J Clin Neurol.  2018 Jan;14(1):48-57. 10.3988/jcn.2018.14.1.48.

Role of Language-Related Functional Connectivity in Patients with Benign Childhood Epilepsy with Centrotemporal Spikes

Affiliations
  • 1Department of Neurology, Ewha Womans University School of Medicine and Ewha Medical Research Institute, Seoul, Korea. leeh@ewha.ac.kr
  • 2Department of Medical Science, Ewha Womans University School of Medicine and Ewha Medical Research Institute, Seoul, Korea.
  • 3Department of Neurology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine and Samsung Biomedical Research Institute, Changwon, Korea.
  • 4Department of Radiology, Ewha Womans University School of Medicine and Ewha Medical Research Institute, Seoul, Korea.

Abstract

BACKGROUND
AND PURPOSE: Benign childhood epilepsy with centrotemporal spikes (BECTS) does not always have a benign cognitive outcome. We investigated the relationship between cognitive performance and altered functional connectivity (FC) in the resting-state brain networks of BECTS patients.
METHODS
We studied 42 subjects, comprising 19 BECTS patients and 23 healthy controls. Cognitive performance was assessed using the Korean version of the Wechsler Intelligence Scale for Children-III, in addition to verbal and visuospatial memory tests and executive function tests. Resting-state functional magnetic resonance imaging was acquired in addition to high-resolution structural data. We selected Rolandic and language-related areas as regions of interest (ROIs) and analyzed the seed-based FC to voxels throughout the brain. We evaluated the correlations between the neuropsychological test scores and seed-based FC values using the same ROIs.
RESULTS
The verbal intelligence quotient (VIQ) and full-scale intelligence quotient (FSIQ) were lower in BECTS patients than in healthy controls (p < 0.001). The prevalence of subjects with a higher performance IQ than VIQ was significantly higher in BECTS patients than in healthy controls (73.7% vs. 26.1%, respectively; p=0.002). Both the Rolandic and language-related ROIs exhibited more enhanced FC to voxels in the left inferior temporal gyrus in BECTS patients than in healthy controls. A particularly interestingly finding was that the enhanced FC was correlated with lower cognitive performance as measured by the VIQ and the FSIQ in both patients and control subjects.
CONCLUSIONS
Our findings suggest that the FC alterations in resting-state brain networks related to the seizure onset zone and language processing areas could be related to adaptive plasticity for coping with cognitive dysfunction.

Keyword

benign childhood epilepsy with centrotemporal spikes; cognition; intelligence quotient; functional connectivity; functional magnetic resonance imaging
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