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, language impairment, functional magnetic resonance imaging