Ictal connectivity in childhood absence epilepsy: Associations with outcome

Tenney, Jeffrey R.; Kadis, Darren S.; Agler, William; Rozhkov, Leonid; Altaye, Mekibib; Xiang, Jing; Vannest, Jennifer; Glauser, Tracy A.

doi:10.1111/epi.14067

Cited by 41 publications

(46 citation statements)

References 43 publications

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“…The connectivity networks and sources during the evolvement of SWDs with spatial and temporal profiles were described (30). Tenney et al revealed that different ictal connectivities in pretreatment were related with response to antiepileptic treatment (31). And the changes of the effective connectivity (EC) network in specific frequency during interictal period were reported by Wu et al (32).…”

Section: Introductionmentioning

confidence: 99%

Differences Between Interictal and Ictal Generalized Spike-Wave Discharges in Childhood Absence Epilepsy: A MEG Study

et al. 2020

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Purpose: To investigate the differences between interictal and ictal generalized spike-wave discharges (GSWDs) for insights on how epileptic activity propagates and the physiopathological mechanisms underlying childhood absence epilepsy (CAE). Methods: Twenty-five patients with CAE were studied using magnetoencephalography (MEG). MEG data were digitized at 6,000 Hz during the interictal and ictal GSWDs. GSWDs were analyzed at both neural magnetic source levels and functional connectivity (FC) in multifrequency bands: 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). Brain FC was studied with the posterior cingulate cortex/precuneus (PCC/pC) as the seed region. Results: The magnetic source of interictal GSWDs mainly locates in the PCC/pC region at 4-8 and 8-12 Hz, while that of ictal GSWDs mainly locates in the medial frontal cortex (MFC) at 80-250 Hz. There were statistically significant differences between interictal and ictal GSWDs (p < 0.05). The FC network involving the PCC/pC showed strong connections in the anterior-posterior pathways (mainly with the frontal cortex) at 80-250 Hz during ictal GSWDs, while the interictal GSWDs FC were mostly limited to the posterior cortex region. There was no significant difference in the magnetic source strength among interictal and ictal GSWDs at all bandwidths. Conclusions: There are significant disparities in the source localization and FC between interictal and ictal GSWDs. Low-frequency activation in the PCC/pC during inhibition of seizures possibly relates to the maintenance of consciousness during interictal GSWDs. High-frequency oscillations (HFOs) of the MFC during CAE may associate with the inducing or occurrence of GSWDs. Weakened network connections may be in favor of preventing overexcitability and relates to the termination of GSWDs.

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Section: Introductionmentioning

confidence: 99%

Differences Between Interictal and Ictal Generalized Spike-Wave Discharges in Childhood Absence Epilepsy: A MEG Study

et al. 2020

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“…Direct applications are most apparent in surgical epilepsies where network approaches have already demonstrated utility in identifying the epileptogenic region for resection and predicting postoperative outcomes of both seizure freedom and functional deficits . Pertaining to the nonsurgical childhood epilepsies, an understanding of network effects has the potential to yield new biomarkers including, as already demonstrated in one study, the possibility of predicting medication refractoriness . In addition, as neuromodulation becomes increasingly viable, this knowledge will provide the requisite background for targeted network modulation, which could lead to improved cognitive outcomes in affected children.…”

Section: Discussionmentioning

confidence: 99%

“…91 Pertaining to the nonsurgical childhood epilepsies, an understanding of network effects has the potential to yield new biomarkers including, as already demonstrated in one study, the possibility of predicting medication refractoriness. 74 In addition, as neuromodulation becomes increasingly viable, this knowledge will provide the requisite background for targeted network modulation, which could lead to improved cognitive outcomes in affected children. A proof of concept has already been demonstrated using transcranial magnetic stimulation to strengthen the attention network and improve cognitive task performance.…”

Section: Discussionmentioning

confidence: 99%

“…With respect to cognitive deficits in CAE, performance during an attention paradigm has been shown to positively correlate with connectivity strength between the anterior insula and medial frontal cortex in both affected children and healthy controls . In a novel application of network analysis, a study of drug‐naive children with newly diagnosed CAE found that ethosuximide nonresponders have increased frontal lobe connectivity and decreased precuneus connectivity …”

Section: Childhood Absence Epilepsymentioning

confidence: 99%

“…71 In a novel application of network analysis, a study of drug-naive children with newly diagnosed CAE found that ethosuximide nonresponders have increased frontal lobe connectivity and decreased precuneus connectivity. 74…”

Section: Executive Functioning and The Frontal Lobementioning

confidence: 99%

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The epileptic network and cognition: What functional connectivity is teaching us about the childhood epilepsies

2019

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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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EEG–fMRI in Adults with Focal Epilepsy

2022

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Ictal connectivity in childhood absence epilepsy: Associations with outcome

Abstract: Pretreatment ictal connectivity differences in children with CAE were associated with response to antiepileptic treatment. This is a possible mechanism for the variable treatment response seen in patients sharing the same epilepsy syndrome.

Cited by 41 publications

References 43 publications

Differences Between Interictal and Ictal Generalized Spike-Wave Discharges in Childhood Absence Epilepsy: A MEG Study

Differences Between Interictal and Ictal Generalized Spike-Wave Discharges in Childhood Absence Epilepsy: A MEG Study

The epileptic network and cognition: What functional connectivity is teaching us about the childhood epilepsies

EEG–fMRI in Adults with Focal Epilepsy

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