Reduced Cortical Thickness in Children with New-Onset Seizures: Fig 1.

Widjaja, Elysa; Mahmoodabadi, S. Zarei; Go, Cristina; Raybaud, C; Chuang, Sylvester H.; Snead, O. Carter; Smith, Mary Lou

doi:10.3174/ajnr.a2982

Cited by 16 publications

(24 citation statements)

References 42 publications

(48 reference statements)

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“…The latter is supported by a study in children with new-onset focal epilepsy that reported reduced cortical thickness, mostly affecting the frontal lobes [28]. Early onset cortical thinning, predominantly in the left hemisphere, was also observed in children with rolandic epilepsy [29].…”

Section: Discussionmentioning

confidence: 72%

Cortical thickness asymmetries and surgical outcome in neocortical epilepsy

Kamson

Pilli

Asano

et al. 2016

Journal of the Neurological Sciences

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Purpose We evaluated if cortical thickness measures were associated with surgical outcome in patients with non-lesional neocortical epilepsy. Methods Twenty-one young patients (age: 2.4–19.7 years) with epilepsy of neocortical origin and normal MRI underwent two-stage epilepsy surgery with subdural EEG monitoring. Cortical thickness was measured on presurgical volumetric MRI using the FreeSurfer software. The prognostic value of hemispheric and lobar/regional cortical thickness measures for 1-year and 2-year post-surgical seizure outcome has been analyzed. Results At one-year follow-up, 14 patients (67%) were seizure-free. Hemispheric and frontal lobe cortical thickness showed no/minimal asymmetry in seizure-free patients but thinner cortex ipsilateral to the seizure focus in those with recurrent seizures (p=0.02). More robust differences were found in patients ≥6 years of age (p=0.006 for frontal asymmetries), whose cortical thickness asymmetries remained prognostic for 2-year post-surgical outcome (p=0.007). By using an optimal cutoff threshold based on a receiver operating characteristic analysis, mean hemispheric asymmetry predicted one-year seizure freedom with 93% sensitivity and 71% specificity in the whole group, and with 100% sensitivity and 92% specificity in patients ≥6 years of age. Conclusion In patients with neocortical epilepsy and normal MRI, neocortical thinning in the epileptic hemisphere, particularly in frontal cortex, is associated with poor surgical outcome. Although these results require validation in a larger cohort prospectively, these data suggest that presurgical evaluation of cortical thickness may assist in identification of patients at high risk for surgical failure.

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Section: Discussionmentioning

confidence: 72%

Cortical thickness asymmetries and surgical outcome in neocortical epilepsy

Kamson

Pilli

Asano

et al. 2016

Journal of the Neurological Sciences

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“…Interestingly, our group and others have demonstrated that children with new-onset epilepsy already exhibited regional [Lin et al, 2012b;Pulsipher et al, 2011] and widespread [Tosun et al, 2007;Widjaja et al, 2012;Yang et al, 2012] changes in brain volume and connectivity when their epilepsy begins, suggesting that factors other than recurrent seizures or iatrogenic medication effects are critically involved in the creation of the altered network.…”

Section: Introductionmentioning

confidence: 83%

“…Interestingly, our group and others have demonstrated that children with new‐onset epilepsy already exhibited regional [Lin et al, ; Pulsipher et al, ] and widespread [Tosun et al, ; Widjaja et al, ; Yang et al, ] changes in brain volume and connectivity when their epilepsy begins, suggesting that factors other than recurrent seizures or iatrogenic medication effects are critically involved in the creation of the altered network. When examining adults with chronic epilepsy, early‐life seizures are associated with poorer cognitive performances and a greater burden of brain structural abnormalities compared with later life onset seizures [Hermann et al, ; Kaaden and Helmstaedter, ].…”

Section: Introductionmentioning

confidence: 85%

Neurodevelopmental alterations of large‐scale structural networks in children with new‐onset epilepsy

Bonilha

Tabesh

Dabbs³

et al. 2014

Human Brain Mapping

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Recent neuroimaging and behavioral studies have revealed that children with new onset epilepsy already exhibit brain structural abnormalities and cognitive impairment. How the organization of large-scale brain structural networks is altered near the time of seizure onset and whether network changes are related to cognitive performances remain unclear. Recent studies also suggest that regional brain volume covariance reflects synchronized brain developmental changes. Here, we test the hypothesis that epilepsy during early-life is associated with abnormalities in brain network organization and cognition. We used graph theory to study structural brain networks based on regional volume covariance in 39 children with new-onset seizures and 28 healthy controls. Children with new-onset epilepsy showed a suboptimal topological structural organization with enhanced network segregation and reduced global integration compared to controls. At the regional level, structural reorganization was evident with redistributed nodes from the posterior to more anterior head regions. The epileptic brain network was more vulnerable to targeted but not random attacks. Finally, a subgroup of children with epilepsy, namely those with lower IQ and poorer executive function, had a reduced balance between network segregation and integration. Taken together, the findings suggest that the neurodevelopmental impact of new onset childhood epilepsies alters large-scale brain networks, resulting in greater vulnerability to network failure and cognitive impairment.

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“…Here we demonstrated for the first time that non-IR obese adolescents had reduced cortical thickness in the OFC and ACC but contrary to prior reports that did not exclude adolescents with clear IR (e.g., 34), we did not find volume changes in those regions. Studies of other disease conditions in adolescents have suggested that cortical thickness is a more sensitive measure of cortical integrity than volume (e.g., 35) as it is more related to GM density. Despite the modest sample size, the DTI results are consistent with our prior reports of obese adolescents with IR (15), and demonstrate FA reduction in major fiber tracts involved in cortico-subcortical as well as interhemispheric signal transmission, and importantly, these observations were independent of hypertension.…”

Section: Discussionmentioning

confidence: 99%

Preliminary evidence of cognitive and brain abnormalities in uncomplicated adolescent obesity

Yau

Kang

Javier

et al. 2014

Obesity

118

136

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Objective We ascertain whether pediatric obesity without clinically-significant insulin resistance (IR) impacts brain structure and function. Design and Methods Thirty obese and 30 matched lean adolescents, all without clinically-significant IR or a diagnosis of metabolic syndrome (MetS), received comprehensive endocrine, neuropsychological, and MRI evaluations. Results Relative to lean adolescents, obese non-IR adolescents had significantly lower academic achievement (i.e. arithmetic and spelling) and tended to score lower on working memory, attention, psychomotor efficiency and mental flexibility. In line with our prior work on adolescent MetS, memory was unaffected in uncomplicated obesity. We also uncovered reductions in the thickness of the orbitofrontal and anterior cingulate cortices as well as reductions of microstructural integrity in major white matter tracts without gross volume changes. Conclusions We document, for the first time, that adolescents with uncomplicated obesity already have subtle brain alterations and lower performance in selective cognitive domains. When interpreting these preliminary data in the context of our prior reports of similar, but more extensive brain findings in obese adolescents with MetS and T2DM, we conclude that “uncomplicated” obesity may also result in subtle brain alterations, suggesting a possible dose effect with more severe metabolic dysregulation giving rise to greater abnormalities.

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Reduced Cortical Thickness in Children with New-Onset Seizures: Fig 1.

Abstract: BACKGROUND AND PURPOSE:Children with new-onset seizures may have antecedent neurobiologic alterations that predispose them to developing seizures. Our aim was to evaluate hippocampal and thalamic volumes and lobar cortical thickness of children with new-onset seizures.

Cited by 16 publications

References 42 publications

Cortical thickness asymmetries and surgical outcome in neocortical epilepsy

Cortical thickness asymmetries and surgical outcome in neocortical epilepsy

Neurodevelopmental alterations of large‐scale structural networks in children with new‐onset epilepsy

Preliminary evidence of cognitive and brain abnormalities in uncomplicated adolescent obesity

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