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

Hyeon Jin Kim; Jung Hwa Lee; Chang Hyun Park; Hye Sun Hong; Yun Seo Choi; Jeong Hyun Yoo; Hyang Woon Lee

doi:10.3988/jcn.2018.14.1.48

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

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

Authors

Hyeon Jin Kim^#^{1

2}, Jung Hwa Lee^#^{1

3}, Chang Hyun Park^{1

2}, Hye Sun Hong^{1

2}, Yun Seo Choi^{1

2}, Jeong Hyun Yoo⁴, Hyang Woon Lee^{1

5}

Affiliations

¹ Department of Neurology, Ewha Womans University School of Medicine and Ewha Medical Research Institute, Seoul, Korea.
² Department of Medical Science, Ewha Womans University School of Medicine and Ewha Medical Research Institute, Seoul, Korea.
³ Department of Neurology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine and Samsung Biomedical Research Institute, Changwon, Korea.
⁴ Department of Radiology, Ewha Womans University School of Medicine and Ewha Medical Research Institute, Seoul, Korea.
⁵ Department of Medical Science, Ewha Womans University School of Medicine and Ewha Medical Research Institute, Seoul, Korea. leeh@ewha.ac.kr.

^# Contributed equally.

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.

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