Brain Structure and Organization Five Decades After Childhood Onset Epilepsy

A1 Journal article (refereed)


Internal Authors/Editors


Publication Details

List of Authors: Camille Garcia-Ramos, Sam Bobholz, Kevin Dabbs, Bruce Hermann, Juho Joutsa, Juha O. Rinne, Mira Karrasch, Vivek Prabhakaran, Shlomo Shinnar, Matti Sillanpaa
Publisher: Wiley
Publication year: 2017
Journal: Human Brain Mapping
Journal acronym: Hum Brain Mapp
Volume number: 38
Issue number: 6
Start page: 3289
End page: 3299
Number of pages: 11
ISSN: 1065-9471


Abstract

The purpose of this project was to characterize brain structure and organization in persons with active and remitted childhood onset epilepsy 50 years after diagnosis compared with healthy controls. Participants from a population-based investigation of uncomplicated childhood onset epilepsy were followed up 5 decades later. Forty-one participants had a history of childhood onset epilepsy (mean age of onset=5.2 years, current chronological age=56.0 years) and were compared with 48 population-based controls (mean age=55.9 years). Of the epilepsy participants, 8 had persisting active epilepsy and in 33 the epilepsy had remitted. All participants underwent 3T MRI with subsequent vertex analysis of cortical volume, thickness, surface area and gyral complexity. In addition, cortical and subcortical volumes, including regions of the frontal, parietal, temporal, and occipital lobes, and subcortical structures including amygdala, thalamus, and hippocampus, were analyzed using graph theory techniques. There were modest group differences in traditional vertex-based analyses of cortical volume, thickness, surface area and gyral index, as well as across volumes of subcortical structures, after correction for multiple comparisons. Graph theory analyses revealed suboptimal topological structural organization with enhanced network segregation and reduced global integration in the epilepsy participants compared with controls, these patterns significantly more extreme in the active epilepsy group. Furthermore, both groups with epilepsy presented a greater number of higher Z-score regions in betweenness centrality (BC) than lower Z-score regions compared with controls. Also, contrary to the group with remitted epilepsy, patients with active epilepsy presented most of their high BC Z-score regions in subcortical areas including the amygdala, thalamus, hippocampus, pallidum, and accumbens. Overall, this population-based investigation of long term outcome (5 decades) of childhood onset epilepsy reveals persisting abnormalities, especially when examined by graph theoretical measurements, and provides new insights into the very long-term outcomes of active and remitted epilepsy. (C) 2017 Wiley Periodicals, Inc.


Keywords

brain development, MRI

Last updated on 2019-18-08 at 06:10