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Ictal Source Locations and Cortico-Thalamic Connectivity in Childhood Absence Epilepsy: Associations with Treatment Response.
Brain Topogr. 2019 01; 32(1):178-191.BT

Abstract

Childhood absence epilepsy (CAE), the most common pediatric epilepsy syndrome, is usually treated with valproic acid (VPA) and lamotrigine (LTG) in China. This study aimed to investigate the ictal source locations and functional connectivity (FC) networks between the cortices and thalamus that are related to treatment response. Magnetoencephalography (MEG) data from 25 patients with CAE were recorded at 300 Hz and analyzed in 1-30 Hz frequency bands. Neuromagnetic sources were volumetrically scanned with accumulated source imaging. The FC networks between the cortices and thalamus were evaluated at the source level through a connectivity analysis. Treatment outcome was assessed after 36-66 months following MEG recording. The children with CAE were divided into LTG responder, LTG non-responder, VPA responder and VPA non-responder groups. The ictal source locations and cortico-thalamic FC networks were compared to the treatment response. The ictal source locations in the post-dorsal medial frontal cortex (post-DMFC, including the medial primary motor cortex and the supplementary sensorimotor area) were observed in all LTG non-responders but in all LTG responders. At 1-7 Hz, patients with fronto-thalamo-parietal/occipital (F-T-P/O) networks were older than those with fronto-thalamic (F-T) networks or other cortico-thalamic networks (p = 0.000). The duration of seizures in patients with F-T-P/O networks at 1-7 Hz was longer than that in patients with F-T networks or other cortico-thalamic networks (p = 0.001). The ictal post-DMFC source localizations suggest that children with CAE might experience initial LTG monotherapy failure. Moreover, the cortico-thalamo-cortical network is associated with age. Finally, the cortico-thalamo-cortical network consists of anterior and posterior cortices and might contribute to the maintenance of discharges.

Authors+Show Affiliations

Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Guang Zhou Road 264, Nanjing, 210029, Jiangsu, China.Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Guang Zhou Road 264, Nanjing, 210029, Jiangsu, China.MEG Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, 45220, USA.Department of Pediatrics, Nanjing Jiangning Hospital, Nanjing, 210029, Jiangsu, China.MEG Center, Nanjing Brain Hospital, Nanjing, 210029, Jiangsu, China.Department of Neurology, The Affiliated Huaian Hospital of Xuzhou Medical University, Huai'an, China.Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Guang Zhou Road 264, Nanjing, 210029, Jiangsu, China.Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Guang Zhou Road 264, Nanjing, 210029, Jiangsu, China.Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Guang Zhou Road 264, Nanjing, 210029, Jiangsu, China.Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Guang Zhou Road 264, Nanjing, 210029, Jiangsu, China.Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Guang Zhou Road 264, Nanjing, 210029, Jiangsu, China.Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Guang Zhou Road 264, Nanjing, 210029, Jiangsu, China.Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Guang Zhou Road 264, Nanjing, 210029, Jiangsu, China.Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Guang Zhou Road 264, Nanjing, 210029, Jiangsu, China.Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Guang Zhou Road 264, Nanjing, 210029, Jiangsu, China.Department of Neurology, Nanjing Children's Hospital, Nanjing, 210029, Jiangsu, China.Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Guang Zhou Road 264, Nanjing, 210029, Jiangsu, China. xiaoshanwang1971@163.com.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30291582

Citation

Miao, Ailiang, et al. "Ictal Source Locations and Cortico-Thalamic Connectivity in Childhood Absence Epilepsy: Associations With Treatment Response." Brain Topography, vol. 32, no. 1, 2019, pp. 178-191.
Miao A, Wang Y, Xiang J, et al. Ictal Source Locations and Cortico-Thalamic Connectivity in Childhood Absence Epilepsy: Associations with Treatment Response. Brain Topogr. 2019;32(1):178-191.
Miao, A., Wang, Y., Xiang, J., Liu, Q., Chen, Q., Qiu, W., Liu, H., Tang, L., Gao, Y., Wu, C., Yu, Y., Sun, J., Jiang, W., Shi, Q., Zhang, T., Hu, Z., & Wang, X. (2019). Ictal Source Locations and Cortico-Thalamic Connectivity in Childhood Absence Epilepsy: Associations with Treatment Response. Brain Topography, 32(1), 178-191. https://doi.org/10.1007/s10548-018-0680-5
Miao A, et al. Ictal Source Locations and Cortico-Thalamic Connectivity in Childhood Absence Epilepsy: Associations With Treatment Response. Brain Topogr. 2019;32(1):178-191. PubMed PMID: 30291582.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ictal Source Locations and Cortico-Thalamic Connectivity in Childhood Absence Epilepsy: Associations with Treatment Response. AU - Miao,Ailiang, AU - Wang,Yingxin, AU - Xiang,Jing, AU - Liu,Qianqian, AU - Chen,Qiqi, AU - Qiu,Wenchao, AU - Liu,Hongxing, AU - Tang,Lu, AU - Gao,Yuan, AU - Wu,Caiyun, AU - Yu,Yuanwen, AU - Sun,Jintao, AU - Jiang,Wenwen, AU - Shi,Qi, AU - Zhang,Tingting, AU - Hu,Zheng, AU - Wang,Xiaoshan, Y1 - 2018/10/05/ PY - 2018/04/06/received PY - 2018/10/01/accepted PY - 2018/10/7/pubmed PY - 2019/5/10/medline PY - 2018/10/7/entrez KW - Childhood absence epilepsy KW - Cortico–thalamic network KW - Magnetoencephalography KW - Source location KW - Treatment response SP - 178 EP - 191 JF - Brain topography JO - Brain Topogr VL - 32 IS - 1 N2 - Childhood absence epilepsy (CAE), the most common pediatric epilepsy syndrome, is usually treated with valproic acid (VPA) and lamotrigine (LTG) in China. This study aimed to investigate the ictal source locations and functional connectivity (FC) networks between the cortices and thalamus that are related to treatment response. Magnetoencephalography (MEG) data from 25 patients with CAE were recorded at 300 Hz and analyzed in 1-30 Hz frequency bands. Neuromagnetic sources were volumetrically scanned with accumulated source imaging. The FC networks between the cortices and thalamus were evaluated at the source level through a connectivity analysis. Treatment outcome was assessed after 36-66 months following MEG recording. The children with CAE were divided into LTG responder, LTG non-responder, VPA responder and VPA non-responder groups. The ictal source locations and cortico-thalamic FC networks were compared to the treatment response. The ictal source locations in the post-dorsal medial frontal cortex (post-DMFC, including the medial primary motor cortex and the supplementary sensorimotor area) were observed in all LTG non-responders but in all LTG responders. At 1-7 Hz, patients with fronto-thalamo-parietal/occipital (F-T-P/O) networks were older than those with fronto-thalamic (F-T) networks or other cortico-thalamic networks (p = 0.000). The duration of seizures in patients with F-T-P/O networks at 1-7 Hz was longer than that in patients with F-T networks or other cortico-thalamic networks (p = 0.001). The ictal post-DMFC source localizations suggest that children with CAE might experience initial LTG monotherapy failure. Moreover, the cortico-thalamo-cortical network is associated with age. Finally, the cortico-thalamo-cortical network consists of anterior and posterior cortices and might contribute to the maintenance of discharges. SN - 1573-6792 UR - https://www.unboundmedicine.com/medline/citation/30291582/Ictal_Source_Locations_and_Cortico_Thalamic_Connectivity_in_Childhood_Absence_Epilepsy:_Associations_with_Treatment_Response_ L2 - https://doi.org/10.1007/s10548-018-0680-5 DB - PRIME DP - Unbound Medicine ER -