Behavioral and Functional Language Effects of Early-Onset Epilepsy Versus Perinatal Stroke
Abstract number :
2.303
Submission category :
11. Behavior/Neuropsychology/Language / 11B. Pediatrics
Year :
2021
Submission ID :
1825559
Source :
www.aesnet.org
Presentation date :
12/5/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:43 AM
Authors :
Madeline Marcelle, BS - 1) Interdisciplinary Program in Neuroscience, Georgetown University Medical Center; 2) Children's National Hospital; Anna Seydell-Greenwald, PhD - Georgetown University Medical Center; Xiaozhen You, PhD - Children's National Hospital; Madison Berl, PhD - Children's National Hospital; William Gaillard, MD - Children's National Hospital; Elissa Newport, PhD - Georgetown University Medical Center
Rationale: Early brain injuries can lead to reorganization of anatomically and functionally defined regions from their typical location. While it is known that age plays an important role in determining the extent of reorganization after brain injury, it is unclear how reorganization in language regions differ due to the chronicity of the injury. Our study compares three groups: subjects with early-onset epilepsy (EPI), perinatal stroke (PS), and controls (TD). We assessed the differential effects of acute (PS) versus chronic (EPI) injury on long-term language organization and cognitive outcomes. We hypothesized that children with a history of perinatal stroke would have better long-term outcomes in language function compared to epilepsy subjects, despite atypical lateralization.
Methods: 50 subjects (26 TD, mean age = 12.1±4.6 yrs; 11 EPI, mean age = 9.4±2.7 yrs; 13 PS, mean age = 15.7±5.3 yrs) were studied. EPIs had left hemisphere focal epilepsy onset before 24 months (mean age = 1.61±0.60 yrs). PSs had documented left hemisphere MCA arterial ischemic stroke during the perinatal period. All subjects completed an fMRI language task (Auditory Description Decision Task) at 3T MRI. Images were processed in SPM12. Analyses used anatomically-defined language ROIs in inferior frontal gyrus (Broca’s area, IFG) and temporal cortex (Wernicke's area, WA). A Laterality Index (LI) was calculated to determine side and strength of language dominance. Descriptive statistics and t-tests were used to compare groups. All subjects completed a battery of neuropsychological assessments.
Results: LI results are shown in Figure 1 and Table 1. TDs were left lateralized for language, and PSs right lateralized, while EPIs demonstrated more spread, particularly in IFG. Language assessment with the Recalling Sentences subtest of the CELF showed a deficit for the EPIs vs TDs (p = 0.003), but there was no difference for PSs vs TDs (p > 0.05). Word Structure and Sentence Comprehension subtests of the CELF showed no differences between PS vs TDs (p’s > 0.05). EPI and PSs showed impairments compared to TDs on IQ measures (WASI: FSIQ-4, VCI, PRI; p’s < 0.001), and greater impairment on executive function measures (BRIEF: BRI, MCI, GEC) vs TDs (p’s < 0.01). Younger EPI children ( < 16 yrs) demonstrated more executive function impairment on the Digit Span subtests (Forward, Backward) vs TDs and PSs (p’s < 0.01).
Behavior