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Published on: December 18, 2016
Functional network connectivity imprint in febrile seizures
Ullas V Acharya1, Karthik Kulanthaivelu1, Rajanikant Panda1,2
1Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bengaluru, 560029, Karnataka, India.
Insights
Complex febrile seizures (CFS) in children show altered brain connectivity compared to simple febrile seizures (SFS). These changes in functional connectivity are linked to seizure recurrence and duration, impacting the developing brain.
Area of Science:
- Neuroscience
- Pediatric Neurology
- Neuroimaging
Background:
- Complex febrile seizures (CFS) are a subset of pediatric febrile seizures (FS) with potential long-term implications.
- Previous research has explored the prognosis, epileptogenic potential, and neurocognitive outcomes of CFS.
- Understanding the neural underpinnings of CFS is crucial for early diagnosis and intervention.
Purpose of the Study:
- To investigate functional connectivity (FC) differences between children with recent-onset CFS and simple febrile seizures (SFS).
- To correlate these FC differences with clinical characteristics such as seizure recurrence and duration.
- To assess the impact of CFS on brain network topology.
Main Methods:
- Resting-state functional magnetic resonance imaging (rs-fMRI) was used to analyze brain activity in 24 children with recent-onset FS (11 SFS, 13 CFS).
- Functional connectivity was calculated using time series correlation, and network topology was assessed with graph theory.
- Statistical analysis, including FDR correction, was applied to identify significant regional connectivity differences and their correlation with clinical data.
Main Results:
- Children with CFS exhibited increased functional connectivity in the bilateral middle temporal pole (MTP) and bilateral thalami compared to SFS patients.
- Network analysis revealed an inefficient and unbalanced topology in CFS patients, characterized by an increased clustering coefficient and decreased participation coefficient in the basal ganglia and thalamus.
- Seizure recurrence negatively correlated with left thalamus integration and MTP connectivity. Longer seizure duration positively correlated with MTP and left thalamus connectivity to various brain regions.
Conclusions:
- Children with CFS demonstrate distinct alterations in brain functional connectivity and network topology compared to those with SFS.
- These connectivity changes are associated with key clinical variables of febrile seizures, namely recurrence and duration.
- The findings highlight the significant impact of CFS on the developing brain's neural networks, irrespective of the underlying causality.
Abstract:
Complex febrile seizures (CFS), a subset of paediatric febrile seizures (FS), have been studied for their prognosis, epileptogenic potential and neurocognitive outcome. We evaluated their functional connectivity differences with simple febrile seizures (SFS) in children with recent-onset FS. Resting-state fMRI (rs-fMRI) datasets of 24 children with recently diagnosed FS (SFS-n = 11; CFS-n = 13) were analysed. Functional connectivity (FC) was estimated using time series correlation of seed region-to-whole-brain-voxels and network topology was assessed using graph theory measures. Regional connectivity differences were correlated with clinical characteristics (FDR corrected p < 0.05). CFS patients demonstrated increased FC of the bilateral middle temporal pole (MTP), and bilateral thalami when compared to SFS. Network topology study revealed increased clustering coefficient and decreased participation coefficient in basal ganglia and thalamus suggesting an inefficient-unbalanced network topology in patients with CFS. The number of seizure recurrences negatively correlated with the integration of Left Thalamus (r = - 0.58) and FC of Left MTP to 'Right Supplementary Motor and left Precentral' gyrus (r = - 0.53). The FC of Right MTP to Left Amygdala, Putamen, Parahippocampal, and Orbital Frontal Cortex (r = 0.61) and FC of Left Thalamus to left Putamen, Pallidum, Caudate, Thalamus Hippocampus and Insula (r 0.55) showed a positive correlation to the duration of the longest seizure. The findings of the current study report altered connectivity in children with CFS proportional to the seizure recurrence and duration. Regardless of the causal/consequential nature, such observations demonstrate the imprint of these disease-defining variables of febrile seizures on the developing brain.
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