Children with Rolandic epilepsy have micro- and macrostructural abnormalities in white matter constituting networks necessary for language function

• Published in: Epilepsy & behavior 2023-07, Vol.144, p.109254-109254, Article 109254
• Main Authors: Ostrowski, Lauren M., Chinappen, Dhinakaran M., Stoyell, Sally M., Song, Daniel Y., Ross, Erin E., Kramer, Mark A., Emerton, Britt C., Chu, Catherine J.
• Format: Article
• Language: English
• Subjects: Anisotropy; Child; Diffusion Tensor Imaging; DTI; Epilepsy, Rolandic - diagnostic imaging; Humans; Language; Magnetic Resonance Imaging; Rolandic epilepsy; Self-limited epilepsy with centrotemporal spikes; Speech; Tractography; White Matter - diagnostic imaging
• ISSN: 1525-5050; 1525-5069; 1525-5069
• DOI: 10.1016/j.yebeh.2023.109254

•Children with SeLECTS show reduced performance on language assessments.•Language assessment scores are worse in children with active SeLECTS than those in children in remission.•White matter micro- and macrostructure are abnormal in regions constituting language networks in SeLECTS.•Connectivity between language network nodes is abnormal in SeLECTS. Self-limited epilepsy with centrotemporal spikes is a transient developmental epilepsy with a seizure onset zone localized to the centrotemporal cortex that commonly impacts aspects of language function. To better understand the relationship between these anatomical findings and symptoms, we characterized the language profile and white matter microstructural and macrostructural features in a cohort of children with SeLECTS. Children with active SeLECTS (n = 13), resolved SeLECTS (n = 12), and controls (n = 17) underwent high-resolution MRIs including diffusion tensor imaging sequences and multiple standardized neuropsychological measures of language function. We identified the superficial white matter abutting the inferior rolandic cortex and superior temporal gyrus using a cortical parcellation atlas and derived the arcuate fasciculus connecting them using probabilistic tractography. We compared white matter microstructural characteristics (axial, radial and mean diffusivity, and fractional anisotropy) between groups in each region, and tested for linear relationships between diffusivity metrics in these regions and language scores on neuropsychological testing. We found significant differences in several language modalities in children with SeLECTS compared to controls. Children with SeLECTS performed worse on assessments of phonological awareness (p = 0.045) and verbal comprehension (p = 0.050). Reduced performance was more pronounced in children with active SeLECTS compared to controls, namely, phonological awareness (p = 0.028), verbal comprehension (p = 0.028), and verbal category fluency (p = 0.031), with trends toward worse performance also observed in verbal letter fluency (p = 0.052), and the expressive one-word picture vocabulary test (p = 0.068). Children with active SeLECTS perform worse than children with SeLECTS in remission on tests of verbal category fluency (p = 0.009), verbal letter fluency (p = 0.006), and the expressive one-word picture vocabulary test (p = 0.045). We also found abnormal superficial white matter microstructure in centrotemporal ROIs in children with SeLECTS, characterized