Changes in functional organization and functional connectivity during story listening in children with benign childhood epilepsy with centro-temporal spikes

Abstract

Children with Benign Epilepsy with Centrotemporal Spikes (BECTS), despite high likelihood for seizure remission, are reported to have subtle difficulties in language and other cognitive skills. We used functional MRI and a story listening task to examine the effect of BECTS on patterns of activation and connectivity. Language and cognitive skills were assessed using standardized measures. Twenty-four children with recently diagnosed BECTS and 40 typically-developing children participated. In a functionally-defined region of interest in right inferior frontal gyrus, BECTS patients showed a lower level of activation. Across both groups combined, increased activation in superior/middle temporal regions of interest was associated with better language scores. Connectivity in the story processing network was similar between groups, but connectivity within left inferior frontal gyrus was decreased in children with BECTS. These results suggest that language networks are largely maintained in new-onset BECTS, but some subtle changes in activation and connectivity can be observed.

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

“…This latter pattern has also been observed in a study reporting greater anticorrelation between the DMN and executive networks . Both increases and decreases of connectivity within frontal regions are reported, with the variability likely being related to choice of analytical method and specific ROIs. Finally, decreased within‐network connectivity involving the dorsal attention network is also reported …”

“…Electrographic measures suggest an overall increase in the connectivity within frontal and frontotemporal regions that appears to be partly driven by the IEDs . The orbitofrontal cortex (OFC) in particular has repeatedly shown disease‐related variations, with decreased regional homogeneity (ReHo) values, less dynamic variability, and greater isolation from other networks . This latter pattern has also been observed in a study reporting greater anticorrelation between the DMN and executive networks .…”

“…With word generation deficits being a common finding in CECTS, it is unsurprising that affected children frequently show altered connectivity patterns involving the IFG. Local connectivity within the IFG appears to be altered, with reduced connectivity to the temporal lobe, the supramarginal and angular gyri, and the superior frontal gyrus, along with other brain regions less commonly associated with language production also being reported. Furthermore, decreased connectivity strength between the left and right IFG has been observed .…”

“…Although inadequately studied to date, there is some suggestion of a relationship between connectivity patterns in the OFC and performance IQ and between the dorsal attention network and ADHD comorbid with CECTS . Three studies of children with CECTS have found no correlation between connectivity measures and general IQ scores . None of the studies of children with CECTS, however, has examined the relationship between executive networks and performance on psychometric assessments of executive function directly.…”

Network analysis of prospective brain development in youth with benign epilepsy with centrotemporal spikes and its relationship to cognition

“…13,14 Similarly, although interest has been longstanding in regard to the complications of language-based abilities in children with BECTS, [15][16][17] cognitive complications of BECTS have been reported in diverse areas of mentation compared to age-matched control peers, 8,15,18,19 including not only language-related skills but intelligence, memory, attention, and executive function (for reviews, see Wickens et al, 5,20 Pal et al 20 ). Importantly, cognitive and magnetic resonance (MR) abnormalities have been reported in new onset cases as well, with the nature and range of anomalies varying across studies, [21][22][23][24] attesting that these abnormalities are not necessarily secondary to the effects of epilepsy chronicity and medication treatment. 19 Prospective cognitive and imaging research in BECTS is much less common.…”