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Children with epilepsy demonstrate macro- and microstructural changes in the thalamus, putamen, and amygdala

  • Paediatric Neuroradiology
  • Published:
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Abstract

Purpose

Despite evidence for macrostructural alteration in epilepsy patients later in life, little is known about the underlying pathological or compensatory mechanisms at younger ages causing these alterations. The aim of this work was to investigate the impact of pediatric epilepsy on the central nervous system, including gray matter volume, cerebral blood flow, and water diffusion, compared with neurologically normal children.

Methods

Inter-ictal magnetic resonance imaging data was obtained from 30 children with epilepsy ages 1–16 (73% F, 27% M). An atlas-based approach was used to determine values for volume, cerebral blood flow, and apparent diffusion coefficient in the cerebral cortex, hippocampus, thalamus, caudate, putamen, globus pallidus, amygdala, and nucleus accumbens. These values were then compared with previously published values from 100 neurologically normal children using a MANCOVA analysis.

Results

Most brain volumes of children with epilepsy followed a pattern similar to typically developing children, except for significantly larger putamen and amygdala. Cerebral blood flow was also comparable between the groups, except for the putamen, which demonstrated decreased blood flow in children with epilepsy. Diffusion (apparent diffusion coefficient) showed a trend towards higher values in children with epilepsy, with significantly elevated diffusion within the thalamus in children with epilepsy compared with neurologically normal children.

Conclusion

Children with epilepsy show statistically significant differences in volume, diffusion, and cerebral blood flow within their thalamus, putamen, and amygdala, suggesting that epilepsy is associated with structural changes of the central nervous system influencing brain development and potentially leading to poorer neurocognitive outcomes.

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Funding

NDF is supported by the Canada Research Chairs program.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

    Sarah J. MacEachern

  2. Division of Neurology, Childrens Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

    Jonathan D. Santoro

  3. Department of Neurology, Division of Child Neurology, Stanford University, Stanford, CA, USA

    Kara J. Hahn

  4. Department of Neurosurgery, Stanford University, Stanford, CA, USA

    Zachary A. Medress & Jin S. Hahn

  5. Radiology Department, Universidad del Desarrollo, Santiago, Chile

    Ximena Stecher

  6. Radiology Department, Clinica Alemana de Santiago, Santiago, Chile

    Ximena Stecher

  7. Department of Radiology, Massachusetts General Hospital, Boston, MA, USA

    Matthew D. Li

  8. Department of Radiology, Lucile Packard Children’s Hospital, Stanford University, Palo Alto, CA, USA

    Kristen W. Yeom

  9. Department of Radiology, Cumming School of Medicine, Universityof Calgary, Calgary, AB, Canada

    Nils D. Forkert

  10. Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada

    Nils D. Forkert

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  1. Sarah J. MacEachern
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Correspondence to Nils D. Forkert.

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MacEachern, S.J., Santoro, J.D., Hahn, K.J. et al. Children with epilepsy demonstrate macro- and microstructural changes in the thalamus, putamen, and amygdala. Neuroradiology 62, 389–397 (2020). https://doi.org/10.1007/s00234-019-02332-8

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  • DOI: https://doi.org/10.1007/s00234-019-02332-8

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