Besseling René M H, Jansen Jacobus F A, Overvliet Geke M, van der Kruijs Sylvie J M, Ebus Saskia C M, de Louw Anton, Hofman Paul A M, Vles Johannes S H, Aldenkamp Albert P, Backes Walter H
Epilepsy Center Kempenhaeghe, Heeze, the Netherlands ; Research School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands ; Department of Radiology, Maastricht University Medical Center, Maastricht, the Netherlands.
Research School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands ; Department of Radiology, Maastricht University Medical Center, Maastricht, the Netherlands.
PLoS One. 2013 Dec 23;8(12):e83568. doi: 10.1371/journal.pone.0083568. eCollection 2013.
Rolandic epilepsy (RE) is a childhood epilepsy with centrotemporal (rolandic) spikes, that is increasingly associated with language impairment. In this study, we tested for a white matter (connectivity) correlate, employing diffusion weighted MRI and language testing.
Twenty-three children with RE and 23 matched controls (age: 8-14 years) underwent structural (T1-weighted) and diffusion-weighted MRI (b = 1200 s/mm(2), 66 gradient directions) at 3T, as well as neuropsychological language testing. Combining tractography and a cortical segmentation derived from the T1-scan, the rolandic tract were reconstructed (pre- and postcentral gyri), and tract fractional anisotropy (FA) values were compared between patients and controls. Aberrant tracts were tested for correlations with language performance.
Several reductions of tract FA were found in patients compared to controls, mostly in the left hemisphere; the most significant effects involved the left inferior frontal (p = 0.005) and supramarginal (p = 0.004) gyrus. In the patient group, lower tract FA values were correlated with lower language performance, among others for the connection between the left postcentral and inferior frontal gyrus (p = 0.043, R = 0.43).
In RE, structural connectivity is reduced for several connections involving the rolandic regions, from which the epileptiform activity originates. Most of these aberrant tracts involve the left (typically language mediating) hemisphere, notably the pars opercularis of the inferior frontal gyrus (Broca's area) and the supramarginal gyrus (Wernicke's area). For the former, reduced language performance for lower tract FA was found in the patients. These findings provide a first microstructural white matter correlate for language impairment in RE.
罗兰多癫痫（RE）是一种伴有中央颞区（罗兰多区）棘波的儿童癫痫，越来越多地与语言障碍相关。在本研究中，我们采用扩散加权磁共振成像（MRI）和语言测试来检测白质（连接性）相关性。
23名患有RE的儿童和23名匹配的对照组儿童（年龄：8 - 14岁）在3T条件下接受了结构（T1加权）和扩散加权MRI检查（b = 1200 s/mm(2)，66个梯度方向），以及神经心理学语言测试。结合纤维束成像和从T1扫描得出的皮质分割，重建了罗兰多束（中央前回和中央后回），并比较了患者和对照组之间的束分数各向异性（FA）值。对异常束与语言表现进行相关性测试。
与对照组相比，患者中发现了多处束FA降低，主要在左半球；最显著的影响涉及左额下回（p = 0.005）和缘上回（p = 0.004）。在患者组中，较低的束FA值与较低的语言表现相关，尤其是左中央后回和额下回之间的连接（p = 0.043，R = 0.43）。
在RE中，涉及癫痫样活动起源的罗兰多区的多个连接的结构连接性降低。这些异常束大多涉及左（通常是语言介导的）半球，特别是额下回的岛盖部（布罗卡区）和缘上回（韦尼克区）。对于前者，在患者中发现较低的束FA与较低的语言表现相关。这些发现为RE中的语言障碍提供了首个微观结构白质相关性证据。
