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Network Analysis of the Default Mode Network Using Functional Connectivity MRI in Temporal Lobe Epilepsy
Published on: August 5, 2014
FMRI activation during paragraph reading in pediatric epilepsy
Gabrielle L Sarlo1, Chloe A Hooker1, Kelly T Macdonald1
1Center for Neuroscience, Children's National Research Institute, Children's National Hospital, Washington, DC, United States.
Insights
Brain scans show similar reading network activation in children with and without epilepsy, despite performance differences. Struggling readers with epilepsy had less activation in key brain areas.
Area of Science:
- Neuroscience
- Developmental Psychology
- Pediatric Neurology
Background:
- Epilepsy in children can impact cognitive functions, including reading abilities.
- Understanding brain activation during reading is crucial for identifying potential learning challenges.
- Functional magnetic resonance imaging (fMRI) offers insights into neural networks involved in reading.
Purpose of the Study:
- To compare brain activation patterns during paragraph reading between children with and without epilepsy.
- To investigate the relationship between brain activation and neuropsychological performance in these groups.
- To explore activation differences in a subset of struggling readers with epilepsy.
Main Methods:
- 41 children with focal epilepsy and 41 healthy controls (mean age ~10 years) underwent fMRI during a paragraph reading task.
- Participants completed a comprehensive neuropsychological battery.
- Group comparisons of brain activation and correlational analyses with performance data were conducted.
Main Results:
- No significant differences in overall brain activation during reading were found between children with and without epilepsy.
- Better reading performance (sight words, fluency, comprehension) correlated with left superior temporal gyrus activation.
- Struggling readers with epilepsy showed reduced activation in specific areas (temporal gyrus, cerebellum, frontal gyrus) compared to controls and non-struggling epilepsy readers.
Conclusions:
- The reading network's activation is largely similar in children with and without epilepsy, despite cognitive differences.
- Reduced activation in specific brain regions is associated with poorer reading performance in children with epilepsy.
- fMRI paragraph reading tasks are robust for identifying language networks, even in pediatric epilepsy populations, and for presurgical mapping.
Objective:
This study examined brain activation differences during paragraph reading between children with and without epilepsy and if findings were related to neuropsychological performance. Exploratory analyses assessed activation in a subset of struggling readers.
Methods:
The study included 41 children with focal epilepsy (M = 10.5 years, 2.2) and 41 healthy controls with a similar mean age (M = 10 years, 1.7) who completed a neuropsychological battery and a functional magnetic resonance imaging (fMRI) paragraph reading task. Analyses included group comparisons of activation, including exploratory analyses with a subset of struggling readers with epilepsy. Correlational analyses examined relationships between activation and neuropsychological performance.
Results:
Despite significant differences in neuropsychological performance, there were no group differences in activation on reading fMRI between children with and without epilepsy. Across the combined sample, better sight word reading, reading fluency, and reading comprehension were positively correlated with activation of the left superior temporal gyrus. A subset analysis comparing healthy controls and non-struggling epilepsy readers to struggling epilepsy readers (SS < 85) showed more activation in the control groups compared to the struggling readers in focused areas including bilateral temporal gyrus, left cerebellum, and right inferior frontal gyrus. The subset of struggling readers was more likely than the non-struggling patient group to have frequent seizures and their seizure focus ipsilateral to their language dominance.
Significance:
Despite worse neuropsychological performance, the reading network was similarly activated in children with and without epilepsy. Relative to the broader functional network for reading, small, focused areas-particularly in the superior temporal lobe-were associated with less activation for those who had worse reading performance. Use of an fMRI paragraph reading task matched to a child's level show no to small differences related to epilepsy or reading performance which suggests its robustness as a task when the goal is to identify the language network such as for presurgical mapping.
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