title: Centrotemporal spikes during NREM sleep: The promoting action of thalamus revealed by simultaneous EEG and fMRI coregistration.
abstract: Benign childhood epilepsy with centrotemporal spikes (BECTS) has been investigated through EEG-fMRI with the aim of localizing the generators of the epileptic activity, revealing, in most cases, the activation of the sensory-motor cortex ipsilateral to the centrotemporal spikes (CTS). In this case report, we investigated the brain circuits hemodynamically involved by CTS recorded during wakefulness and sleep in one boy with CTS and a language disorder but without epilepsy. For this purpose, the patient underwent EEG-fMRI coregistration. During the "awake session", fMRI analysis of right-sided CTS showed increments of BOLD signal in the bilateral sensory-motor cortex. During the "sleep session", BOLD increments related to right-sided CTS were observed in a widespread bilateral cortical-subcortical network involving the thalamus, basal ganglia, sensory-motor cortex, perisylvian cortex, and cerebellum. In this patient, who fulfilled neither the diagnostic criteria for BECTS nor that for electrical status epilepticus in sleep (ESES), the transition from wakefulness to sleep was related to the involvement of a widespread cortical-subcortical network related to CTS. In particular, the involvement of a thalamic-perisylvian neural network similar to the one previously observed in patients with ESES suggests a common sleep-related network dysfunction even in cases with milder phenotypes without seizures. This finding, if confirmed in a larger cohort of patients, could have relevant therapeutic implication.
authors: Department of Biomedical Sciences, Metabolism, and Neuroscience, University of Modena and Reggio Emilia, Italy.
authors: Laura
authors: L
authors: Mirandola
authors: Child Neuropsychiatry Unit, Department of Neuroscience, University-Hospital of Parma, Italy ; Department of Life and Reproduction Sciences, University of Verona, Italy.
authors: Gaetano
authors: G
authors: Cantalupo
authors: Department of Biomedical Sciences, Metabolism, and Neuroscience, University of Modena and Reggio Emilia, Italy.
authors: Anna Elisabetta
authors: AE
authors: Vaudano
authors: Department of Biomedical Sciences, Metabolism, and Neuroscience, University of Modena and Reggio Emilia, Italy ; Department of Neuroscience, University of Parma, Italy.
authors: Pietro
authors: P
authors: Avanzini
authors: Department of Biomedical Sciences, Metabolism, and Neuroscience, University of Modena and Reggio Emilia, Italy.
authors: Andrea
authors: A
authors: Ruggieri
authors: Child Neuropsychiatry Unit, Department of Neuroscience, University-Hospital of Parma, Italy.
authors: Francesco
authors: F
authors: Pisani
authors: Child Neuropsychiatry Unit, Department of Neuroscience, University-Hospital of Parma, Italy ; Department of Neuroscience, University of Parma, Italy.
authors: Giuseppe
authors: G
authors: Cossu
authors: Department of Neuroscience, University of Parma, Italy.
authors: Carlo Alberto
authors: CA
authors: Tassinari
authors: Department of Biomedical Sciences, Metabolism, and Neuroscience, University of Modena and Reggio Emilia, Italy.
authors: Paolo Frigio
authors: PF
authors: Nichelli
authors: Department of Biomedical Sciences, Metabolism, and Neuroscience, University of Modena and Reggio Emilia, Italy.
authors: Francesca
authors: F
authors: Benuzzi
authors: Department of Biomedical Sciences, Metabolism, and Neuroscience, University of Modena and Reggio Emilia, Italy.
authors: Stefano
authors: S
authors: Meletti
keywords: BECTS; BECTS, benign epilepsy with centrotemporal spikes; BOLD, blood oxygen level dependent; CTS, centrotemporal spikes; EEG–fMRI; ESES; ESES, electrical status epilepticus in sleep; ESI, EEG source imaging; Sleep; Thalamus