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Published on: January 2, 2012
Distinct changes of brain cortical thickness relate to post-treatment outcomes in children with epilepsy
Wenjing Zhang1, Tao Yu2, Yi Liao3
1Department of Radiology, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, National Key Laboratory of Biotherapy, West China Second University Hospital, Sichuan University, Chengdu 610041, China; Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China.
Insights
Neuroanatomic measures identified two pediatric epilepsy subgroups with differing seizure recurrence risks. Cortical thinning in temporal regions may indicate a lower risk of recurrent seizures in children with epilepsy.
Area of Science:
- Pediatric Neurology
- Neuroimaging
- Epilepsy Research
Background:
- Epilepsy affects children, and understanding subgroups is crucial for treatment.
- Neuroanatomic differences may underlie varied clinical outcomes in pediatric epilepsy.
Purpose of the Study:
- To investigate if neuroanatomic measures can identify distinct subgroups of children with epilepsy.
- To determine the clinical relevance of these subgroups to post-treatment outcomes.
Main Methods:
- Seventy-two children with epilepsy and 39 healthy controls underwent high-resolution T1-weighted MRI.
- Cortical thickness was measured in 68 regions; data-driven cluster analysis identified patient subgroups.
- Subgroup differences in cortical thickness were compared to healthy controls.
Main Results:
- Two epilepsy subgroups emerged, unrelated to clinical type, but differing in seizure recurrence rates (41.1% vs. 14.3%).
- Subgroup 1 showed increased neocortical thickness; Subgroup 2 exhibited regional thinning in the right superior temporal gyrus compared to controls.
- No significant differences were found in demographics, EEG abnormalities, or sleep issues between subgroups.
Conclusions:
- Distinct subgroups of children with epilepsy exist, characterized by neuroanatomic patterns.
- Regional cortical thinning, particularly in temporal areas, may predict a lower risk of recurrent seizures.
Purpose:
In the current study, we examined the potential of neuroanatomic measures to cluster patients into different subgroups and established their clinical relevance to post-treatment outcomes.
Methods:
We included seventy-two children with epilepsy (aged 14-195 months) who were treated with anti-seizure medication alone and 39 healthy participants (aged 36-60 months). High-resolution T1-weighted imaging was performed for all participants, and brain cortical thickness measurements were obtained for 68 cortical regions for each of them. Amongst the patients, data-driven hierarchical cluster analysis was performed using the selected cortical thickness measures as features. The average thickness measures in each of the 68 brain regions were then compared between patient subgroups and healthy controls.
Results:
Two distinct patient subgroups were identified but were not related to the clinical types. Patients within subgroup 1 (n = 56) had a significantly higher rate of recurrent seizure than those in subgroup 2 (n = 16) (41.1% vs. 14.3%, p<0.05), while the follow-up time or medication did not differ between them. This finding was further confirmed by a recent follow-up through phone calls. The demographic variables, rate of electroencephalogram abnormalities, or sleep problems did not significantly differ between patient subgroups. Compared with healthy controls, patients in subgroup 1 showed significantly increased cortical thickness in the neocortex, whereas patients in subgroup 2 only showed regional cortical thinning in the right superior temporal gyrus.
Conclusion:
These findings suggest the potential existence of distinct subgroups of children with epilepsy that were especially relevant to the differential patterns of post-treatment outcomes, with regional cortical thinning in the temporal regions relative to controls predicting lower risk of recurrent seizure.
