Hemispheric lateralization of microstructural white matter abnormalities in children with active benign childhood epilepsy with centrotemporal spikes (BECTS): a preliminary DTI study.

PURPOSE: The deficit of white matter is reported to be involved during the disease progression in patients with benign childhood epilepsy with centrotemporal spikes (BECTS). The aim of this study is to investigate patterns of white matter damage in children with BECTS with left- or right-hemispheric focus by using diffusion tensor imaging (DTI), and its relationship with the cofactors such duration, seizure frequency and handedness.
METHODS: Diffusion tensor imaging (DTI) was performed in twenty-eight children with BECTS and eighteen healthy controls. The data were analyzed using both tract-based spatial statistics (TBSS) and region of interest (ROI) analyses. Correlations were investigated between the fractional anisotropy (FA) values of the identified altered regions and clinical features such as age, age of onset and seizure frequency.
RESULTS: The TBSS analysis revealed that white matter impairment in children with rolandic spikes on the ipsilateral hemisphere was much wider. The FA value was significantly lower in the body of the corpus callosum and forceps minor in BECTS patients with spikes on the ipsilateral hemisphere. The seizure frequency correlated positively with the FA values of body of corpus callosum (CC), bilateral cingulate gyrus and left uncinate fasciculi (UA).
CONCLUSION: The impaired WM integrity in patients with BECTS was greater in patients with spikes on the dominant hemisphere, possibly due to the greater vulnerability of the left hemisphere and excitotoxic effects of seizures.