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Updated: Jul 15, 2026
A Multimodal Imaging- and Stimulation-based Method of Evaluating Connectivity-related Brain Excitability in Patients with Epilepsy
Published on: November 13, 2016
The association of MRI findings and neuropsychological functioning after the first recognized seizure
Anna W Byars1, Ton J deGrauw, Cynthia S Johnson
1Division of Neurology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Insights
Children with brain abnormalities after their first seizure showed lower cognitive function across all areas. This included language, processing speed, executive function, and memory, even in those with normal intelligence.
Area of Science:
- Pediatric Neurology
- Neuroimaging
- Neuropsychology
Background:
- Epilepsy in children can impact cognitive development.
- Understanding the relationship between brain structure and function is crucial for early intervention.
Purpose of the Study:
- To investigate the association between brain MRI abnormalities and neuropsychological outcomes in children experiencing their first recognized seizure.
- To determine if structural brain changes correlate with specific cognitive deficits.
Main Methods:
- A cohort of 249 children (aged 6-14) with a first seizure underwent neuropsychological testing and brain MRI.
- Neuropsychological function was assessed using factor analysis, identifying domains such as Language, Processing Speed, Executive/Construction, and Verbal Memory.
- MRI findings were categorized as significant (potentially seizure-related) or not.
Main Results:
- 14% of children had significant MRI abnormalities linked to their seizures.
- Children with significant abnormalities exhibited lower overall IQ scores.
- These children also showed deficits in language, processing speed, executive/constructional abilities, and verbal memory and learning.
Conclusions:
- Structural brain abnormalities at the onset of seizures in children are associated with broadly lower cognitive functioning.
- All assessed neuropsychological domains appear to be affected similarly.
- This cognitive impact is observable even in children with intellectual functioning within the normal range.
Purpose:
To explore relationships between MRI abnormalities of the brain and neuropsychological functioning in children who were evaluated following their first recognized seizure.
Methods:
Subjects were children aged 6 to 14 years with a first recognized seizure within the past 3 months who participated in a larger prospective study of child adaptation. The 249 children with neuropsychological testing and neuroimaging were studied. Children underwent neuropsychological examination an average of 2.8 months and MRI examination an average of 1.3 months after the first recognized seizure. On factor analysis four factors were found for neuropsychological function: LANG = Language, PS = Processing Speed, EC = Executive/ Construction, VMEM = Verbal Memory and Learning. For analysis, structural abnormalities found on MRI were classified as significant (yes/no) based on whether they were presumed to be related to the seizure condition.
Results:
On MRI, 34 (14%) had structural abnormalities that were judged to be significant in that they were possibly related to their seizures. Children with significant abnormalities had significantly lower estimated IQ scores and significantly lower language, processing speed, executive/constructional ability, and verbal memory and learning factor scores than did children without significant abnormalities.
Conclusions:
Children who have structural brain abnormalities at onset have slightly lower cognitive functioning overall, and all neuropsychological domains seemed to be affected relatively equally. This pattern was apparent even when we restricted the analysis to children with intellectual functioning in the broadly normal range.
Related Concept Videos
01:13Seizures: Classification
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types:
01:20Seizures l: Introduction