Dysmature superficial white matter microstructure in developmental focal epilepsy
| Autor: | Emily L. Thorn, Dhinakaran M. Chinappen, Sally M. Stoyell, Steven M. Stufflebeam, Uri T. Eden, Daniel Y Song, Britt C. Emerton, Erin E. Ross, Lauren M. Ostrowski, Mark A. Kramer, Amy K. Morgan, Catherine J. Chu |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
BECTS Audiology Electroencephalography White matter 03 medical and health sciences Epilepsy u-fibre 0302 clinical medicine Cortex (anatomy) Fractional anisotropy medicine 10. No inequality 030304 developmental biology 0303 health sciences medicine.diagnostic_test business.industry diffusion General Engineering rolandic epilepsy medicine.disease Rolandic epilepsy medicine.anatomical_structure DTI Epilepsy syndromes Original Article business 030217 neurology & neurosurgery Diffusion MRI |
| Zdroj: | Brain Communications |
| ISSN: | 2632-1297 |
| Popis: | Benign epilepsy with centrotemporal spikes is a common childhood epilepsy syndrome that predominantly affects boys, characterized by self-limited focal seizures arising from the perirolandic cortex and fine motor abnormalities. Concurrent with the age-specific presentation of this syndrome, the brain undergoes a developmentally choreographed sequence of white matter microstructural changes, including maturation of association u-fibres abutting the cortex. These short fibres mediate local cortico-cortical communication and provide an age-sensitive structural substrate that could support a focal disease process. To test this hypothesis, we evaluated the microstructural properties of superficial white matter in regions corresponding to u-fibres underlying the perirolandic seizure onset zone in children with this epilepsy syndrome compared with healthy controls. To verify the spatial specificity of these features, we characterized global superficial and deep white matter properties. We further evaluated the characteristics of the perirolandic white matter in relation to performance on a fine motor task, gender and abnormalities observed on EEG. Children with benign epilepsy with centrotemporal spikes (n = 20) and healthy controls (n = 14) underwent multimodal testing with high-resolution MRI including diffusion tensor imaging sequences, sleep EEG recordings and fine motor assessment. We compared white matter microstructural characteristics (axial, radial and mean diffusivity, and fractional anisotropy) between groups in each region. We found distinct abnormalities corresponding to the perirolandic u-fibre region, with increased axial, radial and mean diffusivity and fractional anisotropy values in children with epilepsy (P = 0.039, P = 0.035, P = 0.042 and P = 0.017, respectively). Increased fractional anisotropy in this region, consistent with decreased integrity of crossing sensorimotor u-fibres, correlated with inferior fine motor performance (P = 0.029). There were gender-specific differences in white matter microstructure in the perirolandic region; males and females with epilepsy and healthy males had higher diffusion and fractional anisotropy values than healthy females (P ≤ 0.035 for all measures), suggesting that typical patterns of white matter development disproportionately predispose boys to this developmental epilepsy syndrome. Perirolandic white matter microstructure showed no relationship to epilepsy duration, duration seizure free, or epileptiform burden. There were no group differences in diffusivity or fractional anisotropy in superficial white matter outside of the perirolandic region. Children with epilepsy had increased radial diffusivity (P = 0.022) and decreased fractional anisotropy (P = 0.027) in deep white matter, consistent with a global delay in white matter maturation. These data provide evidence that atypical maturation of white matter microstructure is a basic feature in benign epilepsy with centrotemporal spikes and may contribute to the epilepsy, male predisposition and clinical comorbidities observed in this disorder. We found abnormalities in the white matter abutting the seizure onset zone in a common childhood epilepsy syndrome. The degree of abnormality predicted the severity of problems with motor coordination, a common symptom in this disease. Healthy boys have similar white matter findings, which may predispose them to this disease. Graphical Abstract Graphical Abstract |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|