A Study Of Brain Function In Benign Epilepsy With Centrotemporal Spikes Based On Magnetic Resonance Imaging

Benign epilepsy with centrotemporal spikes(BECTS),also known as Rolandic epilepsy,is a common form of partial seizures.The seizures always occur before sleep or wakefulness in patients,and the duration is generally less than 2 minutes.Typical clinical characteristics of BECTS are unilateral facial convulsions,distortion of commissure,sialorrhea.The electroencephalogram(EEG)characteristics of the BECTS patients are one or both sides spikes and waves of the central temporal region,which can also diffuse to adjacent regions.Many previous studies have suggested that benign epilepsy with centrotemporal spikes child with or without antiepileptic drug(AED)treatment will have complete remission from seizures by midadolescence.However,an increasing case series literature seems to show that many affected children have a variety of cognitive problems,including attention,language,memory,and executive function.In addition,other studies have found that BECTS patients have different behavioral problems,such as anxiety,depression,aggressive behaviors.Resting-state fMRI is widely used to detect the spontaneous brain activity in epileptic patients.We examined the brain function of patients with BECTS from two aspects: the local brain functional activity and the brain functional network connectivity.To inspect the local brain function in patients with BECTS,we obtained resting-state fMRI data from 52 patients with BECTS,including twenty-eight drug-na?ve patients(DNP)and 24 drug-receiving patients(DRP)with good seizure control,and 24 matched healthy controls(HC).Traditional static ALFF(sALFF)and sliding-window based dynamic ALFF(dALFF)methods were applied on the resting-state fMRI data.ANOVA and post-hoc statistic analysis was performed to detect between-group comparisons.Abnormal sALFF and dALFF values were correlated with illness duration and onset age of patient.The vMPFC,HG and SMA were indicated to be intrinsic affected regions and effective therapeutic targets,which implied neuromodulation targets and helped to underatnding underlying pathomechanism.The sALFF and dALFF had different sensitivity in detecting abnormality in different regions.Long-term AEDs receiving would cause some adverse side effects on brain activity.We also examined the functional connectivity of resting state network of resting-state fMRI data of three groups of subjects.Firstly,we conducted independentcomponent analysis(ICA)on the three groups of subjects,and we identified 13 resting brain networks.Then,the functional network connectivity(FNC)was applied to three groups.We also applied sliding-window approach to obtain the dynamic functional network connectivity(dFNC)of three groups.The functional connectivity showed significant alterations mainly included the frontal network(FPN),the dorsal attention network(DAN),and the default mode network(DMN).This study analyzed the brain function of patients with BECTS from the voxel and network levels.The results showed that patients with BECTS suffered not only local brain function abnormal changes,but also found significant abnormalities in functional connections between networks.The abnormalities in the functional connections of the brain network may mainly reflect the disorder of the brain information interaction function,which may reveal the underlying neuropathologic mechanism of epileptic patients.In addition,the transmission of interictal epileptic discharges in different regions is often transient and affects multiple systems,and dynamic functional network connectivity(dFNC)takes into account fluctuating states of connectivity across the time domain.Therefore,dynamic FNC may provide a supplement for understanding the pathophysiological mechanisms of BECTS patients.