williams CE, Williams F, Agrawal S, Grigoratos DN, Israni A, Kumar R, McCrea N, Patel J, Petropoulos MC, Singh J. Care and three-year outcomes of children with Benign Epilepsy with Centro-Temporal Spikes in England. Epilepsy Behav 2023; 148:109465. [PMID: 37844441 DOI: 10.1016/j.yebeh.2023.109465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 08/16/2023] [Accepted: 09/26/2023] [Indexed: 10/18/2023]
Abstract
PURPOSE Benign Epilepsy with Centro-Temporal Spikes (BECTS) is a pediatric epilepsy with typically good seizure control. Although BECTS may increase patients' risk of developing neurological comorbidities, their clinical care and short-term outcomes are poorly quantified. METHODS We retrospectively assessed adherence to National Institute for Health and Care Excellence (NICE) guidelines relating to specialist referral, electroencephalogram (EEG) conduct and annual review in the care of patients with BECTS, and measured their seizure, neurodevelopmental and learning outcomes at three years post-diagnosis. RESULTS Across ten centers in England, we identified 124 patients (74 male) diagnosed with BECTS between 2015 and 2017. Patients had a mean age at diagnosis of 8.0 (95% CI = 7.6-8.4) years. 24/95 (25%) patients were seen by a specialist within two weeks of presentation; 59/100 (59%) received an EEG within two weeks of request; and 59/114 (52%) were reviewed annually. At three years post-diagnosis, 32/114 (28%) experienced ongoing seizures; 26/114 (23%) had reported poor school progress; 15/114 (13%) were diagnosed with a neurodevelopmental disorder (six autism spectrum disorder, six attention-deficit/hyperactivity disorder); and 10/114 (8.8%) were diagnosed with a learning difficulty (three processing deficit, three dyslexia). Center-level random effects models estimated neurodevelopmental diagnoses in 9% (95% CI: 2-16%) of patients and learning difficulty diagnoses in 7% (95% CI: 2-12%). CONCLUSIONS In this multicenter work, we found variable adherence to NICE guidelines in the care of patients with BECTS and identified a notable level of neurological comorbidity. Patients with BECTS may benefit from enhanced cognitive and behavioral assessment and monitoring.
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Affiliation(s)
- Moritz Steinruecke
- Edinburgh Medical School, College of Medicine and Veterinary Medicine, The University of Edinburgh, UK; University of Cambridge School of Clinical Medicine, UK.
| | - Conor Gillespie
- School of Medicine, University of Liverpool, UK; Department of Clinical Neurosciences, University of Cambridge, UK
| | - Najma Ahmed
- GKT School of Medical Education, Faculty of Life Sciences and Medicine, King's College London, UK
| | - Soham Bandyopadhyay
- Clinical Neurosciences, School of Clinical and Experimental Sciences, University of Southampton, UK; Wessex Neurological Centre, University Hospital Southampton NHS Foundation Trust, UK; Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, UK
| | | | | | - David E Henshall
- Deanery of Clinical Sciences, Edinburgh Medical School, College of Medicine and Veterinary Medicine, The University of Edinburgh, UK
| | - Mehdi Khan
- UCL Medical School, Faculty of Medical Sciences, University College London, UK
| | | | - James Madden
- GKT School of Medical Education, Faculty of Life Sciences and Medicine, King's College London, UK
| | | | | | | | - Emma Jane Norton
- University Division of Anaesthesia, University of Cambridge, UK; Faculty of Medicine, University of Southampton, UK
| | | | | | - John Ong Ying Wei
- College of Medical and Dental Sciences, University of Birmingham, UK
| | - Chloe Ec Williams
- School of Medicine, University of Liverpool, UK; Royal Liverpool University Hospital, Liverpool University Hospitals NHS Foundation Trust, UK
| | | | - Shakti Agrawal
- Paediatric Neurology, Birmingham Women's and Children's NHS Foundation Trust, UK
| | | | - Anil Israni
- Alder Hey Children's Hospital, Alder Hey Children's NHS Foundation Trust, UK; Faculty of Medicine, Parul University, India
| | - Ram Kumar
- Alder Hey Children's Hospital, Alder Hey Children's NHS Foundation Trust, UK
| | - Nadine McCrea
- John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, UK
| | - Jayesh Patel
- Bristol Royal Hospital for Children, University Hospitals Bristol and Weston NHS Foundation Trust, UK
| | - Maria-Christina Petropoulos
- UCL Medical School, Faculty of Medical Sciences, University College London, UK; University College Hospital, University College London Hospitals NHS Foundation Trust, UK
| | - Jaspal Singh
- University Hospital Southampton NHS Foundation Trust, UK
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Halász P, Szũcs A. Self-limited childhood epilepsies are disorders of the perisylvian communication system, carrying the risk of progress to epileptic encephalopathies-Critical review. Front Neurol 2023; 14:1092244. [PMID: 37388546 PMCID: PMC10301767 DOI: 10.3389/fneur.2023.1092244] [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: 11/07/2022] [Accepted: 04/04/2023] [Indexed: 07/01/2023] Open
Abstract
"Sleep plasticity is a double-edged sword: a powerful machinery of neural build-up, with a risk to epileptic derailment." We aimed to review the types of self-limited focal epilepsies..."i.e. keep as two separate paragraphs" We aimed to review the types of self-limited focal epilepsies: (1) self-limited focal childhood epilepsy with centrotemporal spikes, (2) atypical Rolandic epilepsy, and (3) electrical status epilepticus in sleep with mental consequences, including Landau-Kleffner-type acquired aphasia, showing their spectral relationship and discussing the debated topics. Our endeavor is to support the system epilepsy concept in this group of epilepsies, using them as models for epileptogenesis in general. The spectral continuity of the involved conditions is evidenced by several features: language impairment, the overarching presence of centrotemporal spikes and ripples (with changing electromorphology across the spectrum), the essential timely and spatial independence of interictal epileptic discharges from seizures, NREM sleep relatedness, and the existence of the intermediate-severity "atypical" forms. These epilepsies might be the consequences of a genetically determined transitory developmental failure, reflected by widespread neuropsychological symptoms originating from the perisylvian network that have distinct time and space relations from secondary epilepsy itself. The involved epilepsies carry the risk of progression to severe, potentially irreversible encephalopathic forms.
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Affiliation(s)
- Péter Halász
- Department of Neurology, University Medical School, Pécs, Hungary
| | - Anna Szũcs
- Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary
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Xu Y, Wang Y, Xu F, Li Y, Sun J, Niu K, Wang P, Li Y, Zhang K, Wu D, Chen Q, Wang X. Impact of interictal epileptiform discharges on brain network in self-limited epilepsy with centrotemporal spikes: A magnetoencephalography study. Brain Behav 2023; 13:e3038. [PMID: 37137814 PMCID: PMC10275544 DOI: 10.1002/brb3.3038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 04/07/2023] [Accepted: 04/19/2023] [Indexed: 05/05/2023] Open
Abstract
OBJECTIVE This study aimed to investigate the differences on resting-state brain networks between the interictal epileptiform discharge (IED) group with self-limited epilepsy with centrotemporal spikes (SeLECTS), the non-IED group with SeLECTS, and the healthy control (HC) group. METHODS Patients were divided into the IED and non-IED group according to the presence or absence of IED during magnetoencephalography (MEG). We used Wechsler Intelligence Scale for Children, fourth edition (WISC-IV) to assess cognition in 30 children with SeLECTS and 15 HCs. Functional networks were constructed at the whole-brain level and graph theory (GT) analysis was used to quantify the topology of the brain network. RESULTS The IED group had the lowest cognitive function scores, followed by the non-IED group and then HCs. Our MEG results showed that the IED group had more dispersed functional connectivity (FC) in the 4-8 Hz frequency band, and more brain regions were involved compared to the other two groups. Furthermore, the IED group had fewer FC between the anterior and posterior brain regions in the 12-30 Hz frequency band. Both the IED group and the non-IED group had fewer FC between the anterior and posterior brain regions in the 80-250 Hz frequency band compared to the HC group. GT analysis showed that the IED group had a higher clustering coefficient compared to the HC group and a higher degree compared to the non-IED group in the 80-250 Hz frequency band. The non-IED group had a lower path length in the 30-80 Hz frequency band compared to the HC group. CONCLUSIONS The study data obtained in this study suggested that intrinsic neural activity was frequency-dependent and that FC networks of the IED group and the non-IED group underwent changes in different frequency bands. These network-related changes may contribute to cognitive dysfunction in children with SeLECTS.
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Affiliation(s)
- Yue Xu
- Department of NeurologyThe Affiliated Brain HospitalNanjing Medical UniversityNanjingJiangsuP. R. China
| | - Yingfan Wang
- Department of NeurologyThe Affiliated Brain HospitalNanjing Medical UniversityNanjingJiangsuP. R. China
| | - Fengyuan Xu
- Department of NeurologyThe Affiliated Brain HospitalNanjing Medical UniversityNanjingJiangsuP. R. China
| | - Yihan Li
- Department of NeurologyThe Affiliated Brain HospitalNanjing Medical UniversityNanjingJiangsuP. R. China
| | - Jintao Sun
- Department of NeurologyThe Affiliated Brain HospitalNanjing Medical UniversityNanjingJiangsuP. R. China
| | - Kai Niu
- Department of NeurologyThe Affiliated Brain HospitalNanjing Medical UniversityNanjingJiangsuP. R. China
| | - Pengfei Wang
- Department of NeurologyThe Affiliated Brain HospitalNanjing Medical UniversityNanjingJiangsuP. R. China
| | - Yanzhang Li
- Department of NeurologyThe Affiliated Brain HospitalNanjing Medical UniversityNanjingJiangsuP. R. China
| | - Ke Zhang
- Department of NeurologyThe Affiliated Brain HospitalNanjing Medical UniversityNanjingJiangsuP. R. China
| | - Di Wu
- Department of NeurologyThe Affiliated Brain HospitalNanjing Medical UniversityNanjingJiangsuP. R. China
| | - Qiqi Chen
- MEG CenterNanjing Brain HospitalNanjingJiangsuP. R. China
| | - Xiaoshan Wang
- Department of NeurologyThe Affiliated Brain HospitalNanjing Medical UniversityNanjingJiangsuP. R. China
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Xu F, Xu Y, Wang Y, Niu K, Li Y, Wang P, Li Y, Sun J, Chen Q, Wang X. Language-related brain areas in childhood epilepsy with centrotemporal spikes studied with MEG. Clin Neurophysiol 2023; 152:11-21. [PMID: 37257319 DOI: 10.1016/j.clinph.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 05/05/2023] [Accepted: 05/10/2023] [Indexed: 06/02/2023]
Abstract
OBJECTIVE Children with self-limited epilepsy with centrotemporal spikes (SeLECTS) typically indicate cognitive impairment with widespread speech impairment. We explored how epilepsy affects language-related brain areas and areas in their vicinity. METHODS Twenty-two children with SeLECTS and declined verbal comprehension (DVC), 21 with SeLECTS and normal verbal comprehension (NVC), and 23 healthy controls (HCs) underwent high-sampling magnetoencephalography recordings. According to a previous study, 24 language-related regions of interest were selected bilaterally, and the relative spectral power was estimated using a minimum norm estimate. RESULTS The highest mean power spectral density was observed in the delta band for the DVC group, in the theta band for the NVC group, and in the alpha band for HCs within language-specific brain regions. The distinctions between the DVC and NVC groups in the delta and theta frequency bands were primarily concentrated in the right linguistic brain area. CONCLUSIONS Children with SeLECTS may have developmental problems in language-related brain areas, with different developmental levels observed in the DVC, NVC, and HC groups. The DVC group could have inferior speech comprehension due to a more significant number of seizures and more left-sided spike locations. SIGNIFICANCE Children having SeLECTS showed impaired brain maturation, leading to associated language impairment.
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Affiliation(s)
- Fengyuan Xu
- Country Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yue Xu
- Country Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yingfan Wang
- Country Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Kai Niu
- Country Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yihan Li
- Country Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Pengfei Wang
- Country Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yanzhang Li
- Country Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Jintao Sun
- Country Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Qiqi Chen
- Country MEG Center, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaoshan Wang
- Country Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.
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Li X, Zhang H, Lai H, Wang J, Wang W, Yang X. High-Frequency Oscillations and Epileptogenic Network. Curr Neuropharmacol 2022; 20:1687-1703. [PMID: 34503414 PMCID: PMC9881061 DOI: 10.2174/1570159x19666210908165641] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 08/26/2021] [Accepted: 08/31/2021] [Indexed: 11/22/2022] Open
Abstract
Epilepsy is a network disease caused by aberrant neocortical large-scale connectivity spanning regions on the scale of several centimeters. High-frequency oscillations, characterized by the 80-600 Hz signals in electroencephalography, have been proven to be a promising biomarker of epilepsy that can be used in assessing the severity and susceptibility of epilepsy as well as the location of the epileptogenic zone. However, the presence of a high-frequency oscillation network remains a topic of debate as high-frequency oscillations have been previously thought to be incapable of propagation, and the relationship between high-frequency oscillations and the epileptogenic network has rarely been discussed. Some recent studies reported that high-frequency oscillations may behave like networks that are closely relevant to the epileptogenic network. Pathological highfrequency oscillations are network-driven phenomena and elucidate epileptogenic network development; high-frequency oscillations show different characteristics coincident with the epileptogenic network dynamics, and cross-frequency coupling between high-frequency oscillations and other signals may mediate the generation and propagation of abnormal discharges across the network.
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Affiliation(s)
- Xiaonan Li
- Bioland Laboratory, Guangzhou, China; ,Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China
| | | | | | - Jiaoyang Wang
- Bioland Laboratory, Guangzhou, China; ,Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China
| | - Wei Wang
- Bioland Laboratory, Guangzhou, China; ,Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China
| | - Xiaofeng Yang
- Bioland Laboratory, Guangzhou, China; ,Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China,Address correspondence to this author at the Bioland Laboratory, Guangzhou, China; Tel: 86+ 18515855127; E-mail:
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Bernardo HNSA, Miziara CSMG, Manreza MLGD, Mansur LL. Oral dyspraxia in self-limited epilepsy with centrotemporal spikes: a comparative study with a control group. ARQUIVOS DE NEURO-PSIQUIATRIA 2021; 79:1076-1083. [PMID: 34816971 DOI: 10.1590/0004-282x-anp-2021-0056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 04/12/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND self-limited epilepsy with centrotemporal spikes, previously considered benign focal childhood epilepsy with centrotemporal spikes show clinical signs of involvement of Rolandic areas, mainly lower area, which may affect the planning and execution of motor sequences. OBJECTIVE This study aimed to evaluated oral praxis in children with self-limited epilepsy with centrotemporal spikes and compare to the age-matched control group. METHODS This was a descriptive study with 74 children with self-limited epilepsy with centrotemporal spikes, with the classical forms according to International League Against Epilepsy, and between 4 and 15 years of age, selected from the child neurology outpatient clinic of the Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil, and 239 age-matched and educational level-matched (convenience sampling) control children. All children were submitted to the battery of oral volitional movements, which consisted of 44 tests for oral movement (tongue, lip, cheek, jaw, and palate) and 34 phonemes and consonant cluster tasks, with simple and sequenced oral movements. RESULTS The mean age and standard deviation (SD) of children with epilepsy was 9.08 years (SD 2.55) and of controls 9.61 years (SD 3.12). The results showed significant differences between the groups with a poorer performance of children with epilepsy compared to children without epilepsy in simple and particularly in sequenced movements. CONCLUSION These findings can be attributed to the genetically determined immaturity of cortical structures related to motor planning in children with self-limited epilepsy with centrotemporal spikes.
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Affiliation(s)
| | - Carmen Sílvia Molleis Galego Miziara
- Centro Universitário Faculdade de Medicina do ABC, Departamento Comunitário de Saúde, Santo André SP, Brazil.,Universidade de São Paulo, Hospital das Clínicas, Departamento de Neurologia, São Paulo SP, Brazil
| | | | - Letícia Lessa Mansur
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, São Paulo SP, Brazil
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Zanaboni MP, Varesio C, Pasca L, Foti A, Totaro M, Celario M, Provenzi L, De Giorgis V. Systematic review of executive functions in children with self-limited epilepsy with centrotemporal spikes. Epilepsy Behav 2021; 123:108254. [PMID: 34428616 DOI: 10.1016/j.yebeh.2021.108254] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/28/2021] [Accepted: 07/28/2021] [Indexed: 12/01/2022]
Abstract
Self-limited Epilepsy with Centrotemporal Spikes (ECTS) is a self-limiting childhood epilepsy with an overall good prognosis. The neurocognitive profile of ECTS shows various degrees of neuropsychological impairment, with speech impairment and executive dysfunction being the most prominent. This review aimed to clarify the executive function (EF) profile of children with ECTS and the clinical variables' impact on these abilities. We conducted a systematic review of the relevant literature for articles published up to January 2021. Demographic and clinical characteristics were abstracted from the original records. EF tasks used in the studies were classified according to Diamond's model, which identified four components: working memory, inhibitory control, cognitive flexibility, and higher order EFs. Twenty-three studies were included. Among the included records, 14 studies examined working memory, 15 inhibitory control, 15 flexibility, 4 higher order EFs, and 2 general EFs. Results confirmed the presence of a specific impairment in two abilities: inhibitory control and cognitive flexibility. This review confirms the need to assess each EF both in verbal and visual-spatial tasks. The early detection of children with ECTS at risk of developing neuropsychological impairment could activate interventions and prevent worse school achievement, social functioning, and a poor quality of life. Systematic review registration: PROSPERO: CRD42021245959.
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Affiliation(s)
| | - Costanza Varesio
- Department of Child Neurology and Psychiatry, IRCCS Mondino Foundation, Pavia, Italy; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
| | - Ludovica Pasca
- Department of Child Neurology and Psychiatry, IRCCS Mondino Foundation, Pavia, Italy; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Annalisa Foti
- Department of Child Neurology and Psychiatry, IRCCS Mondino Foundation, Pavia, Italy
| | - Martina Totaro
- Department of Child Neurology and Psychiatry, IRCCS Mondino Foundation, Pavia, Italy; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Massimiliano Celario
- Department of Child Neurology and Psychiatry, IRCCS Mondino Foundation, Pavia, Italy; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Livio Provenzi
- Department of Child Neurology and Psychiatry, IRCCS Mondino Foundation, Pavia, Italy
| | - Valentina De Giorgis
- Department of Child Neurology and Psychiatry, IRCCS Mondino Foundation, Pavia, Italy
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Niu K, Li Y, Zhang T, Sun J, Sun Y, Shu M, Wang P, Zhang K, Chen Q, Wang X. Impact of Antiepileptic Drugs on Cognition and Neuromagnetic Activity in Childhood Epilepsy With Centrotemporal Spikes: A Magnetoencephalography Study. Front Hum Neurosci 2021; 15:720596. [PMID: 34566605 PMCID: PMC8461317 DOI: 10.3389/fnhum.2021.720596] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 08/13/2021] [Indexed: 11/24/2022] Open
Abstract
Objective: Childhood epilepsy with centrotemporal spikes (CECTS), the most common childhood epilepsy, still lacks longitudinal imaging studies involving antiepileptic drugs (AEDs). In order to examine the effect of AEDs on cognition and brain activity. We investigated the neuromagnetic activities and cognitive profile in children with CECTS before and after 1 year of treatment. Methods: Fifteen children with CECTS aged 6–12 years underwent high-sampling magnetoencephalography (MEG) recordings before treatment and at 1 year after treatment, and 12 completed the cognitive assessment (The Wechsler Intelligence Scale for Children). Next, magnetic source location and functional connectivity (FC) were investigated in order to characterize interictal neuromagnetic activity in the seven frequency sub-bands, including: delta (1–4 Hz), theta (4–8 Hz), alpha (8–12 Hz), beta (12–30 Hz), gamma (30–80 Hz), ripple (80–250 Hz), and fast ripple (250–500 Hz). Results: After 1 year of treatment, children with CECTS had increased scores on full-scale intelligence quotient, verbal comprehension index (VCI) and perceptual reasoning index (PRI). Alterations of neural activity occurred in specific frequency bands. Source location, in the 30–80 Hz frequency band, was significantly increased in the posterior cingulate cortex (PCC) after treatment. Moreover, FC analysis demonstrated that after treatment, the connectivity between the PCC and the medial frontal cortex (MFC) was enhanced in the 8–12 Hz frequency band. Additionally, the whole-brain network distribution was more dispersed in the 80–250 Hz frequency band. Conclusion: Intrinsic neural activity has frequency-dependent characteristic. AEDs have impact on regional activity and FC of the default mode network (DMN). Normalization of aberrant DMN in children with CECTS after treatment is likely the reason for improvement of cognitive function.
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Affiliation(s)
- Kai Niu
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yihan Li
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Tingting Zhang
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.,Department of Neurology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Jintao Sun
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yulei Sun
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Mingzhu Shu
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Pengfei Wang
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Ke Zhang
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Qiqi Chen
- MEG Center, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaoshan Wang
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
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An O, Nagae LM, Winesett SP. A Self-Limited Childhood Epilepsy as Co-Incidental in Cerebral Palsy. Int Med Case Rep J 2021; 14:509-517. [PMID: 34385844 PMCID: PMC8352636 DOI: 10.2147/imcrj.s315550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 07/13/2021] [Indexed: 11/23/2022] Open
Abstract
Background Cerebral palsy is the most frequent motor disability in childhood and is associated with a higher incidence of seizure disorders. In many instances, it is recognized that motor difficulties, as well as seizures, are from the same underlying brain lesion. However, self-limited childhood epilepsies, being a common group of epilepsy syndromes, would be expected to occur in patients with cerebral palsy merely on chance association and be unrelated to the structural brain imaging abnormality causing the motor impairment. Differential diagnosis in this case is important determining the long-term prognosis and need for anticonvulsant treatment. Case Presentation Here, we report two patients with cerebral palsy combined with epilepsy, whose age at onset, seizure semiology and electroclinical features were similar to children with self-limited childhood-specific seizure disorders (childhood epilepsy with centrotemporal spikes and Panayiotopoulos syndrome). Conclusion These cases highlight the importance of comprehensive differential diagnosis of seizures in cerebral palsy. Co-existence of age-dependent focal epilepsies with an underlying brain pathology as white matter injury, not affecting the cerebral cortex, might take place in the case of children with impaired motor skills. With health systems increasingly utilizing clinical pathways, it is important to consider the possibility of a self-limited childhood epilepsy and avoid aggressive and unnecessary medication treatment in children with cerebral palsy.
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Affiliation(s)
- Olga An
- Department of Children's Diseases, Kazakhstan's Medical University "KSPH" - School of Public Health, Almaty, Kazakhstan
| | - Lidia Mayumi Nagae
- Department of Medical Imaging, Neuroradiology, Banner University Medical Center, Tucson, AZ, USA
| | - Steven Parrish Winesett
- Department of Pediatrics, Division of Pediatric Neurology, University of Florida, Gainesville, FL, USA
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13
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Ramos IDSS, Coelho CVG, Ribeiro F, Lopes AF. Executive functioning in children with self-limited epilepsy with centrotemporal spikes: a systematic review and meta-analysis. Child Neuropsychol 2021; 28:30-60. [PMID: 34251988 DOI: 10.1080/09297049.2021.1945019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Self-limited epilepsy with centrotemporal spikes (ECTS) is one of the most frequent focal epilepsies amongst children. Because remission usually occurs before 16 years old and patients present infrequent clinical manifestation, ECTS was considered benign for a long time. Despite the reports on cognitive deficits associated with ECTS in the last years, knowledge about the condition's specific executive function domains (inhibitory control, working memory, cognitive flexibility, verbal fluency, and higher-order executive functions) is still lacking. The following systematic review was conducted according to PRISMA guidelines. The PubMed and Scopus databases and gray literature were searched according to the following eligibility criteria: (1) original articles published in peer-review journals; (2) studies that present assessment of children with ECTS; and (3) studies with an available assessment of the executive function of the participants. A total of 43 studies (1179 patients and 1086 healthy controls) met the inclusion criteria. Data from 19 studies were extracted, and meta-analysis methods were used to compare results in the three main executive function domains and verbal fluency. The study quality was measured through the Newcastle-Ottawa Scale (NOS) and the evidence quality with the GRADEpro tool. Results and conclusions: The present systematic review is the first to gather information about executive functioning in children with ECTS. According to the meta-analyses, children with ECTS show weaker performances when compared with a control group in inhibitory control, cognitive flexibility, and verbal fluency. However, because the quality of evidence was classified as very low, caution is needed when interpreting the strength of the results.
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Affiliation(s)
- Inês Duarte Sá Seixas Ramos
- Institute of Health Sciences, Centre for Interdisciplinary Research in Health, Universidade Católica Portuguesa, Lisboa, Portugal
| | - Carolina Vanessa Gomes Coelho
- Institute of Health Sciences, Centre for Interdisciplinary Research in Health, Universidade Católica Portuguesa, Lisboa, Portugal.,CIERL-UMa - Research Centre for Regional and Local Studies, Funchal, Ilha da Madeira, Portugal
| | - Filipa Ribeiro
- Institute of Health Sciences, Centre for Interdisciplinary Research in Health, Universidade Católica Portuguesa, Lisboa, Portugal
| | - Ana Filipa Lopes
- Centro de Desenvolvimento da Criança Torrado da Silva do Hospital Garcia de Orta, Almada, Portugal.,Neuropsychological Assessment and Ageing Processes (NAAP-CINEICC-FPCE) da Universidade de Coimbra, Coimbra, Portugal
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Fu C, Aisikaer A, Chen Z, Yu Q, Yin J, Yang W. Different Functional Network Connectivity Patterns in Epilepsy: A Rest-State fMRI Study on Mesial Temporal Lobe Epilepsy and Benign Epilepsy With Centrotemporal Spike. Front Neurol 2021; 12:668856. [PMID: 34122313 PMCID: PMC8193721 DOI: 10.3389/fneur.2021.668856] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 05/06/2021] [Indexed: 11/13/2022] Open
Abstract
The stark discrepancy in the prognosis of epilepsy is closely related to brain damage features and underlying mechanisms, which have not yet been unraveled. In this study, differences in the epileptic brain functional connectivity states were explored through a network-based connectivity analysis between intractable mesial temporal lobe epilepsy (MTLE) patients and benign epilepsy with centrotemporal spikes (BECT). Resting state fMRI imaging data were collected for 14 MTLE patients, 12 BECT patients and 16 healthy controls (HCs). Independent component analysis (ICA) was performed to identify the cortical functional networks. Subcortical nuclei of interest were extracted from the Harvard-Oxford probability atlas. Network-based statistics were used to detect functional connectivity (FC) alterations across intranetworks and internetworks, including the connectivity between cortical networks and subcortical nuclei. Compared with HCs, MTLE patients showed significant lower activity between the connectivity of cortical networks and subcortical nuclei (especially hippocampus) and lower internetwork FC involving the lateral temporal lobe; BECT patients showed normal cortical-subcortical FC with hyperconnectivity between cortical networks. Together, cortical-subcortical hypoconnectivity in MTLE suggested a low efficiency and collaborative network pattern, and this might be relevant to the final decompensatory state and the intractable prognosis. Conversely, cortical-subcortical region with normal connectivity remained well in global cooperativity, and compensatory internetwork hyperconnectivity caused by widespread cortical abnormal discharge, which might account for the self-limited clinical outcome in BECT. Based on the fMRI functional network study, different brain network patterns might provide a better explanation of mechanisms in different types of epilepsy.
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Affiliation(s)
- Cong Fu
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Aikedan Aisikaer
- Department of Radiology, Tianjin First Central Hospital, Tianjin, China
| | - Zhijuan Chen
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Qing Yu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jianzhong Yin
- Department of Radiology, Tianjin First Central Hospital, Tianjin, China
| | - Weidong Yang
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
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Ciumas C, Montavont A, Ilski F, Laurent A, Saignavongs M, Lachaux JP, de Bellescize J, Panagiotakaki E, Ostrowsky-Coste K, Herbillon V, Ibarrola D, Hermier M, Arzimanoglou A, Ryvlin P. Neural correlates of verbal working memory in children with epilepsy with centro-temporal spikes. NEUROIMAGE-CLINICAL 2020; 28:102392. [PMID: 32927234 PMCID: PMC7495114 DOI: 10.1016/j.nicl.2020.102392] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 08/17/2020] [Accepted: 08/17/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Previous functional magnetic resonance imaging (fMRI) studies have identified brain systems underlying different components of working memory (WM) in healthy subjects. The aim of this study was to compare the functional integrity of these neural networks in children with self-limited childhood epilepsy with centro-temporal spikes (ECTS) as compared to healthy controls, using a verbal working memory task (WMT). METHODS Functional MRI of WM in seventeen 6-to-13 year-old children, diagnosed with ECTS, and 17 sex- and age-matched healthy controls were conducted at 3 T. To estimate BOLD responses during the maintenance of low, medium, and high WMT loads, we used a Sternberg verbal WMT. Neuropsychological testing prior to scanning and behavioral data during scanning were also acquired. RESULTS Behavioral performances during WMT, in particular accuracy and response time, were poorer in children with ECTS than in controls. Increased WM load was associated with increased BOLD signal in all subjects, with significant clusters detected in frontal and parietal regions, predominantly in the left hemisphere. However, under the high load condition, patients showed reduced activation in the frontal, temporal and parietal regions as compared to controls. In brain regions where WM-triggered BOLD activation differed between groups, this activation correlated with neuropsychological performances in healthy controls but not in patients with ECTS, further suggesting WM network dysfunction in the latter. CONCLUSION Children with ECTS differ from healthy controls in how they control WM processes during tasks with increasing difficulty level, notably for high WM load where patients demonstrate both reduced BOLD activation and behavioral performances.
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Affiliation(s)
- Carolina Ciumas
- Translational and Integrative Group in Epilepsy Research (TIGER), INSERM U1028, CNRS UMR5292, Centre de Recherche en Neuroscience de Lyon, Université Lyon1, Lyon, France; Institute of Epilepsies (IDEE), Lyon, France; Department of Clinical Neurosciences, CHUV, Lausanne, Switzerland.
| | - Alexandra Montavont
- University Hospitals of Lyon (HCL), Department of Clinical Epileptology, Sleep Disorders and Functional Neurology in Children, Member of the ERN EpiCARE, Lyon, France
| | - Faustine Ilski
- University Hospitals of Lyon (HCL), Department of Clinical Epileptology, Sleep Disorders and Functional Neurology in Children, Member of the ERN EpiCARE, Lyon, France
| | - Agathe Laurent
- Department of Neurosurgery, Sainte-Anne Hospital, 75014 Paris, France
| | - Mani Saignavongs
- Translational and Integrative Group in Epilepsy Research (TIGER), INSERM U1028, CNRS UMR5292, Centre de Recherche en Neuroscience de Lyon, Université Lyon1, Lyon, France
| | - Jean-Philippe Lachaux
- Brain Dynamics and Cognition team (DYCOG), INSERM U1028, CNRS UMR5292, Centre de Recherche en Neuroscience de Lyon, Lyon, France
| | - Julitta de Bellescize
- University Hospitals of Lyon (HCL), Department of Clinical Epileptology, Sleep Disorders and Functional Neurology in Children, Member of the ERN EpiCARE, Lyon, France
| | - Eleni Panagiotakaki
- University Hospitals of Lyon (HCL), Department of Clinical Epileptology, Sleep Disorders and Functional Neurology in Children, Member of the ERN EpiCARE, Lyon, France
| | - Karine Ostrowsky-Coste
- University Hospitals of Lyon (HCL), Department of Clinical Epileptology, Sleep Disorders and Functional Neurology in Children, Member of the ERN EpiCARE, Lyon, France
| | - Vania Herbillon
- University Hospitals of Lyon (HCL), Department of Clinical Epileptology, Sleep Disorders and Functional Neurology in Children, Member of the ERN EpiCARE, Lyon, France; Department of Neurosurgery, Sainte-Anne Hospital, 75014 Paris, France
| | | | - Marc Hermier
- University Hospitals of Lyon (HCL), Department of Diagnostic and Functional Neuroradiology, Hôpital Neurologique & Neurochirurgical P. Wertheimer, Bron, France
| | - Alexis Arzimanoglou
- University Hospitals of Lyon (HCL), Department of Clinical Epileptology, Sleep Disorders and Functional Neurology in Children, Member of the ERN EpiCARE, Lyon, France; Department of Neurosurgery, Sainte-Anne Hospital, 75014 Paris, France
| | - Philippe Ryvlin
- Department of Clinical Neurosciences, CHUV, Lausanne, Switzerland
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