Michael Yoong1, Matthew Hunter2, Jacqueline Stephen3, Alan Quigley4, Jeremy Jones4, Jay Shetty5, Ailsa McLellan5, Mark E Bastin6, Richard F M Chin7. 1. Muir Maxwell Epilepsy Centre, University of Edinburgh, UK; Department of Paediatric Neurology, Royal Hospital for Sick Children, Edinburgh, UK. Electronic address: michael.yoong@ed.ac.uk. 2. Muir Maxwell Epilepsy Centre, University of Edinburgh, UK. 3. Edinburgh Clinical Trials Unit, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, UK. 4. Department of Radiology, Royal Hospital for Sick Children, Edinburgh, UK. 5. Department of Paediatric Neurology, Royal Hospital for Sick Children, Edinburgh, UK. 6. Muir Maxwell Epilepsy Centre, University of Edinburgh, UK; Brain Research Imaging Centre, University of Edinburgh, UK. 7. Muir Maxwell Epilepsy Centre, University of Edinburgh, UK; Department of Paediatric Neurology, Royal Hospital for Sick Children, Edinburgh, UK.
Abstract
OBJECTIVE: The objective of this study was to investigate whether reduction of thalamic volumes in children with early onset epilepsy (CWEOE) is associated with cognitive impairment. METHODS: This is a nested case-control study including a prospectively recruited cohort of 76 children with newly-diagnosed early onset epilepsy (onset <5years age) and 14 healthy controls presenting to hospitals within NHS Lothian and Fife. Quantitative volumetric analysis of subcortical structures was performed using volumetric T1-weighted magnetic resonance imaging (MRI) and correlated with the results of formal neurocognitive and clinical assessment. False discovery rate was used to correct for multiple comparisons as appropriate with q<0.05 used to define statistical significance. RESULTS: Age, gender, and intracranial volume (ICV)-adjusted left thalamic volumes were significantly reduced in CWEOE with cognitive impairment compared to CWEOE without impairment (5295mm3 vs 6418mm3, q=0.008) or healthy controls (5295mm3 vs 6410mm3, q<0.001). The differences in left thalamic volume remained if gray matter or cortical/cerebellar volumes were used as covariates rather than ICV (q<0.05). The degree of volume reduction correlated with the severity of cognitive impairment (q=0.048). SIGNIFICANCE: Reduced left thalamic volume may be a biomarker for cognitive impairment in CWEOE and could help inform the need for further formal cognitive evaluations and interventions.
OBJECTIVE: The objective of this study was to investigate whether reduction of thalamic volumes in children with early onset epilepsy (CWEOE) is associated with cognitive impairment. METHODS: This is a nested case-control study including a prospectively recruited cohort of 76 children with newly-diagnosed early onset epilepsy (onset <5years age) and 14 healthy controls presenting to hospitals within NHS Lothian and Fife. Quantitative volumetric analysis of subcortical structures was performed using volumetric T1-weighted magnetic resonance imaging (MRI) and correlated with the results of formal neurocognitive and clinical assessment. False discovery rate was used to correct for multiple comparisons as appropriate with q<0.05 used to define statistical significance. RESULTS: Age, gender, and intracranial volume (ICV)-adjusted left thalamic volumes were significantly reduced in CWEOE with cognitive impairment compared to CWEOE without impairment (5295mm3 vs 6418mm3, q=0.008) or healthy controls (5295mm3 vs 6410mm3, q<0.001). The differences in left thalamic volume remained if gray matter or cortical/cerebellar volumes were used as covariates rather than ICV (q<0.05). The degree of volume reduction correlated with the severity of cognitive impairment (q=0.048). SIGNIFICANCE: Reduced left thalamic volume may be a biomarker for cognitive impairment in CWEOE and could help inform the need for further formal cognitive evaluations and interventions.
Authors: Kyle H Bennett; Suresh S Pujar; Marina M Martinos; Christopher A Clark; Michael Yoong; Rod C Scott; Richard F M Chin Journal: Epilepsy Behav Date: 2020-06-08 Impact factor: 2.937