Thalamofrontal neurodevelopment in new-onset pediatric idiopathic generalized epilepsy

Abstract

Background:Quantitative MRI techniques have demonstrated thalamocortical abnormalities in

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

“…This is partly related to wait times for a pediatric neurologist consult and also for MR imaging, in particular if the MR imaging had to be performed with the patient under general anesthesia. In the prospective studies by Hermann et al 24 and Pulsipher et al, 39 the time interval between the diagnosis of epilepsy and imaging was also within 1 year of diagnosis, similar to that in our study. Further study that evaluates structural changes in the brain within a shorter time interval between the diagnosis of new seizures or epilepsy and neuroimaging is needed to exclude any potential effects of these ongoing changes from as-yet-unknown predisposing factors.…”

“…The reduction in cortical thickness in our patients may be related to differences in population characteristics or methodologic assessment of the cortex, in that thickness measures by using surface-based morphometry are more sensitive than volume measures by using voxel-based morphometry. Pulsipher et al 39 also assessed pediatric patients with new-onset idiopathic generalized epilepsy and found a smaller right thalamic volume but no change in the left thalamic volume within 1 year of the diagnosis of epilepsy. They also found that the frontal gray matter volume was decreased in patients with new-onset idiopathic generalized epilepsy compared with controls.…”

Thalamic volume reduction in drug‐naive patients with new‐onset genetic generalized epilepsy

“…Hence it is not clear whether the thalamic morphologic abnormality reported would have been present at the onset of epilepsy. Furthermore, in a cohort of CAE patients scanned twice (baseline within a few months of first diagnosis and then again 2 years later) and who were receiving AED treatment at both time points, there was evidence of thalamic volume loss at the end of the 2‐year interval, suggesting that disease and/or treatment factors may impact thalamic volume early in the disease course 33. It is important to note that evidence from our study suggests that thalamic volume loss is present at epilepsy onset and is therefore likely to be an underlying disease feature, not a consequence of AED treatment or recurring seizures over a prolonged period.…”

Reading, listening and memory-related brain activity in children with early-stage temporal lobe epilepsy of unknown cause-an fMRI study

“…Traditionally, the thalamus has been considered to be a central structure in epileptogenesis, being active via thalamo-cortical loop abnormalities this data being mostly based on animal models with generalized spike and wave discharges (Destexhe 2008, Badawy et al 2009) or on EEG-fMRI studies of humans with different types of generalized epilepsy ). In addition, structural MRI studies have reported lower baseline thalamic volumes in adult TLE (Tuchscherer et al 2010) and even developmental trajectory changes in children with new onset epilepsies (Pulsipher et al 2011;Tosun et al 2011). This literature has linked the baseline and developmental volumetric differences with cognitive impairment particularly in the executive function.…”