title: Impaired development of intrinsic connectivity networks in children with medically intractable localization-related epilepsy.
abstract: Typical childhood development is characterized by the emergence of intrinsic connectivity networks (ICNs) by way of internetwork segregation and intranetwork integration. The impact of childhood epilepsy on the maturation of ICNs is, however, poorly understood. The developmental trajectory of ICNs in 26 children (8-17 years) with localization-related epilepsy and 28 propensity-score matched controls was evaluated using graph theoretical analysis of whole brain connectomes from resting-state functional magnetic resonance imaging (fMRI) data. Children with epilepsy demonstrated impaired development of regional hubs in nodes of the salience and default mode networks (DMN). Seed-based connectivity and hierarchical clustering analysis revealed significantly decreased intranetwork connections, and greater internetwork connectivity in children with epilepsy compared to controls. Significant interactions were identified between epilepsy duration and the expected developmental trajectory of ICNs, indicating that prolonged epilepsy may cause progressive alternations in large-scale networks throughout childhood. DMN integration was also associated with better working memory, whereas internetwork segregation was associated with higher full-scale intelligence quotient scores. Furthermore, subgroup analyses revealed the thalamus, hippocampus, and caudate were weaker hubs in children with secondarily generalized seizures, relative to other patient subgroups. Our findings underscore that epilepsy interferes with the developmental trajectory of brain networks underlying cognition, providing evidence supporting the early treatment of affected children.
authors: Division of Neurosurgery, Hospital for Sick Children, Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.
authors: George M
authors: GM
authors: Ibrahim
authors: Benjamin R
authors: BR
authors: Morgan
authors: Wayne
authors: W
authors: Lee
authors: Mary Lou
authors: ML
authors: Smith
authors: Elizabeth J
authors: EJ
authors: Donner
authors: Frank
authors: F
authors: Wang
authors: Craig A
authors: CA
authors: Beers
authors: Paolo
authors: P
authors: Federico
authors: Margot J
authors: MJ
authors: Taylor
authors: Sam M
authors: SM
authors: Doesburg
authors: James T
authors: JT
authors: Rutka
authors: O Carter
authors: OC
authors: Snead
mesh_terms: D000293:Adolescent; D001921:Brain / Q000098:blood supply / Q000473:pathology*; D001931:Brain Mapping; D002648:Child; D016000:Cluster Analysis; D063132:Connectome; D002658:Developmental Disabilities / Q000209:etiology* / Q000473:pathology*; D004827:Epilepsy / Q000150:complications* / Q000473:pathology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D009415:Nerve Net / Q000098:blood supply / Q000473:pathology; D009434:Neural Pathways / Q000098:blood supply / Q000473:pathology; D009483:Neuropsychological Tests; D010100:Oxygen / Q000097:blood; D012146:Rest
chemical_list: D010100:Oxygen
keywords: functional connectivity; generalized tonic clonic (GTC); graph theoretical analysis; intrinsic connectivity network; resting-state fMRI