Abstract
PurposeEpilepsy with centrotemporal spikes (ECTS) is the most common epilepsy syndrome in children and usually presents with cognitive dysfunctions. However, little is known about the processing speed dysfunction and the associated neuroimaging mechanism in ECTS. This study aims to investigate the brain functional abnormality of processing speed dysfunction in ECTS patients by using the 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) and resting-state functional magnetic resonance imaging (rs-fMRI).MethodsThis prospective study recruited twenty-eight ECTS patients who underwent the 18F-FDG PET, rs-fMRI, and neuropsychological examinations. Twenty children with extracranial tumors were included as PET controls, and 20 healthy children were recruited as MRI controls. The PET image analysis investigated glucose metabolism by determining standardized uptake value ratio (SUVR). The MRI image analysis explored abnormal functional connectivity (FC) within the cortical–striatal circuit through network-based statistical (NBS) analysis. Correlation analysis was performed to explore the relationship between SUVR, FC, and processing speed index (PSI).ResultsCompared with healthy controls, ECTS patients showed normal intelligence quotient but significantly decreased PSI (P = 0.04). PET analysis showed significantly decreased SUVRs within bilateral caudate, putamen, pallidum, left NAc, right rostral middle frontal gyrus, and frontal pole of ECTS patients (P < 0.05). Rs-fMRI analysis showed absolute values of 20 FCs were significantly decreased in ECTS patients compared with MRI controls, which connected 16 distinct ROIs. The average SUVR of right caudate and the average of 20 FCs were positively correlated with PSI in ECTS patients (P = 0.034 and P = 0.005, respectively).ConclusionThis study indicated that ECTS patients presented significantly reduced PSI, which is closely associated with decreased SUVR and FC of cortical–striatal circuit. Caudate played an important role in processing speed dysfunction.Clinical trial registrationNCT04954729; registered on July 8, 2021, public site, https://clinicaltrials.gov/ct2/show/NCT04954729
Highlights
Epilepsy with centrotemporal spikes (ECTS) is the most common focal epilepsy syndrome in children, accounting for 15–20% of pediatric epilepsy [1]
The processing speed index (PSI) of ECTS patients was significantly decreased than controls (P = 0.04), and no significant differences in verbal comprehension index (VCI) (P = 0.70), perceptual reasoning index (PRI) (P = 0.32), working memory index (WMI) (P = 0.94), and FSIQ (P = 0.26) were found between ECTS patients and healthy controls
Our study showed that the reduced PSI was associated with the decreased standardized uptake value ratio (SUVR) and functional connectivity (FC) of cortical–striatal circuit in ECTS patients
Summary
Epilepsy with centrotemporal spikes (ECTS) is the most common focal epilepsy syndrome in children, accounting for 15–20% of pediatric epilepsy [1]. Language and working memory impairments have been widely investigated in ECTS patients [3, 5];. European Journal of Nuclear Medicine and Molecular Imaging little is known about processing speed dysfunction. Processing speed is a key cognitive ability that measures the capacity of decision-making and visual and auditory information processing [6]. Processing speed dysfunction may weaken the learning efficiency of ECTS patients, who are usually school-age children [7]. In order to provide rational bases to improve processing speed, it is necessary to investigate processing speed dysfunction and its associated brain functional abnormality in ECTS patients
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