Brain Maturation in Children With Localization Related Epilepsy
Condition: Benign Childhood Epilepsy With Centro-temporal Spikes (BCECTS); Focal Cryptogenic Epilepsy of Childhood; Cryptogenic Epilepsy of Childhood
MeSH terms: Epilepsy; Epilepsies, Partial; Epilepsy, Rolandic
Study type: Interventional

Summary: 
      This project intends to investigate children with idiopathic and cryptogenic localization
      related epilepsies, using a longitudinal assessment of structural and functional MRI data, in
      relation to neuropsychological evaluation. The rationale is primarily based on: 1) the
      frequent observation of selective cognitive dysfunctions in such children, the
      pathophysiology of which remains largely uncertain; 2) the recent major advances in the MRI
      investigation of brain maturation showing striking age and region dependant patterns.

      The primary hypothesis is that some children with localization related epilepsies suffer from
      altered maturation in the epileptic brain regions, and that this abnormal maturation affects
      their cognitive abilities. 100 children with localization related epilepsies and 100 matched
      controls will be prospectively enrolled during the first two years of the disease (for
      patients) and benefit from a comprehensive phenotypic and neuropsychological evaluation once
      a year for 5 years. The brain maturation of these children will be longitudinally assessed
      using structural and functional MRI, and correlated with neuropsychological data.
      Investigators hope to demonstrate that children with localization related epilepsies and
      cognitive dysfunctions suffer from an abnormal brain maturation in regions underlying the
      epileptic activity and the altered cognitive processes. The finding could partly bridge the
      gap between these two abnormalities and help better understand their interaction and
      respective dynamic. Once validated, the study of regional brain maturation in children with
      epilepsy might be further used as a reliable surrogate marker or predictor of associated
      cognitive dysfunction.
    


Intervention name(s): MRI; functional MRI (fMRI); neuropsychological assessment
Intervention type(s): Procedure; Procedure; Behavioral
Intervention description(s): Patients are investigated with the following sequences:
High-resolution 3D T1-weighted anatomical MRI.
DTI with 48 directions (to examine white matter); fMRI investigations will be focused on :
language: investigation on possible atypical language networks in children with epilepsy. The fMRI task is a silent verb generation.
Social cognition: investigations on social cognition skills
Memory :
Declarative memory: investigations on the pattern of activations in the brain associated with successful memory formation and changes from childhood to adolescence
Working memory: A verbal and a spatial working memory task has been chosen, and is an adaptation of two published cross-sectional studies of working memory from Gabrieli and Sowell groups.; Patients undergo a repeated annual neuropsychological assessment over the five years of their participation in the project.
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Basic Science
Keywords: Benign childhood epilepsy with centro-temporal spikes; rolandic epilepsy; brain development; DTI; functional MRI; structural MRI; idiopathic focal epilepsy; cryptogenic epilepsy of childhood