title: Investigating inhibitory control in children with epilepsy: an fMRI study.
abstract: OBJECTIVE
  Deficits in executive function are noted increasingly in children with epilepsy and have been associated with poor academic and psychosocial outcomes. Impaired inhibitory control contributes to executive dysfunction in children with epilepsy; however, its neuroanatomic basis has not yet been investigated. We used functional magnetic resonance imaging (fMRI) to probe the integrity of activation in brain regions underlying inhibitory control in children with epilepsy.
  
  
  METHODS
  This cross-sectional study consisted of 34 children aged 8-17 years: 17 with well-controlled epilepsy and 17 age- and sex-matched controls. Participants performed the antisaccade (AS) task, representative of inhibitory control, during fMRI scanning. We compared AS performance during neutral and reward task conditions and evaluated task-related blood oxygen level-dependent (BOLD) activation.
  
  
  RESULTS
  Children with epilepsy demonstrated impaired AS performance compared to controls during both neutral (nonreward) and reward trials, but exhibited significant task improvement during reward trials. Post hoc analysis revealed that younger patients made more errors than older patients and all controls. fMRI results showed preserved activation in task-relevant regions in patients and controls, with the exception of increased activation in the left posterior cingulate gyrus in patients specifically with generalized epilepsy across neutral and reward trials.
  
  
  CONCLUSIONS
  Despite impaired inhibitory control, children with epilepsy accessed typical neural pathways as did their peers without epilepsy. Children with epilepsy showed improved behavioral performance in response to the reward condition, suggesting potential benefits of the use of incentives in cognitive remediation.
authors.affiliation: University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A.
authors.forename: Regina L
authors.initials: RL
authors.lastname: Triplett
authors.forename: Katerina
authors.initials: K
authors.lastname: Velanova
authors.forename: Beatriz
authors.initials: B
authors.lastname: Luna
authors.forename: Aarthi
authors.initials: A
authors.lastname: Padmanabhan
authors.forename: William D
authors.initials: WD
authors.lastname: Gaillard
authors.forename: Miya R
authors.initials: MR
authors.lastname: Asato
mesh_terms: D000293:Adolescent; D001921:Brain / Q000503:physiopathology*; D016022:Case-Control Studies; D002648:Child; D003430:Cross-Sectional Studies; D004827:Epilepsy / Q000503:physiopathology*; D056344:Executive Function / Q000502:physiology; D005260:Female; D059907:Functional Neuroimaging; D006801:Humans; D007266:Inhibition, Psychological; D008279:Magnetic Resonance Imaging; D008297:Male
keywords: Antisaccade; Executive function; Pediatric