Massachusetts General Hospital, Department of Neurology, Boston, MA 02114, USA; Graduate Program in Neuroscience, Boston University, Boston, MA 02215, USA.
Massachusetts General Hospital, Department of Neurology, Boston, MA 02114, USA.
Clin Neurophysiol. 2023 Sep;153:21-27. doi: 10.1016/j.clinph.2023.05.013. Epub 2023 Jun 24.
Median nerve somatosensory evoked fields (SEFs) conduction times reflect the integrity of neural transmission across the thalamocortical circuit. We hypothesized median nerve SEF conduction time would be abnormal in children with Rolandic epilepsy (RE).
22 children with RE (10 active; 12 resolved) and 13 age-matched controls underwent structural and diffusion MRI and median nerve and visual stimulation during magnetoencephalography (MEG). N20 SEF responses were identified in contralateral somatosensory cortices. P100 were identified in contralateral occipital cortices as controls. Conduction times were compared between groups in linear models controlling for height. N20 conduction time was also compared to thalamic volume and Rolandic thalamocortical structural connectivity inferred using probabilistic tractography.
The RE group had slower N20 conduction compared to controls (p = 0.042, effect size 0.6 ms) and this difference was driven by the resolved RE group (p = 0.046). There was no difference in P100 conduction time between groups (p = 0.83). Ventral thalamic volume positively correlated with N20 conduction time (p = 0.014).
Children with resolved RE have focally decreased Rolandic thalamocortical connectivity.
These results identify a persistent focal thalamocortical circuit abnormality in resolved RE and suggest that decreased Rolandic thalamocortical connectivity may support symptom resolution in this self-limited epilepsy.
正中神经体感诱发电位（SEF）的传导时间反映了丘脑皮质回路中神经传递的完整性。我们假设，在 Rolandic 癫痫（RE）患儿中，正中神经 SEF 传导时间异常。
22 名 Rolandic 癫痫患儿（10 名活动期；12 名缓解期）和 13 名年龄匹配的对照组接受了结构和弥散 MRI 以及正中神经和视觉刺激的磁共振脑磁图（MEG）检查。在对侧感觉皮质中识别 N20 SEF 反应。对照组在对侧枕叶皮质中识别 P100。在线性模型中，通过控制身高，比较两组之间的传导时间。还将 N20 传导时间与丘脑体积和使用概率追踪推断的 Rolandic 丘脑皮质结构连接进行了比较。
与对照组相比，RE 组的 N20 传导时间较慢（p=0.042，效应大小 0.6ms），这种差异是由缓解的 RE 组引起的（p=0.046）。两组之间的 P100 传导时间无差异（p=0.83）。腹侧丘脑体积与 N20 传导时间呈正相关（p=0.014）。
缓解期 Rolandic 癫痫患儿存在 Rolandic 丘脑皮质连接的局灶性降低。
这些结果表明，在缓解期 Rolandic 癫痫中存在持续的局灶性丘脑皮质回路异常，并提示 Rolandic 丘脑皮质连接减少可能支持这种自限性癫痫的症状缓解。
