title: EEG-fMRI reveals activation of brainstem and thalamus in patients with Lennox-Gastaut syndrome.
abstract: OBJECTIVE
  Even if etiologies of Lennox-Gastaut syndrome (LGS) are diverse, the multiple causes converge into a final common pathway that results in this specific epilepsy phenotype. There is little knowledge, however, about neuronal networks that may be a part of this pathway.
  
  
  METHODS
  To investigate these networks, 11 children with LGS and 9 control children with multifocal epileptic activity were investigated using simultaneous recordings of EEG and functional MRI (EEG-fMRI) in a 3 Tesla scanner.
  
  
  RESULTS
  Individual and group analyses revealed significant activation of brainstem and thalamus (especially centromedian and anterior thalamus) associated with epileptiform discharges in patients with LGS. None of the patients with multifocal epileptic activity presented with the same hemodynamic activation pattern.
  
  
  CONCLUSIONS
  Because brainstem activation has been associated with infantile spasms, which often evolve into LGS, and thalamus activation has been observed in patients with primary (idiopathic generalized syndromes) and secondary (focal epilepsies) bilateral synchrony, the described network in LGS may represent the common pathogenetic pathway of these different conditions.
authors.affiliation: Department of Neuropediatrics, Christian-Albrechts-University, Kiel, Germany. m.siniatchkin@pedneuro.uni-kiel.de
authors.forename: Michael
authors.initials: M
authors.lastname: Siniatchkin
authors.forename: Diana
authors.initials: D
authors.lastname: Coropceanu
authors.forename: Friederike
authors.initials: F
authors.lastname: Moeller
authors.forename: Rainer
authors.initials: R
authors.lastname: Boor
authors.forename: Ulrich
authors.initials: U
authors.lastname: Stephani
mesh_terms: D001933:Brain Stem / Q000098:blood supply / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography / Q000379:methods*; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000175:diagnosis / Q000503:physiopathology; D065768:Lennox Gastaut Syndrome; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D013036:Spasms, Infantile / Q000175:diagnosis / Q000503:physiopathology; D013788:Thalamus / Q000098:blood supply / Q000503:physiopathology*