Thalamic volumetric analysis in Developmental and/or Epileptic Encephalopathy with Spike Wave Activation in Sleep
Gautam Kamila1, Prashant Jauhari1, Atin Kumar2
1Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
Insights
Children with Developmental and/or Epileptic Encephalopathy with Spike-Wave Activation in Sleep (D/EE-SWAS) show reduced thalamic volume (TV). This finding holds true for both structural and genetic D/EE-SWAS, indicating a widespread impact on brain development.
Area of Science:
- Neuroscience
- Pediatric Neurology
- Medical Imaging
Background:
- Developmental and/or Epileptic Encephalopathy with Spike-Wave Activation in Sleep (D/EE-SWAS) is a severe neurological condition in children.
- The thalamus plays a crucial role in cognitive and sensory processing, and its development can be affected in various encephalopathies.
Purpose of the Study:
- To compare the thalamic volume (TV) in children diagnosed with D/EE-SWAS against age-matched children with well-controlled epilepsy (WCE).
- To investigate potential differences in thalamic volume between D/EE-SWAS and WCE groups using advanced neuroimaging techniques.
Main Methods:
- Cross-sectional study involving children aged 5-12 years.
- Quantitative volumetric analysis of T1-weighted brain MRI sequences using 'volBrain' software to determine absolute and relative thalamic volume (ATV/RTV).
- Comparison between D/EE-SWAS (n=20) and WCE (n=20) groups, including subgroups with structural lesions and presumed genetic etiology in the D/EE-SWAS cohort.
Main Results:
- Children with D/EE-SWAS exhibited significantly reduced mean absolute thalamic volume (ATV) and relative thalamic volume (RTV) compared to the WCE group (p < 0.0001 for both).
- Reduced ATV was detected in 60% of D/EE-SWAS participants, whereas visual inspection identified thalamic involvement in only 30%.
- Thalamic volume reduction was significant in both structural (n=16) and presumed genetic (n=4) D/EE-SWAS subgroups.
Conclusions:
- A majority of children with D/EE-SWAS, irrespective of etiology (structural or genetic), demonstrate reduced thalamic volume.
- Quantitative MRI volumetric analysis is a sensitive method for detecting thalamic abnormalities in D/EE-SWAS.
- These findings highlight the thalamus as a potential key area affected in D/EE-SWAS.
Objectives:
This cross-sectional study compared the thalamic volume (TV) of children with Developmental and/or Epileptic Encephalopathy with Spike-Wave Activation in Sleep (D/EE-SWAS) with age matched children with well-controlled epilepsy(WCE).
Methods:
An unaided eye assessment of T1-weighted brain MRI sequences and quantitative volumetric analysis through "volBrain" online software was performed in children (5-12 years) with steroid-naïve D/EE-SWAS {spike-wave-index(SWI) in sleep≥50 %} and typically developing children with WCE (seizure-free period ≥1-year). The absolute and relative thalamic volume (ATV/RTV) (RTV: thalamic volume as percentage of the total intracranial volume), were compared between the two groups.
Results:
Twenty-children each with D/EE-SWAS (14 boys; mean age: 8.05±1.76 years) and WCE (15 boys; mean age: 9.1 ± 1.74 years) were analysed. In the D/EE-SWAS group, (16/20) 80% of participants had a structural lesion while all the children in the WCE group had a presumed genetic etiology. Volumetric analysis detected low ATV (<2 standard deviation) in 12/20 (60 %) children with D/EE-SWAS while unaided eye assessment could pick up thalamic involvement only in six (30 %). On comparison with WCE group (N = 20), mean ATV and RTV in structural D/EE-SWAS (n = 16) [(7.25 cm3 ± 1.66 versus 11.17 cm3 ± 1.22; p < 0.0001)(0.73 % ± 0.17 versus 0.87 % ± 0.05; p < 0.001)] and presumed genetic D/EE-SWAS (n = 4) [(9.25 cm3 ± 0.55, versus 11.17 cm3 ± 1.22, p < 0.01)(0.74 % ± 0.04 versus 0.87 % ± 0.05; p < 0.0001)] were significantly reduced. ATV did not correlate with SWI in sleep EEG (r =-0.25) in D/EE-SWAS.
Conclusion:
Thalamic volume is reduced in majority of children with D/EE-SWAS in both structural and presumed genetic etiology.
More Related Videos
10:22Interictal High Frequency Oscillations Detected with Simultaneous Magnetoencephalography and Electroencephalography as Biomarker of Pediatric Epilepsy
Published on: December 6, 2016
09:32Network Analysis of Foramen Ovale Electrode Recordings in Drug-resistant Temporal Lobe Epilepsy Patients
Published on: December 18, 2016
