Resting state signal latency predicts laterality in pediatric medically refractory temporal lobe epilepsy
- 76 Downloads
Temporal lobe epilepsy (TLE) affects resting state brain networks in adults. This study aims to correlate resting state functional MRI (rsMRI) signal latency in pediatric TLE patients with their laterality.
From 2006 to 2016, 26 surgical TLE patients (12 left, 14 right) with a mean age of 10.7 years (range 0.9–18) were prospectively studied. Preoperative rsMRI was obtained in patients with concordant lateralizing structural MRI, EEG, and PET studies. Standard preprocessing techniques and seed-based rsMRI analyses were performed. Additionally, the latency in rsMRI signal between each 6 mm voxel sampled was examined, compared to the global mean signal, and projected onto standard atlas space for individuals and the cohort.
All but one of the 26 patients improved seizure frequency postoperatively with a mean follow-up of 2.9 years (range 0–7.7), with 21 patients seizure-free. When grouped for epileptogenic laterality, the latency map qualitatively demonstrated that the right TLE patients had a relatively early signal pattern, whereas the left TLE patients had a relatively late signal pattern compared to the global mean signal in the right temporal lobe. Quantitatively, the two groups had significantly different signal latency clusters in the bilateral temporal lobes (p < 0.001).
There are functional MR signal latency changes in medical refractory pediatric TLE patients. Qualitatively, signal latency in the right temporal lobe precedes the mean signal in right TLE patients and is delayed in left TLE patients. With larger confirmatory studies, preoperative rsMRI latency analysis may offer an inexpensive, noninvasive adjunct modality to lateralize pediatric TLE.
KeywordsDefault mode network Functional magnetic resonance imaging Pediatric epilepsy Resting state Temporal lobe epilepsy
Compliance with ethical standards
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.
Informed consent was obtained from all study participants.
- 2.Mohamed A, Wyllie E, Ruggieri P, Kotagal P, Babb T, Hilbig A, Wylie C, Ying Z, Staugaitis S, Najm I, Bulacio J, Foldvary N, Luders H, Bingaman W (2001) Temporal lobe epilepsy due to hippocampal sclerosis in pediatric candidates for epilepsy surgery. Neurology 56:1643–1649CrossRefPubMedGoogle Scholar
- 3.Smyth MD, Limbrick DD Jr, Ojemann JG, Zempel J, Robinson S, O'Brien DF, Saneto RP, Goyal M, Appleton RE, Mangano FT, Park TS (2007) Outcome following surgery for temporal lobe epilepsy with hippocampal involvement in preadolescent children: emphasis on mesial temporal sclerosis. J Neurosurg 106:205–210PubMedGoogle Scholar
- 5.Cross JH, Jayakar P, Nordli D, Delalande O, Duchowny M, Wieser HG, Guerrini R, Mathern GW, International League against Epilepsy SfPES, Commissions of N, Paediatrics (2006) Proposed criteria for referral and evaluation of children for epilepsy surgery: recommendations of the Subcommission for Pediatric Epilepsy Surgery. Epilepsia 47:952–959CrossRefPubMedGoogle Scholar
- 6.Boshuisen K, van Schooneveld MM, Uiterwaal CS, Cross JH, Harrison S, Polster T, Daehn M, Djimjadi S, Yalnizoglu D, Turanli G, Sassen R, Hoppe C, Kuczaty S, Barba C, Kahane P, Schubert-Bast S, Reuner G, Bast T, Strobl K, Mayer H, de Saint-Martin A, Seegmuller C, Laurent A, Arzimanoglou A, Braun KP, TimeToStop cognitive outcome study group (2015) Intelligence quotient improves after antiepileptic drug withdrawal following pediatric epilepsy surgery. Ann Neurol 78:104–114CrossRefPubMedGoogle Scholar
- 28.Bettus G, Guedj E, Joyeux F, Confort-Gouny S, Soulier E, Laguitton V, Cozzone PJ, Chauvel P, Ranjeva JP, Bartolomei F, Guye M (2009) Decreased basal fMRI functional connectivity in epileptogenic networks and contralateral compensatory mechanisms. Hum Brain Mapp 30:1580–1591CrossRefPubMedGoogle Scholar
- 32.Mitra A, Snyder AZ, Constantino JN, Raichle ME (2015) The lag structure of intrinsic activity is focally altered in high functioning adults with autism. Cereb CortexGoogle Scholar
- 37.Buckner RL, Head D, Parker J, Fotenos AF, Marcus D, Morris JC, Snyder AZ (2004) A unified approach for morphometric and functional data analysis in young, old, and demented adults using automated atlas-based head size normalization: reliability and validation against manual measurement of total intracranial volume. NeuroImage 23:724–738CrossRefPubMedGoogle Scholar
- 45.Arya R, Tenney JR, Horn PS, Greiner HM, Holland KD, Leach JL, Gelfand MJ, Rozhkov L, Fujiwara H, Rose DF, Franz DN, Mangano FT (2015) Long-term outcomes of resective epilepsy surgery after invasive presurgical evaluation in children with tuberous sclerosis complex and bilateral multiple lesions. J Neurosurg Pediatr 15:26–33CrossRefPubMedGoogle Scholar
- 55.Osipowicz K, Sperling MR, Sharan AD, Tracy JI (2015) Functional MRI, resting state fMRI, and DTI for predicting verbal fluency outcome following resective surgery for temporal lobe epilepsy. J Neurosurg 1–9Google Scholar