Abstract
Objective: Childhood epilepsy with centrotemporal spikes (CECTS), the most common childhood epilepsy, still lacks longitudinal imaging studies involving antiepileptic drugs (AEDs). In order to examine the effect of AEDs on cognition and brain activity. We investigated the neuromagnetic activities and cognitive profile in children with CECTS before and after 1 year of treatment.Methods: Fifteen children with CECTS aged 6–12 years underwent high-sampling magnetoencephalography (MEG) recordings before treatment and at 1 year after treatment, and 12 completed the cognitive assessment (The Wechsler Intelligence Scale for Children). Next, magnetic source location and functional connectivity (FC) were investigated in order to characterize interictal neuromagnetic activity in the seven frequency sub-bands, including: delta (1–4 Hz), theta (4–8 Hz), alpha (8–12 Hz), beta (12–30 Hz), gamma (30–80 Hz), ripple (80–250 Hz), and fast ripple (250–500 Hz).Results: After 1 year of treatment, children with CECTS had increased scores on full-scale intelligence quotient, verbal comprehension index (VCI) and perceptual reasoning index (PRI). Alterations of neural activity occurred in specific frequency bands. Source location, in the 30–80 Hz frequency band, was significantly increased in the posterior cingulate cortex (PCC) after treatment. Moreover, FC analysis demonstrated that after treatment, the connectivity between the PCC and the medial frontal cortex (MFC) was enhanced in the 8–12 Hz frequency band. Additionally, the whole-brain network distribution was more dispersed in the 80–250 Hz frequency band.Conclusion: Intrinsic neural activity has frequency-dependent characteristic. AEDs have impact on regional activity and FC of the default mode network (DMN). Normalization of aberrant DMN in children with CECTS after treatment is likely the reason for improvement of cognitive function.
Highlights
Childhood epilepsy with centrotemporal spikes (CECTS) is the most common idiopathic focal epilepsy syndrome, and accounts for 13–23% of childhood epilepsy (Heijbel et al, 1975; Panayiotopoulos et al, 2008)
Several studies based on functional magnetic resonance have further investigated brain alterations in CECTS during antiepileptic drugs (AEDs) treatment, the results of which have shown that AEDs have an effect on functional connectivity (FC) (Jiang et al, 2019, 2020), and regional activity (Zhang et al, 2017, 2018)
Whether different types of AEDs have different effects on neural activity, or whether there are differences in the brain network patterns among children with different outcomes needs to be clarified in future studies. This longitudinal study investigated the effects of long-term use of AEDs on brain activity and cognitive function among children with CECTS
Summary
Childhood epilepsy with centrotemporal spikes (CECTS) is the most common idiopathic focal epilepsy syndrome, and accounts for 13–23% of childhood epilepsy (Heijbel et al, 1975; Panayiotopoulos et al, 2008). Numerous studies have demonstrated that the restingstate brain activity of children with CECTS has been altered (McGinnity et al, 2017; Bourel-Ponchel et al, 2019; Zhang et al, 2020) On this basis, several studies based on functional magnetic resonance (fMRI) have further investigated brain alterations in CECTS during AEDs treatment, the results of which have shown that AEDs have an effect on functional connectivity (FC) (Jiang et al, 2019, 2020), and regional activity (Zhang et al, 2017, 2018). The effect of AEDs on cognitive function has been widely reported among previous studies (Tacke et al, 2016; Han and Kim, 2018; Operto et al, 2019), the lack of synchronized cognitive assessment weakens the clinical significance of neuroimaging results
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