title: Serial changes of prefrontal lobe growth in the patients with benign childhood epilepsy with centrotemporal spikes presenting with cognitive impairments/behavioral problems.
abstract: Several studies have reported a higher incidence of learning and behavioral difficulties in association with frontal lobe dysfunctions in children with benign childhood epilepsy with centrotemporal spikes (BCECTS). We studied serial changes in frontal and prefrontal lobe volumes using three-dimensional magnetic resonance imaging in BCECTS with or without cognitive impairments and behavioral problems and evaluated correlations between prefrontal lobe growth and active seizure period. Serial changes in regional cerebral volumes were measured in two patients with cognitive impairments and behavioral problems (BCECTS(+)) and five patients without neuropsychiatric deficits (BCECTS(-)). Eleven normal subjects (4-13years old) served as controls. Volumes of the frontal and prefrontal lobes were determined using a workstation, and the prefrontal-to-frontal lobe volume ratio was calculated. Frontal and prefrontal lobe volumes revealed growth disturbance in BCECTS(+) compared with BCECTS(-) and control subjects. In addition, prefrontal-to-frontal lobe volume ratio increased serially in BCECTS(-) similarly to controls, but was stagnant or decreased in BCECTS(+). Prefrontal growth also revealed more rapid recovery in a BCECTS(+) patient with shorter active seizure period. These findings suggest that longer active seizure period as frequent spike-waves coupled with the occurrence of frequent seizures may be associated with prefrontal lobe growth disturbance, which relates to neuropsychological problems.
authors.affiliation: Department of Pediatrics, University of Yamanashi, Japan. ykimu@yamanashi.ac.jp
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kanemura
authors.forename: Sonoko
authors.initials: S
authors.lastname: Hata
authors.forename: Kakuro
authors.initials: K
authors.lastname: Aoyagi
authors.forename: Kanji
authors.initials: K
authors.lastname: Sugita
authors.forename: Masao
authors.initials: M
authors.lastname: Aihara
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D001526:Behavioral Symptoms / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D002220:Carbamazepine / Q000627:therapeutic use; D002675:Child, Preschool; D003072:Cognition Disorders / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D004569:Electroencephalography; D019305:Epilepsy, Rolandic / Q000150:complications* / Q000188:drug therapy / Q000473:pathology*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D017397:Prefrontal Cortex / Q000187:drug effects / Q000254:growth & development* / Q000473:pathology; D013997:Time Factors; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D002220:Carbamazepine