Activation Map Reveals Language Impairment in Children with Benign Epilepsy with Centrotemporal Spikes (BECTS)

Tong Mo; Wenxian Huang; Weisheng Sun; Yan Hu; Leroy Mcdonald; Zhanqi Hu; Li Chen; Jianxiang Liao; Bruce Hermann; Vivek Prabhakaran; Hongwu Zeng

doi:10.2147/NDT.S419840

Activation Map Reveals Language Impairment in Children with Benign Epilepsy with Centrotemporal Spikes (BECTS)

Neuropsychiatr Dis Treat. 2023 Sep 13:19:1949-1957. doi: 10.2147/NDT.S419840. eCollection 2023.

Authors

Tong Mo^#¹, Wenxian Huang^#², Weisheng Sun¹, Yan Hu³, Leroy Mcdonald⁴, Zhanqi Hu³, Li Chen³, Jianxiang Liao³, Bruce Hermann⁵, Vivek Prabhakaran^{4

5

6}, Hongwu Zeng^{1

6}

Affiliations

¹ Department of Radiology, Shenzhen Children's Hospital, Shenzhen, Guangdong, People's Republic of China.
² Department of Pediatrics, Shenzhen Children's Hospital, Shenzhen, Guangdong, People's Republic of China.
³ Department of Neurology, Shenzhen Children's Hospital, Shenzhen, Guangdong, People's Republic of China.
⁴ Neurosciences Training Program, University of Wisconsin, Madison, WI, USA.
⁵ Department of Neurology, University of Wisconsin, Madison, WI, USA.
⁶ Department of Radiology, University of Wisconsin, Madison, WI, USA.

^# Contributed equally.

Abstract

Objective: Neuropsychological evidence revealed language impairment in children with benign epilepsy with centrotemporal spikes (BECTS). This study investigates language function using task-activated fMRI.

Methods: We conducted a language task fMRI study on three groups on a 3.0T MRI scanner, including a new onset drug naïve group (NODN-BECTS, n=11, age=9.6±1.6), an established epilepsy with medication-treated group (Med-BECTS, n=17, age=10.7±2.2) and a healthy control group (HC, n=18, age=10.8±1.7). We use MATLAB14 and SPM12 to pre-process and analyze the data. A one-sample t-test was used to identify task-related brain activation changes in each group, based on the general linear model (GLM). And, then two sample t-test was performed to compare different activated regions between groups. In addition, scores on the most recent Mandarin school exams were acquired to examine and contrast extra-scanner language performance.

Results: Statistical results show that some language-related brain regions (such as the left superior frontal gyrus and cerebellar vermis) were additionally activated in the NODN-BECTS group compared with the HC group. Compared with NODN-BECTS and HC groups, decreased activations were found in language-related regions in the Med-BECTS group, including the left insula, superior and middle frontal gyri, and bilateral middle occipital gyri. On the Mandarin school exams, the average score for HC was 87.3±8.2, NODN was 84.8±7.8, and Med was 78.2±13.2. There was a trend toward statistical significance between the Med and the HC (p = 0.074) as well as NODN (p = 0.092) groups. No statistically significant differences were found between the HC and the NODN-BECTS groups.

Significance: Language task fMRI reveals additional areas of activation in new onset BECTS compared to healthy controls which may be compensatory in nature. Antiseizure medications (ASMs) and/or longer duration of BECTS additionally appears to affect language-related regions and reduce their functional ability.

Keywords: benign epilepsy with centrotemporal spikes; cognition; functional magnetic resonance imaging; language impairment.

Grants and funding

This project was supported by RSNA Seed Grant (No. RSD1214), Sanming Project of Medicine in Shenzhen (No. SZSM202011005), Sciences and Technology Project of Shenzhen (No. JCYJ20220530155805012), Natural Science Foundation of Guangdong Province (No. 2022A1515011427), Guangdong High-level Hospital Construction Fund (ynkt2021-zz47).