title: Aberrant functional connectivity between motor and language networks in rolandic epilepsy.
abstract: BACKGROUND
  Rolandic epilepsy (RE) is an idiopathic focal childhood epilepsy with a well-established neuropsychological profile of language impairment. The aim of this study is to provide a functional correlate that links rolandic (sensorimotor) pathology to language problems using functional MRI.
  
  
  METHODS
  Twenty-three children with RE (8-14 years old) and 21 matched controls underwent extensive language assessment (Clinical Evaluation of Language Fundamentals). fMRI was performed at rest and using word generation, reading, and finger tapping paradigms. Since no activation group differences were found, regions of interest (ROIs) were defined at pooled (patients and controls combined) activation maxima and in contralateral homotopic cortex, and used to assess language lateralization as well as for a resting-state connectivity analysis. Furthermore, the association between connection strength and language performance was investigated.
  
  
  RESULTS
  Reduced language performance was found in the children with RE. Bilateral activation was found for both language tasks with some predominance of the left hemisphere in both groups. Compared to controls, patient connectivity was decreased between the left sensorimotor area and right inferior frontal gyrus (p<0.01). For this connection, lower connectivity was associated with lower language scores in the patient group (r=0.49, p=0.02), but not in the controls.
  
  
  CONCLUSIONS
  Language laterality analysis revealed bilateral language representation in the age range under study (8-14 years). As a consequence, the connection of reduced functional connectivity we found represents an impaired interplay between motor and language networks, and aberrant functional connectivity associated with poorer language performance. These findings provide a first neuronal correlate in terms of aberrant resting-state functional connectivity for language impairment in RE.
authors.affiliation: Epilepsy Center Kempenhaeghe, Heeze, The Netherlands; Research School for Mental Health & Neuroscience, Maastricht University, Maastricht, The Netherlands; Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: René M H
authors.initials: RM
authors.lastname: Besseling
authors.forename: Geke M
authors.initials: GM
authors.lastname: Overvliet
authors.forename: Jacobus F A
authors.initials: JF
authors.lastname: Jansen
authors.forename: Sylvie J M
authors.initials: SJ
authors.lastname: van der Kruijs
authors.forename: Johannes S H
authors.initials: JS
authors.lastname: Vles
authors.forename: Saskia C M
authors.initials: SC
authors.lastname: Ebus
authors.forename: Paul A M
authors.initials: PA
authors.lastname: Hofman
authors.forename: Anton J A
authors.initials: AJ
authors.lastname: de Louw
authors.forename: Albert P
authors.initials: AP
authors.lastname: Aldenkamp
authors.forename: Walter H
authors.initials: WH
authors.lastname: Backes
mesh_terms: D000293:Adolescent; D002540:Cerebral Cortex / Q000473:pathology* / Q000502:physiology; D002648:Child; D019305:Epilepsy, Rolandic / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007802:Language; D007807:Language Tests; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009415:Nerve Net / Q000473:pathology* / Q000502:physiology*; D011597:Psychomotor Performance / Q000502:physiology*; D055139:Sensory Gating / Q000502:physiology
keywords: Benign rolandic epilepsy of childhood with centro temporal spikes; Language impairment; RE; Resting-state functional MRI; rolandic epilepsy