Salience network hub dysfunction is associated with cognitive impairment in self-limited epilepsy with centrotemporal...

Self-limited epilepsy with centrotemporal spikes (SeLECTS), although characterized by well-controlled seizures, is frequently associated with persistent cognitive deficits in affected children. This study aimed to investigate whether hub dysfunction of the salience network (SN) is associated with cognitive impairment in SeLECTS, using optically pumped magnetometer- magnetoencephalography (OPM-MEG) within the framework of the triple network model (TNM), which encompasses the salience, default mode, and central executive networks (CENs).

This cross-sectional case-control study enrolled 30 children with SeLECTS and 15 matched healthy controls (HC). Data acquisition comprised resting-state OPM-MEG, structural MRI, and the Das-Naglieri Cognitive Assessment System (CAS). Within the framework of the TNM, graph theory was employed to analyze hub function in the SN across multiple frequency bands.

The SeLECTS group exhibited widespread reductions in functional connectivity across the theta, alpha, and beta bands, with the beta band demonstrating the most pronounced decrease. Graph-theoretical analysis revealed that betweenness centrality of the SN was significantly lower in the SeLECTS group and was independently associated with cognitive scores (B = 248.98, 95% CI 57.95-440.02; β = 0.28, p < 0.05). Exploratory mediation analysis suggested that beta-band SN hub function was statistically consistent with an indirect pathway linking disease status and cognitive performance.

This OPM-MEG study suggests that beta-band hub dysfunction of the SN is associated with cognitive impairment in children with SeLECTS. These findings provide hypothesis-generating evidence that altered SN hub topology may contribute to cognitive vulnerability in SeLECTS and may serve as a potential MEG-based biomarker of cognitive risk.

Children with a common childhood epilepsy called self-limited epilepsy with centrotemporal spikes may have learning and attention difficulties even when seizures are well controlled. We used a child-friendly magnetic brain-recording method to study how key brain networks communicate at rest. These children showed weaker network communication, especially in the beta frequency band, and a less central role of the salience network was linked to poorer cognitive performance. These findings may help identify children at greater risk of cognitive difficulties.