Kraus Dror, Farah Rola, Fischer Haya, Vannest Jennifer, Wade Shari L, Radhakrishnan Rupa, Modi Avani C, Horowitz-Kraus Tzipi
Pediatric Neurology Institute, Schneider Children's Medical Center of Israel, Tel Aviv University, Israel.
Educational Neuroimaging Group, Faculty of Education in Science and Technology, Faculty of Biomedical Engineering, Technion, Haifa, Israel.
Eur J Paediatr Neurol. 2023 Sep;46:82-88. doi: 10.1016/j.ejpn.2023.07.004. Epub 2023 Jul 23.
Deficits in executive functions (EF) are a common comorbidity among adolescents with epilepsy. EF deficits were previously correlated with altered connectivity of the fronto-parietal and cingulo-opercular neural networks. The current study investigated white matter integrity in adolescents with epilepsy (n = 29) relative to healthy controls (n = 19). Participants completed questionnaires, neuropsychological testing, and brain magnetic resonance imaging (MRI) that included diffusion tensor imaging (DTI) sequences. On BRIEF parent-report questionnaires, adolescents with epilepsy demonstrated lower working memory and planning abilities than healthy controls. Among adolescents with epilepsy, DTI measurements revealed lower fractional anisotropy (FA) within the right superior longitudinal fasciculus, forceps minor, and the superior frontal segment of the corpus callosum, and higher FA in the left uncinate fasciculus, compared to healthy controls. Better working memory ability in the epilepsy group was associated with higher FA in the superior frontal segment of the corpus callosum. Only in healthy controls, working memory and planning were positively associated with FA values in the left UF, forceps minor and the superior frontal segment of the corpus callosum. The current study complements previous functional studies on the same cohort and suggests that EF impairments among adolescents with epilepsy may be related to the altered anatomical organization of white matter tracts. Combining structural and functional data could potentially enrich the neuropsychological assessment of executive functioning in adolescents with epilepsy.
执行功能（EF）缺陷是癫痫青少年中常见的共病情况。EF缺陷先前与额顶叶和扣带回-岛盖神经网络的连接改变有关。本研究调查了癫痫青少年（n = 29）相对于健康对照组（n = 19）的白质完整性。参与者完成了问卷调查、神经心理学测试以及包括扩散张量成像（DTI）序列的脑磁共振成像（MRI）。在BRIEF家长报告问卷上，癫痫青少年的工作记忆和计划能力低于健康对照组。在癫痫青少年中，与健康对照组相比，DTI测量显示右侧上纵束、小钳和胼胝体上额段的分数各向异性（FA）较低，而左侧钩束的FA较高。癫痫组中较好的工作记忆能力与胼胝体上额段较高的FA相关。仅在健康对照组中，工作记忆和计划与左侧钩束、小钳和胼胝体上额段的FA值呈正相关。本研究补充了先前对同一队列的功能研究，并表明癫痫青少年的EF损害可能与白质束解剖结构改变有关。结合结构和功能数据可能会丰富癫痫青少年执行功能的神经心理学评估。
