Evaluation of Thalamic Volume in Patients Diagnosed with BECTS and ESES Using the MRI-Cloud Method

Benign epilepsy with centrotemporal spikes (BECTS) is a common form of epilepsy in childhood. In some patients with BECTS, electrical status epilepticus in sleep (ESES) may develop, and ESES can also be present in children with different types of structural brain lesions. In children with BECTS and ESES, where conventional magnetic resonance imaging (MRI) findings are normal, the results of microstructural examinations of the thalamus may differ.

The main aim of this study was to investigate brain anatomical differences in patients with BECTS using MRI-Cloud, a more objective and quantitative evaluation method, which has been done for the first time in the literature.

We included 27 patients with BECTS and 27 healthy controls in this study. We analyzed subcortical gray matter volumes of patients diagnosed with BECTS for the first time via the "MRI-Cloud" method. Limitations of our study were the small sample size.

Total relative thalamic volume was significantly lower in patients with ESES than in healthy controls (P < 0.001), and the total relative thalamic volume was significantly lower in patients with ESES than in patients with BECTS without ESES (P < 0.001). Thalamic volumes were reduced in the ESES group compared to the control group, with both right and left thalami showing significantly lower volumes (P < 0.001). In addition, patients with ESES had markedly smaller thalamic volumes than those with BECTS and without ESES (right and left thalami, P < 0.001).

In this study, we emphasize the contribution of volume analysis and the MRI-Cloud method in detecting microstructural changes at the thalamic level in patients with ESES even when conventional MRI findings are normal.