Brain Maturation in Children With Localization Related Epilepsy

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.

Conditions

• Benign Childhood Epilepsy With Centro-temporal Spikes (BCECTS)
• Focal Cryptogenic Epilepsy of Childhood
• Cryptogenic Epilepsy of Childhood

Interventions

PROCEDURE

MRI

Patients are investigated with the following sequences: * High-resolution 3D T1-weighted anatomical MRI. * DTI with 48 directions (to examine white matter)

PROCEDURE

functional MRI (fMRI)

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.

BEHAVIORAL

neuropsychological assessment

Patients undergo a repeated annual neuropsychological assessment over the five years of their participation in the project.

Sponsors & Collaborators

• Hospices Civils de Lyon

  lead OTHER

Principal Investigators

• Sylvain RHEIMS · Service d'épileptologie fonctionnelle, Hôpital Pierre Wertheimer, Hospices Civils de Lyon

Study Design

Allocation

NON_RANDOMIZED

Purpose

BASIC_SCIENCE

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

6 Years

Max Age

16 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2008-09-30

Primary Completion

2018-12-07

Completion

2018-12-07

Countries

• France

Study Locations