title: Simultaneous EEG-fMRI in drug-naive children with newly diagnosed absence epilepsy.
abstract: OBJECTIVE
  In patients with idiopathic generalized epilepsy (IGE), blood oxygen level dependent (BOLD) EEG during functional MRI (EEG-fMRI) has been successfully used to link changes in regional neuronal activity to the occurrence of generalized spike-and-wave (GSW) discharges. Most EEG-fMRI studies have been performed on adult patients with long-standing epilepsy who were on antiepileptic medication. Here, we applied EEG-fMRI to investigate BOLD signal changes during absence seizures in children with newly diagnosed childhood absence epilepsy (CAE).
  
  
  METHODS
  Ten drug-naive children with newly diagnosed CAE underwent simultaneous EEG-fMRI. BOLD signal changes associated with ictal EEG activity (i.e., periods of three per second GSW) were analyzed in predefined regions-of-interests (ROIs), including the thalamus, the precuneus, and caudate nucleus.
  
  
  RESULTS
  In 6 out of 10 children, EEG recordings showed periods of three per second GSW during fMRI. Three per second GSW were associated with regional BOLD signal decreases in parietal areas, precuneus, and caudate nucleus along with a bilateral increase in the BOLD signal in the medial thalamus. Taking into account the normal delay in the hemodynamic response, temporal analysis showed that the onset of BOLD signal changes coincided with the onset of GSW.
  
  
  CONCLUSIONS
  In drug-naive individuals with CAE, ictal three per second GSW are associated with BOLD signal changes in the same striato-thalamo-cortical network that changes its regional activity during primary and secondary generalized paroxysms in treated adults. No BOLD signal changes in the striato-thalamo-cortical network preceded the onset of three per second GSW in unmediated children with CAE.
authors.affiliation: Department of Neuropediatrics, Christian-Albrechts-University, Kiel, Germany. f.moeller@pedneuro.uni-kiel.de
authors.forename: Friederike
authors.initials: F
authors.lastname: Moeller
authors.forename: Hartwig R
authors.initials: HR
authors.lastname: Siebner
authors.forename: Stephan
authors.initials: S
authors.lastname: Wolff
authors.forename: Hiltrud
authors.initials: H
authors.lastname: Muhle
authors.forename: Oliver
authors.initials: O
authors.lastname: Granert
authors.forename: Olav
authors.initials: O
authors.lastname: Jansen
authors.forename: Ulrich
authors.initials: U
authors.lastname: Stephani
authors.forename: Michael
authors.initials: M
authors.lastname: Siniatchkin
mesh_terms: D001921:Brain / Q000033:anatomy & histology* / Q000503:physiopathology*; D002421:Caudate Nucleus / Q000503:physiopathology; D002648:Child; D004569:Electroencephalography; D004832:Epilepsy, Absence / Q000175:diagnosis* / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D009415:Nerve Net / Q000503:physiopathology; D010100:Oxygen / Q000097:blood; D012720:Severity of Illness Index; D013788:Thalamus / Q000503:physiopathology
chemical_list: D010100:Oxygen