Reduced structural connectivity between sensorimotor and language areas in rolandic epilepsy.

Area of Science:

• Neuroscience
• Pediatric Neurology
• Neuroimaging

Background:

• Rolandic epilepsy (RE) is a common childhood epilepsy characterized by centrotemporal spikes.
• RE is increasingly linked to language impairments in affected children.
• The underlying white matter (connectivity) basis for these language deficits remains unclear.

Purpose of the Study:

• To investigate white matter structural connectivity differences in children with RE compared to healthy controls.
• To explore the relationship between white matter integrity and language performance in RE.

Main Methods:

• Diffusion-weighted MRI and tractography were used to reconstruct specific white matter tracts in 23 children with RE and 23 controls (ages 8-14).
• Fractional anisotropy (FA) values, a measure of white matter integrity, were compared between groups.
• Neuropsychological language testing was performed, and correlations between FA values and language performance were analyzed.

Main Results:

• Children with RE exhibited reduced FA in several white matter tracts compared to controls, predominantly in the left hemisphere.
• Significant reductions were observed in tracts connecting to the left inferior frontal gyrus (Broca's area) and supramarginal gyrus (Wernicke's area).
• Lower FA values in specific tracts, including the connection between the postcentral and inferior frontal gyri, correlated with poorer language performance in patients.

Conclusions:

• Rolandic epilepsy is associated with reduced structural connectivity in white matter tracts linked to the rolandic regions.
• These connectivity deficits, particularly in language-dominant left hemisphere areas, may underlie language impairments in RE.
• This study provides the first microstructural white matter evidence linking impaired connectivity to language deficits in Rolandic epilepsy.