Sreedharan Ruma Madhu, Kesavadas Chandrasekharan, Aiyappan Subramonium, Anila K M, Mohan Amitha C, Thomas Sanjeev V
Department of Radiology, Government Medical College Hospital, Trivandrum, Kerala, India.
Department of Imaging Science and Interventional Radiology, SCTIMST, Trivandrum, Kerala, India.
Ann Indian Acad Neurol. 2020 Mar-Apr;23(2):167-173. doi: 10.4103/aian.AIAN_402_19. Epub 2020 Feb 26.
Children of women with epilepsy and antenatal antiepileptic drug (AED) exposure have increased risk of language dysfunction. Our objective was to compare language related functional MRI network connectivity (FC) of children with women with epilepsy with antenatal AED exposure (CAED) with that of healthy children (COAED) for delineating functional basis of the language dysfunction.
CAED under prospective follow up in Kerala Registry of Epilepsy and Pregnancy were consecutively sampled. COAED were identified from volunteers with normal brain MRI. Clinical Evaluation of Language Fundamentals score (CELF) was used to assess language. Functional MRI done using verb generation paradigm to activate language areas and key language network nodes were identified. A multivariate ROI-to-ROI and Seed-to-Voxel based FC was done using the selected seed regions in the language areas located in the right and left hemisphere in all subjects using the CONN functional connectivity toolbox in SPM8 under MATLAB.
Strong connectivity was observed within the identified language network between all language nodes bilaterally in CAED compare to controls. The mean connectivity strength of language network (LN) on the left side in CAED was 9.63 ± 4.62 (Mean ± SD) while for COAED it was 6.96 ± 3.67 (p=0.0001). The mean connectivity strength of LN between CAED (4.86 ± 1.07) and COAED (4.32 ±1.2) on the right hemisphere was not statistically significant (p=0.18).
CAED with impaired language function had significantly increased functional connectivity which may indicate poor differentiation and localization of language centers.
患有癫痫的女性及其子女在孕期接触抗癫痫药物（AED）会增加语言功能障碍的风险。我们的目标是比较孕期接触AED的癫痫女性子女（CAED）与健康儿童（COAED）的语言相关功能磁共振成像网络连通性（FC），以描绘语言功能障碍的功能基础。
连续抽取喀拉拉邦癫痫与妊娠登记处前瞻性随访的CAED。从脑MRI正常的志愿者中确定COAED。使用语言基本技能临床评估量表（CELF）评估语言能力。使用动词生成范式进行功能磁共振成像以激活语言区域，并确定关键语言网络节点。在MATLAB环境下，使用SPM8中的CONN功能连通性工具箱，对所有受试者左右半球语言区域中选定的种子区域进行多变量感兴趣区域到感兴趣区域以及基于种子点到体素的FC分析。
与对照组相比，在CAED中，双侧所有语言节点之间在已确定的语言网络内观察到强连通性。CAED左侧语言网络（LN）的平均连通强度为9.63±4.62（均值±标准差），而COAED为6.96±3.67（p=0.0001）。CAED（4.86±1.07）和COAED（4.32±1.2）在右半球的LN平均连通强度无统计学意义（p=0.18）。
语言功能受损的CAED功能连通性显著增加，这可能表明语言中枢的分化和定位较差。
