Alterations of Cerebral Perfusion and Functional Connectivity in Children With Idiopathic Generalized Epilepsy

Abstract

BackgroundStudies have demonstrated that adults with idiopathic generalized epilepsy (IGE) have functional abnormalities; however, the neuropathological pathogenesis differs between adults and children. This study aimed to explore alterations in the cerebral blood flow (CBF) and functional connectivity (FC) to comprehensively elucidate the neuropathological mechanisms of IGE in children.MethodsWe obtained arterial spin labeling (ASL) and resting state functional magnetic resonance imaging data of 28 children with IGE and 35 matched controls. We used ASL to determine differential CBF regions in children with IGE. A seed-based whole-brain FC analysis was performed for regions with significant CBF changes. The mean CBF and FC of brain areas with significant group differences was extracted, then its correlation with clinical variables in IGE group was analyzed by using Pearson correlation analysis.ResultsCompared to controls, children with IGE had CBF abnormalities that were mainly observed in the right middle temporal gyrus, right middle occipital gyrus (MOG), right superior frontal gyrus (SFG), left inferior frontal gyrus (IFG), and triangular part of the left IFG (IFGtriang). We observed that the FC between the left IFGtriang and calcarine fissure (CAL) and that between the right MOG and bilateral CAL were decreased in children with IGE. The CBF in the right SFG was correlated with the age at IGE onset. FC in the left IFGtriang and left CAL was correlated with the IGE duration.ConclusionThis study found that CBF and FC were altered simultaneously in the left IFGtriang and right MOG of children with IGE. The combination of CBF and FC may provide additional information and insight regarding the pathophysiology of IGE from neuronal and vascular integration perspectives.

Altered neurovascular coupling in children with idiopathic generalized epilepsy

“…The study finally included 61 right‐handed subjects (26 children with IGE and 35 healthy controls [HCs]), some of whom were also included in our previous studies 11,35 . Among the children with IGE, 16 patients were regularly administered antiepileptic drugs in accordance with the ILAE treatment guidelines.…”

“…The study finally included 61 right-handed subjects (26 children with IGE and 35 healthy controls [HCs]), some of whom were also included in our previous studies. 11,35 Among the children with IGE, 16 patients were regularly administered antiepileptic drugs in accordance with the ILAE treatment guidelines. Eight participants were using valproate sodium, four a combination of valproate sodium and oxcarbazepine, two valproate sodium and clonazepam, one valproate sodium and levetiracetam, and one oxcarbazepine.…”

“…6 Seizure activity in IGE patients may affect the cerebral blood flow (CBF) and metabolism, and neuroimaging evidence of neuronal injury and cerebral perfusion changes in IGE has been provided by restingstate functional MRI (rs-fMRI) studies. [7][8][9][10][11] However, these studies on IGE mainly used a single imaging modality, and this method cannot comprehensively and sensitively reflect the altered regional CBF and neuronal activity caused by seizures. 10,12 In contrast, combining rs-fMRI and arterial spin labeling (ASL) imaging can promptly and comprehensively detect altered neurovascular coupling (NVC), reflecting the relationship between changes in neural activity and in regional CBF.…”

“…Magnetic resonance imaging (MRI) is a reliable and noninvasive technique to study the pathological mechanisms of epilepsy in the human brain, analyzing the brain structure and function in an omnidirectional and multangular manner 6 . Seizure activity in IGE patients may affect the cerebral blood flow (CBF) and metabolism, and neuroimaging evidence of neuronal injury and cerebral perfusion changes in IGE has been provided by resting‐state functional MRI (rs‐fMRI) studies 7–11 . However, these studies on IGE mainly used a single imaging modality, and this method cannot comprehensively and sensitively reflect the altered regional CBF and neuronal activity caused by seizures 10,12 .…”

Systematically altered connectome gradient in benign childhood epilepsy with centrotemporal spikes: Potential effect on cognitive function

“…MRI is a noninvasive and comprehensive detection tool, it is useful for studying spontaneous neural activity of the brain at rest and to evaluate functional connections and networks of various brain regions. It has been widely used in research on neuropsychiatric disorders, such as Alzheimer’s disease, mild cognitive impairment ( Ibrahim et al, 2021 ), psychosis ( Collin et al, 2020 ), epilepsy ( Chen et al, 2022 ). In patients with BECTS, discharge sites are mainly located in the center of the brain sensorimotor cortex ( Dryżałowski et al, 2018 ), which exhibits abnormal changes in the functional connections of exercise-related networks ( Jiang et al, 2020 ).…”