Abstract
Benign childhood epilepsy with centrotemporal spikes (BECTS) is associated with cognitive and language problems. According to recent studies, disruptions in brain structure and function in children with BECTS are beyond a Rolandic focus, suggesting atypical cortical development. However, previous studies utilizing surface-based metrics (e.g., cortical gyrification) and their structural covariance networks at high resolution in children with BECTS are limited. Twenty-six children with BECTS (15 males/11 females; 10.35 ± 2.91 years) and 26 demographically matched controls (15 males/11 females; 11.35 ± 2.51 years) were included in this study and subjected to high-resolution structural brain MRI scans. The gyrification index was calculated, and structural brain networks were reconstructed based on the covariance of the cortical folding. In the BECTS group, significantly increased gyrification was observed in the bilateral Sylvain fissures and the left pars triangularis, temporal, rostral middle frontal, lateral orbitofrontal, and supramarginal areas (cluster-corrected p < 0.05). Global brain network measures were not significantly different between the groups; however, the nodal alterations were most pronounced in the insular, frontal, temporal, and occipital lobes (FDR corrected, p < 0.05). In children with BECTS, brain hubs increased in number and tended to shift to sensorimotor and temporal areas. Furthermore, we observed significantly positive relationships between the gyrification index and age (vertex p < 0.001, cluster-level correction) as well as duration of epilepsy (vertex p < 0.001, cluster-level correction). Our results suggest that BECTS may be a condition that features abnormal over-folding of the Sylvian fissures and uncoordinated development of structural wiring, disrupted nodal profiles of centrality, and shifted hub distribution, which potentially represents a neuroanatomical hallmark of BECTS in the developing brain.
Highlights
Benign childhood epilepsy with centrotemporal spikes (BECTS) is one of the most common types of epilepsy occurring between the age of 3–13 years, typically characterized by a total of 2–10 infrequent seizures, resolution by the age of 15–17 years [1], an excellent prognosis, and a “benign” nature
The cortical gyrification analysis identified several clusters in bilateral cerebral cortices that were increased as the BECTS group compared with the controls (Figure 1; Table 2)
We investigated differences in cortical folding and its structural covariance networks between children with BECTS and their peer controls to confirm the effects of centrotemporal spikes on the developing brain
Summary
Benign childhood epilepsy with centrotemporal spikes (BECTS) is one of the most common types of epilepsy occurring between the age of 3–13 years, typically characterized by a total of 2–10 infrequent seizures, resolution by the age of 15–17 years [1], an excellent prognosis, and a “benign” nature. BECTS children frequently have language, cognitive, and somatosensory problems after reaching. Neuroimaging techniques have enabled improved characterization of the neural basis of BECTS. Morphometric studies revealed subtle anomalies in gray matter volume in the frontal, temporal, and left pars triangularis regions in BECTS children [3, 4]. Language task paradigms have revealed atypical activation across different brain regions, increased activation in the frontal, parietal and temporal areas [8,9,10,11,12,13]. Children with BECTS present a wide distribution of alterations in the functional and structural organization within the brain
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