Study Of The Brain Microstructure And Cognitive Function Of Electrical Status Epilepticus During Sleep In Children

Objective:To investigate the alteration of cerebral cortex microstructure in children with Electrical Status Epilepticus During Sleep(ESES),analyzed the correlation between morphologically abnormal brain regions and onset age,duration,cognitive function,inder to explore potential mechanism of cognitive function defect from the level of cerebral cortex microstructure,enrich the theory of cognitive dysfunction in children with ESES,and provide imaging basis for further clinical research.Methods:Children with ESES from Shenzhen Children’s Hospital between June 2017 and January 2021 were collected.Gender and age matched healthy control group children were collected during the same period.All the subjects were right-handed.All the subjects were tested for cognitive function employing the fourth edition of Chinese Wechsler Intelligence Scale for Children(C-WISC).MRI data were collected from a Simons MAGNETOM Skyra 3.0T superconduct magnetic resonance imaging system,including T1WI,T2WI,T2-FLAIR and three-dimensional magnetization prepared rapid(3D-MPRAGE).The voxel-based morphometry and surface-based morphometry were used for data analysis.The differences of brain microstructure between ESES group and healthy group were compared by two-independent sample t-test.Cluster size>30 was set,and P<0.001 was considered statistically significant.Pearson correlation analysis was performed between the abnormal brain regions obtained through the above steps and the age of onset,course of disease,and cognitive function(speech scale score,perceptual reasoning score,working memory score,Processing speed score).When P<0.05,the differences were considered having statistical significance.Results:1.27 patients were enrolled to ESES group,including 14 males and 13 females,aging from 6.33 to 12.91years old,In healthy control group,there were 26 volunteers,aging from 6.58 to 12.91 years old,including 12 males and 14 females,aging from 4.75 to 12.33 years old.2.There were no significant differences in gender and age between the ESES group and the normal control group(P>0.05),and there were significant differences in the scores of the language scale,perceptual reasoning scale,working memory scale and Processing speed scale(P<0.05).3.Compared with healthy controls,the volumes of right superior temporal gyrus,right middle temporal gyrus,and bilateral cerebellar area 6 were less in ESES children(P<0.001,cluster size>30).4.Compared with healthy control group,the right cingulate gyrus,right fusiform gyrus,left middle frontal gyrus,left middle temporal gyrus,left occipital lobe(BA19),left lingual gyrus,left inferior frontal gyrus cortex thickness thinning(P<0.001,cluster size>30).5.Compared with healthy control group,the gyrification index of the right middle frontal gyrus was reduced,the gyrification index of the bilateral middle occipital gyrus,the left anterior cingulate gyrus and the right parhippocampal gyrus were increased(P<0.001,cluster size>30).6.Compared with healthy control group,the sulcus depth of the right middle temporal gyrus and the fusiform gyrus were decreased(P<0.001,cluster size>30).7.Compared with healthy control group,the fractal dimension of the right inferior temporal gyrus and the left precentral gyrus were decreased,and the fractal dimension of the left postcentral gyrus was increased(P<0.001,cluster size>30).8.In the ESES group,the depth of the right middle temporal gyrus sulcus was negatively correlated with the score of the speech scale(rs=-0.600,P=0.009),and the foldability of the left cingulate gyrus was negatively correlated with the score of the working memory scale(rs=-0.423,P=0.027).Conclusions:1.The microstructural alteration of bilateral temporal lobe,cingulate cortex,right parhippocampal cortex and bilateral frontal lobe in ESES children reflected the structural damage of language,memory and thinking reasoning network in these children,which could better explain the clinical language dysfunction,working memory loss and the decline of diverging thinking ability in children.2.The structural changes of bilateral occipital lobes,bilateral cerebellar area 6,left precentral gyrus and left postcentral gyrus in ESES children reflected the structural damage of visual cortex,motor cortex and sensory cortex in these children,which could be speculated that there may be abnormal visual,motor sensory and sensory functions in these children.