Study On Alterations In White Matter Integrity And Asymmetry In Benign Childhood Epilepsy Syndromes

Objective:Benign childhood epilepsy with centrotemporal spikes(BECTS)and childhood absence epilepsy(CAE)are the most common childhood epilepsy syndromes.Although previous diffusion tensor imaging(DTI)studies have reported white matter abnormalities in patients with BECTS or CAE respectively,no study yet has directly compared white matter properties between BECTS and CAE.In this study,we aimed to investigate whether patients with BECTS or CAE show distinct patterns of white matter alterations and structural asymmetry compared with healthy controls using an advanced DTI technique,as well as the relationship between white matter alterations and epilepsy-related clinical variables.Methods:We acquired DTI data from twenty-six patients with BECTS,twenty-nine patients with CAE,and twenty-four healthy controls and then used automated fiber quantification software to create tract profiles of fractional anisotropy(FA)and mean diffusivity(MD)in three groups.Group differences in FA and MD were quantified at100 equidistant nodes along the fiber tract and these alterations and epilepsy-related clinical variables were correlated.A lateralization index(LI)representing the structural asymmetry of the fiber tract was computed for each fiber tract and compared between both patient groups and controls.Results:Compared with healthy controls,the BECTS group showed widespread FA reduction in 43.75%(7/16)and MD elevation in 50%(8/16)of identified fiber tracts,and the CAE group showed regional FA reduction in 31.25%(5/16)and MD elevation in25%(4/16)of identified fiber tracts.In the BECTS group,FA and MD in the right anterior thalamic radiation positively and negatively correlated with the number of antiepileptic drugs,respectively,and MD in the right arcuate fasciculus(AF)positively correlated with seizure frequency.In the CAE group,the LI values were significantly lower in the inferior fronto-occipital fasciculus and the AF.Conclusion:The two childhood epilepsy syndromes display different patterns of alterations in white matter integrity and asymmetry,suggesting they have different forms of white matter pathology that may reflect qualitatively distinct genetic influences or neurodevelopmental alterations.Our findings provide further support that neuroanatomical differences may underlie the different profiles of these two childhood epilepsy syndromes.