Study Of Structure And Functional Brain Network In Benign Epilepsy Of Childhood With Centrotemporal Spikes

Objective: To observe the changes of cognitive function and explore the changes of brain microstructure and functional brain network in patients with benign epilepsy of childhood with centrotemporal spikes(BECTS). And preliminarily discuss on the correlation of the brain structure changes and clinical factors(onset age and course of the disease) and cognitive function, in order to reveal the mechanism of brain networks and provide some references for the clinical diagnosis and treatment of BECTS.Methods: 21 patients with BECTS and 20 healthy volunteers, BECTS group and control group, who were similar in gender, age and education both groups, have enrolled in this study from December 2013 to May 2015 in affiliated hospital of north sichuan medical college. All subjects were adopted neuropsychological assessment(in China revised wechsler intelligence scale for children(WISC) the subjects’ verbal IQ(VIQ) operation IQ(PIQ) and full scale IQ(FSIQ)/total IQ) and 3.0 T magnetic resonance high-resolution T1-weighted imaging(3D-T1)and rest-state functional magnetic resonance imaging(f MRI) scans. Using SPSS13.0 software package, with two sample t test for comparing two groups of neuropsychological assessment data. For all 3D-T1 and f MRI images by the statistical parameter graph data packets(SPM8) preprocessing, using Voxel-based morphometry(VBM) and functional connectivity analysis respectively, two sample t test to compare the volume of gray matter and functional connectivity between the two groups. Finally making correlation analysis between the obtained volume of gray matter changes respectively with clinical factors and neuropsychological assessment data in BECTS group.Results:(1) Neuropsychological assessment results: FSIQ, VIQ and PIQ of BECTS group were significantly lower than the control group, the difference was statistically significant(all p < 0.001).(2) Magnetic resonance imaging results: Compared with the controls, patients with BECTS showed significantly increased gray matter volume in the bilateral putamen, paracentral lobule(PCL), right anterior insula/frontal operculum, right supplementary motor area(SMA), right inferior temporal gyrus and left cerebellum(all p<0.05, FDR-corrected).(3) Correlation analysis results: We found a significant negative correlation between the gray matter volume of the bilateral putamen and age of epilepsy onset(r=-0.586, p=0.017 for the left putamen; r=-0.520, p=0.039 for the right putamen). We observed a significant positive correlation of the volume of the right anterior insula/frontal operculum with the verbal IQ(r=0.644, p=0.007) and Full scale IQ(r=0.708, p=0.002).Conclusions:(1) Verify that there is a certain degree of cognitive function damage in patients with BECTS, it could be premonitory signs or symptoms of BECTS.(2) Patients with BECTS have some changes in brain microstructure, it may be related to chronic epileptic activity(clinical or interictal epileptic discharges) affects children’s physical development cycle, at the same time it may be a structure foundation of cognitive impairment in patients with BECTS.(3) The smaller the age of onset, patients with BECTS may be the greater impact of the changes on striatum, it may be the disease led to the striatum neurodevelopmental abnormalities.(4) Patients showed decreased functional connections between the right putamen and right anterior cingulate cortex(ACC) and right medial frontal gyrus; between the right anterior insula/frontal operculum and the bilateral ACC, left superior frontal gyrus, left caudate head, right middle frontal gyrus and right thalamus; between right SMA and the left precentral gyrus; between the left PCL and the right angular gyrus, bilateral precuneus, bilateral medial superior frontal gyri and bilateral middle temporal gyri; it may be associated with the electrical activity of patients with BECTS, at the same time the network adjustment disorder may result in neuropsychological dysfunction.