Cognitive impairment and cortical reorganization in children with benign epilepsy with centrotemporal spikes
Cognitive impairment and cortical reorganization in children with benign epilepsy with centrotemporal spikes
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DOI：
10.1111/epi.12067
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发表时间：
2013-03-01
期刊：
影响因子：
5.6
通讯作者：
Penner, Iris-Katharina
中科院分区：
文献类型：
--
作者：
Datta, Alexandre N.;Oser, Nadine;Penner, Iris-Katharina
目的：良性中央颞区棘波癫痫（BECTS）伴有轻度认知功能障碍，尤其是语言功能障碍。本研究旨在阐明与健康对照组相比，具有左右半球或双侧焦点的BECTS儿童是否具有特定的神经心理语言缺陷，这些缺陷是否与语言网络组织（典型与非典型）功能相关，以及辅助因素（如持续时间，惯用手和药物）是否对语言重组过程有相关影响。方法对27例患者和19例健康对照者进行神经心理学测试（韦氏儿童智力量表（WISC-IV）、Regensburger语言流畅性测试（RWT）、Corsiblock前后和手支配测试（HDT））和功能磁共振成像（fMRI）两种语言范式：词对无声阅读和简单句无声生成。主要结果虽然神经心理学测试结果只有不同的BECTS患者和对照组之间的趋势，语言偏侧指数（LI）在功能磁共振成像显着低于患者比对照组。特别是，与布罗卡区和辅助运动区（SMA）的前语言网络显示最低的LI和最双边或右半球激活的句子生成任务。药物和癫痫持续时间对语言重组和患者的表现没有任何显着影响。BECTS患者的语言重组发生在双侧或右半球的语言网络中，主要集中在前语言区域。这些功能变化可以解释为中枢神经系统（CNS）稳定认知，特别是语言表现的重要代偿策略。
Purpose Benign epilepsy with centrotemporal spikes (BECTS) is associated with mild cognitive deficits, especially language impairment. This study aimed to clarify whether children with BECTS with left- or right-hemispheric, or bilateral focus have specific neuropsychological language deficits when compared to healthy controls, whether these deficits correlate functionally with language network organization (typical vs. atypical), and whether cofactors such as duration, handedness, and medication have a relevant impact on language reorganization processes. Methods Twenty-seven patients and 19 healthy controls were examined with several neuropsychological tests (German version of the Wechsler Intelligence Scale for Children [WISC-IV], Regensburger verbal fluency test [RWT], Corsiblock forward and backward and Hand-Dominanz-Test [HDT]) and with two language paradigms on functional magnetic resonance imaging (fMRI): silent reading of word-pairs and silent generation of simple sentences. Key Findings Although neuropsychological test results only differed by trend between BECTS patients and controls, language laterality indices (LIs) in fMRI were significantly lower in patients than in controls. In particular, the anterior language network with Broca's area and the supplementary motor area (SMA) revealed the lowest LIs and showed the most bilateral or right hemispheric activations in the sentence generation task. Medication and duration of epilepsy did not have any significant effect on language reorganization and patients' performances. Significance Language reorganization in BECTS patients takes place in bilateral or right hemispheric language networks, with a strong focus in anterior language regions. These functional changes can be interpreted as important compensatory strategies of the central nervous system (CNS) to stabilize cognitive, especially language performance.