title: Early onset of cortical thinning in children with rolandic epilepsy.
abstract: BACKGROUND
  Rolandic epilepsy, a childhood epilepsy associated with language impairments, was investigated for language-related cortical abnormalities.
  
  
  METHODS
  Twenty-four children with rolandic epilepsy and 24 controls (age 8-14 years) were recruited and underwent the Clinical Evaluation of Language Fundamentals test. Structural MRI was performed at 3 T (voxel size 1 × 1 × 1 mm(3)) for fully automated quantitative assessment of cortical thickness. Regression analysis was used to test for differences between patients and controls and to assess the effect of age and language indices on cortical thickness.
  
  
  RESULTS
  For patients the core language score (mean ± SD: 92 ± 18) was lower than for controls (106 ± 11, p = 0.0026) and below the norm of 100 ± 15 (p = 0.047). Patients showed specific impairments in receptive language index (87 ± 19, p = 0.002) and language content index (87 ± 18, p = 0.0016). Cortical thickness was reduced in patients (p < 0.05, multiple-comparisons corrected) in left perisylvian regions. Furthermore, extensive cortical thinning with age was found in predominantly left-lateralized frontal, centro-parietal and temporal regions. No associations were found between cortical thickness and language indices in the regions of aberrant cortex.
  
  
  CONCLUSIONS
  The cortical abnormalities described represent subtle but significant pathomorphology in this critical phase of brain development (8-14 years) and suggest that rolandic epilepsy should not be considered merely a benign condition. Future studies employing longitudinal designs are prompted for further investigations into cerebral abnormalities in RE and associations with cognitive impairment and development.
authors.affiliation: Epilepsy Center Kempenhaeghe, Heeze, The Netherlands ; School for Mental Health & Neuroscience, Maastricht University, Maastricht, The Netherlands ; Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Geke M
authors.initials: GM
authors.lastname: Overvliet
authors.forename: René M H
authors.initials: RM
authors.lastname: Besseling
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: Paul A M
authors.initials: PA
authors.lastname: Hofman
authors.forename: Saskia C M
authors.initials: SC
authors.lastname: Ebus
authors.forename: Anton
authors.initials: A
authors.lastname: de Louw
authors.forename: Albert P
authors.initials: AP
authors.lastname: Aldenkamp
authors.forename: Walter H
authors.initials: WH
authors.lastname: Backes
keywords: Benign rolandic epilepsy of childhood with centro-temporal spikes; Cortical thickness (quantitative); Developmental trajectory; Language impairment