title: Brain structure and organization five decades after childhood onset epilepsy.
abstract: The purpose of this project was to characterize brain structure and organization in persons with active and remitted childhood onset epilepsy 50 years after diagnosis compared with healthy controls. Participants from a population-based investigation of uncomplicated childhood onset epilepsy were followed up 5 decades later. Forty-one participants had a history of childhood onset epilepsy (mean age of onset = 5.2 years, current chronological age = 56.0 years) and were compared with 48 population-based controls (mean age = 55.9 years). Of the epilepsy participants, 8 had persisting active epilepsy and in 33 the epilepsy had remitted. All participants underwent 3T MRI with subsequent vertex analysis of cortical volume, thickness, surface area and gyral complexity. In addition, cortical and subcortical volumes, including regions of the frontal, parietal, temporal, and occipital lobes, and subcortical structures including amygdala, thalamus, and hippocampus, were analyzed using graph theory techniques. There were modest group differences in traditional vertex-based analyses of cortical volume, thickness, surface area and gyral index, as well as across volumes of subcortical structures, after correction for multiple comparisons. Graph theory analyses revealed suboptimal topological structural organization with enhanced network segregation and reduced global integration in the epilepsy participants compared with controls, these patterns significantly more extreme in the active epilepsy group. Furthermore, both groups with epilepsy presented a greater number of higher Z-score regions in betweenness centrality (BC) than lower Z-score regions compared with controls. Also, contrary to the group with remitted epilepsy, patients with active epilepsy presented most of their high BC Z-score regions in subcortical areas including the amygdala, thalamus, hippocampus, pallidum, and accumbens. Overall, this population-based investigation of long term outcome (5 decades) of childhood onset epilepsy reveals persisting abnormalities, especially when examined by graph theoretical measurements, and provides new insights into the very long-term outcomes of active and remitted epilepsy. Hum Brain Mapp 38:3289-3299, 2017. © 2017 Wiley Periodicals, Inc.
authors.affiliation: Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.|Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
authors.forename: Camille
authors.identifier: 0000-0003-4365-9895
authors.initials: C
authors.lastname: Garcia-Ramos
authors.affiliation: Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
authors.forename: Sam
authors.initials: S
authors.lastname: Bobholz
authors.affiliation: Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
authors.forename: Kevin
authors.initials: K
authors.lastname: Dabbs
authors.affiliation: Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
authors.forename: Bruce
authors.initials: B
authors.lastname: Hermann
authors.affiliation: Turku PET Centre, University of Turku, Turku, 20500, Finland.|Division of Clinical Neurosciences, Turku University Hospital, Turku, 20500, Finland.|Department of Clinical Neurophysiology, Turku University Hospital, Turku, 20500, Finland.
authors.forename: Juho
authors.identifier: 0000-0002-3457-9415
authors.initials: J
authors.lastname: Joutsa
authors.affiliation: Turku PET Centre, University of Turku, Turku, 20500, Finland.|Division of Clinical Neurosciences, Turku University Hospital, Turku, 20500, Finland.
authors.forename: Juha O
authors.initials: JO
authors.lastname: Rinne
authors.affiliation: Department of Psychology, Abo Akademi University, Turku, 20500, Finland.
authors.forename: Mira
authors.initials: M
authors.lastname: Karrasch
authors.affiliation: Department of, Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
authors.forename: Vivek
authors.initials: V
authors.lastname: Prabhakaran
authors.affiliation: Departments of Neurology, Pediatrics and Epidemiology and Population Health, Montefiore Medical Center, Albert Einstein College of Medicine, 111 E. 210th Street Bronx, New York, 10467.
authors.forename: Shlomo
authors.initials: S
authors.lastname: Shinnar
authors.affiliation: Department of Public Health, University of Turku, Turku, 20014, Finland.|Department of, Child Neurology, University of Turku, and Turku University Hospital, Turku, 20014, Finland.
authors.forename: Matti
authors.initials: M
authors.lastname: Sillanpää
mesh_terms: D017668:Age of Onset; D001921:Brain / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D001931:Brain Mapping; D004827:Epilepsy / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D008959:Models, Neurological; D010100:Oxygen / Q000097:blood; D018709:Statistics, Nonparametric
chemical_list: D010100:Oxygen
keywords: MRI; brain development; epilepsy; graph theory