Cognition and brain development in children with benign epilepsy with centrotemporal spikes.
OBJECTIVE
Benign epilepsy with centrotemporal spikes (BECTS), the most common focal childhood epilepsy, is associated with subtle abnormalities in cognition and possible developmental alterations in brain structure when compared to healthy participants, as indicated by previous cross-sectional studies. To examine the natural history of BECTS, we investigated cognition, cortical thickness, and subcortical volumes in children with new/recent onset BECTS and healthy controls (HC).


METHODS
Participants were 8-15 years of age, including 24 children with new-onset BECTS and 41 age- and gender-matched HC. At baseline and 2 years later, all participants completed a cognitive assessment, and a subset (13 BECTS, 24 HC) underwent T1 volumetric magnetic resonance imaging (MRI) scans focusing on cortical thickness and subcortical volumes.


RESULTS
Baseline cognitive abnormalities associated with BECTS (object naming, verbal learning, arithmetic computation, and psychomotor speed/dexterity) persisted over 2 years, with the rate of cognitive development paralleling that of HC. Baseline neuroimaging revealed thinner cortex in BECTS compared to controls in frontal, temporal, and occipital regions. Longitudinally, HC showed widespread cortical thinning in both hemispheres, whereas BECTS participants showed sparse regions of both cortical thinning and thickening. Analyses of subcortical volumes showed larger left and right putamens persisting over 2 years in BECTS compared to HC.


CONCLUSIONS
Cognitive and structural brain abnormalities associated with BECTS are present at onset and persist (cognition) and/or evolve (brain structure) over time. Atypical maturation of cortical thickness antecedent to BECTS onset results in early identified abnormalities that continue to develop abnormally over time. However, compared to anatomic development, cognition appears more resistant to further change over time.
Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, U.S.A.
Camille
C
Garcia-Ramos
Department of Neurology, University of Wisconsin-Madison, Madison, Wisconsin, U.S.A.
Daren C
DC
Jackson
Department of Clinical Neurology, University of California-Irvine, Irvine, California, U.S.A.
Jack J
JJ
Lin
Department of Neurology, University of Wisconsin-Madison, Madison, Wisconsin, U.S.A.
Kevin
K
Dabbs
Department of Neurology, University of Wisconsin-Madison, Madison, Wisconsin, U.S.A.
Jana E
JE
Jones
Department of Neurology, University of Wisconsin-Madison, Madison, Wisconsin, U.S.A.
David A
DA
Hsu
Department of Neurology, Johns Hopkins University, Baltimore, Maryland, U.S.A.
Carl E
CE
Stafstrom
Department of Neurology, University of Wisconsin-Madison, Madison, Wisconsin, U.S.A.
Lucy
L
Zawadzki
Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, U.S.A.
Michael
M
Seidenberg
Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, U.S.A.
Vivek
V
Prabhakaran
Department of Neurology, University of Wisconsin-Madison, Madison, Wisconsin, U.S.A.
Bruce P
BP
Hermann
D000293:Adolescent; D016022:Case-Control Studies; D002540:Cerebral Cortex / Q000254:growth & development / Q000473:pathology*; D002648:Child; D003072:Cognition Disorders / Q000209:etiology*; D019305:Epilepsy, Rolandic / Q000150:complications*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging; D008297:Male; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D014706:Verbal Learning
Benign epilepsy with centrotemporal spikes; Cortical thickness; Neuropsychological assessment; Pediatric development