Clinical, Radiologic, and Pathologic Associations of Executive Dysfunction in Children With Focal Cortical...

Area of Science:

• Neuroscience
• Epileptology
• Cognitive Neurology

Background:

• Executive dysfunction (ExD) is a frequent comorbidity in focal epilepsy.
• Focal cortical dysplasia (FCD) is the most common cause of epilepsy in children.
• Understanding the relationship between FCD, brain networks, and ExD is crucial for patient care.

Purpose of the Study:

• To investigate associations between FCD location, pathology, and ExD in children with FCD-related epilepsy.
• To determine if FCD colocalization to specific brain networks (frontoparietal control, attention) is linked to ExD.
• To examine the role of FCD type I pathology in ExD.

Main Methods:

• Retrospective analysis of 93 pediatric patients with FCD and preoperative neuropsychological testing.
• FCD colocalization assessed using the Yeo 7-network atlas.
• ExD measured using the Behavior Rating Inventory of Executive Function (BRIEF) Global Executive Composite (GEC) T-score.

Main Results:

• FCD colocalization to the frontoparietal control network was associated with ExD (OR 3.6, p < 0.05).
• FCD type I pathology was significantly associated with ExD (OR 4.45, p = 0.009) and specific BRIEF subscales.
• No association found between ExD and FCD colocalization to attention networks, lobar location, or age of seizure onset.

Conclusions:

• Lesion-network interactions are critical in the development of ExD in FCD-related epilepsy.
• FCD colocalization to the frontoparietal control network is a key factor in ExD.
• These findings support a network-level structure-function correlation in understanding cognitive deficits in epilepsy.