Behavior And Resting State FMRI Study In Patients With Benign Childhood Epilepsy With Centrotemporal Spikes

Objectives: Assess the cognitive function of centrotemporal spikes inchildren with benign epilepsy (BECT) and use the imaging technique of theresting state functional magnetic resonance imaging (FMRI) to observe theBECT default mode brain network (DMN) characteristics and the change infunctional connectivity and explore the correlation between the changes ofcognitive function of BECT, the features and changes in cognitive function ofDMN and functional connection of FMRI. Provide evidence from theperspective of brain networks to explore BECT clinical diagnosis andpathophysiology.Methods：Collect27cases of patients who meet the diagnostic criteriafor the BECT group and normal control group of healthy volunteers, in whichBECT group was divided into the treated group (n=13patients) and nomedication group (n=14patients). With Chinese revised Wechsler Intelli-gence Scale for Children (WISC), get the measurement of intelligence of allchildren to obtain verbal IQ (VIQ), performance IQ (PIQ) and total IQ (FSIQ).Use SPSS13.0software package for statistical analysis. comparison about thedifferences between groups use the independent sample t to tes and singlefactor analysis of variancet, and the measurement data is expressed by x±s.Then all data acquired at3.0T MRI environment resting state fMRI, Then allthe subjects in the test are under3.0T MRI resting state fMRI to finish dataacquisition. After getting data analysis, cingulate cortex (PCC) of seeds, then use the analytical methods based on the region of interest (ROI) functionalconnection to have the DMN features and the changes of function connectionof BECT. Finally, get Z-score values based on the reduced functionalconnection of brain regions and ROI as seed points, which and WISC scoresof BECT group have respectively correlation analysis.Results:1WISC test results:(1) Children of BECT group scored signi-ficantly lower than the control group of children in the information, simila-rities, arithmetic, vocabulary, comprehension, picture completion, picturearrangement, block design, object assembly, coding, with a significant diffe-rence (p<0.01).(2) BECT group of children’s VIQ, PIQ and FSIQ were lowerthan the control group. There were significant differences (p<0.01).(3) InMedicine group and unmedicated group, children’s VIQ, PIQ and FSIQ werelower than those in the normal control group. There were significantdifference (p<0.01). But compare the VIQ, PIQ and FSIQ of medicationgroup, and unmedicated group of children,no significant difference exist(p>0.05).2As to FMRI data, among27cases in BECT group, five cases wereeliminated because of excessive head movement in test. In the normal controlgroup, three cases were eliminated because of excessive head movement intest too. FMRI function connection research results:(1) with PCC as the seedpoint using DMN model based on ROI network analysis of all the subjects,positive correlation area mainly located in the anterior cingulate gyrus、precuneus、bilateral angular gyrus、medial prefrontal cortex、superior frontalgyrus、inferior temporal cortex、cerebellum and caudate nucleus. Negativelyrelated areas are mainly located in the supplementary motor area, thecingulate gyrus, bilateral inferior parietal lobe, insula, mid-forehead, inferior parietal lobule, bilateral lingual gyrus and right occipital lobe, inferior frontallobe.(2) The differences between the DMN indicate that compared with thecontrol group, the reduced functional connectivity brain regions of BECTgroup and PCC are in the right middle cingulate gyrus, precuneus. It is thebrain regions close to seed zone that have reduced connections.Increasedfunctional connectivity brain regions of BECT group and PCC are thebilateral frontal gyrus, right middle frontal gyrus.(3) Among No medicationgroup, medication group and the normal control group, DMN networkdifferences between any two groups indicate that compared with normalcontrol group, reduced functional connectivity brain regions of no medicationgroup and PCC are the precu-neus, right middle cingulate. It is the brainregions close to seed zone that have reduced connections. Increasedfunctional connectivity brain regions of no medication group and PCC are thebilateral frontal gyrus, right middle frontal gyrus. Compared with the normalcontrol group, the reduced functional connectivity in brain regions ofmedication group and PCC are the precuneus, and the increased functionalconnectivity in brain regions are right superior frontal gyrus, paracentrallobule. Compared with the medication group, The reduced functionalconnectivity of brain regions of no medication group are cerebellar lobe, rightcaudate nucleus, precuneus or central gyrus, the left paracentral lobule, andthe increased functional connectivity in brain regions are Medial frontal gyrus,left middle frontal.3The analysis results of the Internal nodes of DMN network functionalconnectivity of ROI show that compared with the control group, the DMNnetwork connection is more densely populated.4the analysis results of the correlation between the changes of cognitive function and FMRI function connection.(1) In BECT group, DMN functionalconnectivity was significantly reduced in two brain regions, that areprecuneus (Precuneus) and the right frontal mid (R.MCC) connection (Z scorevalue) which has significant positive correlation with VIQ, PIQ of BECT.According to DMN functional connectivity between ROI and BECT groupWISC score line correlation analysis showed a negative correlation betweenoverall.(2) Based on the correlation analysis of DMN functional connectivityin ROI and BECT group WISC score showed that both of them have anegative correlation overall.Conclusions:1. VIQ, PIQ and FSIQ of BECT children are reduced, there is a certaindegree of cognitive impairment.2.Among Medication group and no medication group, VIQ, PIQ andFSIQ had no significant differences (p>0.05), speculate that the cognitiveimpairment may be an early sign of BECT symptoms or accompanyingsymptoms.3. The function connection analysis method of the PCC as seed point canget stable and spontaneous low frequent oscillation signal and DMN conne-ction diagram in BECT patients.4. DMN brain regions obtained by BECT group consist with previousstudies of brain regions, but the DMN brain regions of BECT is wider inscope. Probably, Epilepsy indirectly affect the child’s physical developmentcycle, or epilepsy directly lead to children’s brain abnormalities in networkconnection as to redistribution of DMN.5. BECT internal functional connectivity changes may result in changesin integrated function of DMN. It may be derived from BECT child neurodevelopmental abnormalities or the reorganization of the brain struct-ure and function,leading to cognitive dysfunction.6. BECT children’s DMN internal functional connectivity more tend to aruled network development. This may go against improvement of the functionof children in brain area development, cause the brain network controldisorders, and lead to neural psychological behavioral abnormalities.