title: Impaired default mode network on resting-state FMRI in children with medically refractory epilepsy.
abstract: OBJECTIVE
  Resting-state networks including the DMN have been shown to be abnormal in adults with temporal lobe epilepsy. However, little is known about the DMN in children with medically refractory epilepsy. The aim was to determine whether there was a difference in the DMN in children with medically refractory epilepsy relative to controls.
  
  
  METHODS
  Eleven children with medically refractory epilepsy and 11 age-matched healthy controls underwent resting-state fMRI. IC analysis was used to identify the DMN. A random-effects analysis was performed on the Z-maps of the DMN within each group and between groups. We calculated the temporal correlation coefficients of pairs of ROIs: PCC/PCUN, mPFC, and left and right lateral parietal cortices. The relations between z scores of temporal correlation coefficients of pairs of ROIs and clinical seizure parameters and IQ were assessed.
  
  
  RESULTS
  The patients demonstrated decreased DMN connectivity in the PCC/PCUN, bilateral lateral parietal cortex, and anterior and midcingulate relative to controls. There was reduced connectivity between the mPFC-right lateral parietal cortex, the PCC/PCUN-left lateral parietal cortex, and the PCC/PCUN-right lateral parietal cortex pairs of ROIs in patients compared with controls. There were no significant correlations between the z scores of temporal correlation coefficients of the 6 pairs of ROIs in patients and age of seizure onset, duration of epilepsy, number of medications, seizure frequency, and IQ.
  
  
  CONCLUSIONS
  We have found reduced connectivity in the DMN in children with medically refractory epilepsy. Further studies are needed to determine whether different seizure types have different effects on the DMN and whether the impaired connectivity is related to cognitive functions subserved by the DMN.
authors.affiliation: Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada. Elysa.Widjaja@sickkids.ca
authors.forename: E
authors.initials: E
authors.lastname: Widjaja
authors.forename: M
authors.initials: M
authors.lastname: Zamyadi
authors.forename: C
authors.initials: C
authors.lastname: Raybaud
authors.forename: O C
authors.initials: OC
authors.lastname: Snead
authors.forename: M L
authors.initials: ML
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D001931:Brain Mapping / Q000379:methods*; D002540:Cerebral Cortex / Q000473:pathology / Q000503:physiopathology*; D004827:Epilepsy / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009415:Nerve Net / Q000473:pathology / Q000503:physiopathology*; D012146:Rest; D017211:Treatment Failure