Pediatric frontal lobe epilepsy: white matter abnormalities and cognitive impairment

Braakman, Hilde M. H.; Vaessen, Maarten J.; Jansen, Jacobus F. A.; Hall, Mariette H. J. A. Debeij‐van; Louw, Anton de; Hofman, Paul; Vles, Johan S.H.; Aldenkamp, Albert P.; Backes, Walter H.

doi:10.1111/ane.12183

Cited by 18 publications

(14 citation statements)

References 33 publications

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“…The mechanism behind the larger white matter volumes in children with FLE is unknown, but could include sprouting of white matter fibres in response to white matter damage or may reflect an accelerated myelination process. Using diffusion tensor imaging in this same patient cohort, we have also demonstrated increased myelination, thus preterm maturation, or an increase in axonal packing, in the children with FLE as compared to the controls .…”

Section: Discussionmentioning

confidence: 57%

“…Another explanation for the larger cortex volumes might be that they result from disturbed maturation processes. In a diffusion tensor imaging study in the same patient cohort, we found that brain maturation in children with FLE, particularly the cognitively impaired patients, was disturbed . Both areas of increased myelination or increased axonal packing that could explain the larger cortex volumes, and areas of decreased myelination or decreased axonal packing that could explain the smaller cortex volumes, were seen throughout the whole brain.…”

Section: Discussionmentioning

confidence: 80%

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Aetiology of cognitive impairment in children with frontal lobe epilepsy

et al. 2014

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Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 80%

Aetiology of cognitive impairment in children with frontal lobe epilepsy

et al. 2014

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“…Full text was screened in 71 cases and reference lists were inspected to detect additional studies not identified with the initial search. Forty-two studies met the inclusion criteria for the meta-analysis (Ahmadi et al, 2009, Andrade et al, 2014, Arfanakis et al, 2002, Braakman et al, 2014, Campos et al, 2015, Concha et al, 2005, Concha et al, 2007, Concha et al, 2009, Deppe et al, 2008, Diao et al, 2015, Diehl et al, 2008, Duning et al, 2010, Gao et al, 2012, Govindan et al, 2008, Gross et al, 2006, Holt et al, 2011, Hutchinson et al, 2010, Keller et al, 2011, Keller et al, 2012, Kemmotsu et al, 2011, Kemmotsu et al, 2014, Kim et al, 2011, Knake et al, 2009, Kori et al, 2013, Labate et al, 2015, Lee et al, 2013, Lee et al, 2014, Li et al, 2010, Liacu et al, 2012, Lin et al, 2008, Liu et al, 2011, Mao et al, 2011, McDonald et al, 2008, Meng et al, 2010a, Nilsson et al, 2008, Powell et al, 2007, Pustina et al, 2015, Rodrigo et al, 2007, Scanlon et al, 2013, Vulliemoz et al, 2011, Wang et al, 2010, Xiao et al, 2014). The total number of people with epilepsy and controls was 1027 and 1122, respectively.…”

Section: Resultsmentioning

confidence: 99%

White matter abnormalities at a regional and voxel level in focal and generalized epilepsy: A systematic review and meta-analysis

Slinger

Sinke

Braun

et al. 2016

NeuroImage: Clinical

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ObjectiveSince the introduction of diffusion tensor imaging, white matter abnormalities in epilepsy have been studied extensively. However, the affected areas reported, the extent of abnormalities and the association with relevant clinical parameters are highly variable. We aimed to obtain a more consistent estimate of white matter abnormalities and their association with clinical parameters in different epilepsy types.MethodsWe systematically searched for differences in white matter fractional anisotropy and mean diffusivity, at regional and voxel level, between people with epilepsy and healthy controls. Meta-analyses were used to quantify the directionality and extent of these differences. Correlations between white matter differences and age of epilepsy onset, duration of epilepsy and sex were assessed with meta-regressions.ResultsForty-two studies, with 1027 people with epilepsy and 1122 controls, were included with regional data. Sixteen voxel-based studies were also included. People with temporal or frontal lobe epilepsy had significantly decreased fractional anisotropy (Δ –0.021, 95% confidence interval –0.026 to –0.016) and increased mean diffusivity (Δ0.026 × 10–3 mm2/s, 0.012 to 0.039) in the commissural, association and projection white matter fibers. White matter was much less affected in generalized epilepsy. White matter changes in people with focal epilepsy correlated with age at onset, epilepsy duration and sex.SignificanceThis study provides a better estimation of white matter changes in different epilepsies. Effects are particularly found in people with focal epilepsy. Correlations with the duration of focal epilepsy support the hypothesis that these changes are, at least partly, a consequence of seizures and may warrant early surgery. Future studies need to guarantee adequate group sizes, as white matter differences in epilepsy are small.

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“…Here the focus of interest has been the impact of epilepsy and its treatment on brain development and understanding the relationship of abnormalities in brain structure with commonly occurring cognitive, academic, and behavioral comorbidities (Besseling et al, 2014; Bonilha et al, 2014; Braakman et al, 2014, 2015; Ibrahim et al, 2014; Widjaja et al, 2014a; Widjaja et al, 2015; Widjaja et al, 2014b). …”

Section: Introductionmentioning

confidence: 99%

Brain structure and organization five decades after childhood onset epilepsy

Garcia‐Ramos¹,

Bobholz²,

Dabbs³

et al. 2017

Human Brain Mapping

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The purpose of this project was to characterize brain structure and organization in persons with active and remitted childhood onset epilepsy 50 years after diagnosis compared to healthy controls. Participants from a population-based investigation of uncomplicated childhood onset epilepsy were followed up 5 decades later. Forty-one participants had a history of childhood onset epilepsy (mean age of onset= 5.2 yrs, current chronological age= 56.0 yrs) and were compared to 48 population-based controls (mean age= 55.9 yrs). Of the epilepsy participants, 8 had persisting active epilepsy and in 33 the epilepsy had remitted. All participants underwent 3T MRI with subsequent vertex analysis of cortical volume, thickness, surface area and gyral complexity. In addition, cortical and subcortical volumes, including regions of the frontal, parietal, temporal, and occipital lobes, and subcortical structures including amygdala, thalamus, and hippocampus, were analyzed using graph theory techniques. There were modest group differences in traditional vertex-based analyses of cortical volume, thickness, surface area and gyral index, as well as across volumes of subcortical structures, after correction for multiple comparisons. Graph theory analyses revealed suboptimal topological structural organization with enhanced network segregation and reduced global integration in the epilepsy participants compared to controls, these patterns significantly more extreme in the active epilepsy group. Furthermore, both groups with epilepsy presented a greater number of higher Z-score regions in betweenness centrality (BC) than lower Z-score regions compared to controls. Also, contrary to the group with remitted epilepsy, patients with active epilepsy presented most of their high BC Z-score regions in subcortical areas including the amygdala, thalamus, hippocampus, pallidum and accumbens. Overall, this population-based investigation of long term outcome (5 decades) of childhood onset epilepsy reveals persisting abnormalities, especially when examined by graph theoretical measurements, and provides new insights into the very long term outcomes of active and remitted epilepsy.

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Pediatric frontal lobe epilepsy: white matter abnormalities and cognitive impairment

Cited by 18 publications

References 33 publications

Aetiology of cognitive impairment in children with frontal lobe epilepsy

Aetiology of cognitive impairment in children with frontal lobe epilepsy

White matter abnormalities at a regional and voxel level in focal and generalized epilepsy: A systematic review and meta-analysis

Brain structure and organization five decades after childhood onset epilepsy

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