Authors :
Presenting Author: F. Kathryn King, MS – Cook Children’s Health Care System
Brianna-marie McCullough, BS – Research Assistant, Jane and John Justin Institute for Mind Health, Cook Children’s Health Care System; M. Scott Perry, MD – Medical Director, Jane and John Justin Institute for Mind Health, Cook Children’s Health Care System; Christos Papadelis, PhD – Director of Research, Jane and John Justin Institute for Mind Health, Cook Children’s Health Care System; Crystal Cooper, PhD – Principal Investigator, Jane and John Justin Institute for Mind Health, Cook Children’s Health Care System
Rationale:
Epilepsy and psychiatric disorders are highly comorbid suggesting shared brain dysfunction. Anxiety and depression have been characterized by deficits in emotion regulation via functional MRI, yet these processes have not been investigated in people with epilepsy (PWE), nor have methods with high temporal resolution been utilized. Here, we examine the spatiotemporal profile of emotional conflict processing in adolescents with epilepsy using magnetoencephalography (MEG). We hypothesize that adolescents with epilepsy, relative to typically developing controls (TD), will exhibit deficits in emotional conflict processing in behavior and brain function; this includes decreased activation in brain regions such as the insula, cingulate, and prefrontal cortices, which will be associated with psychiatric symptoms.Methods:
Forty-five adolescents (20 PWE and 25 TD; aged 10-19y) underwent MEG recording during an emotional conflict task, responding to emotional faces with overlaid words that were either congruent or incongruent with the facial emotion (Figure 1A). Accuracy and response times were compared between conditions and groups. Conflict (incongruent – congruent) source activity maps time-locked to stimulus presentation (-500—1000 ms) were computed with dynamic statistical parametric mapping and compared between groups using cluster-based permutation tests at 10 non-overlapping 100 ms time windows (Figure 1C). Peak source activity in significant clusters was extracted (|t| > 3.0) and related to clinical scores of anxiety, depression, and anhedonia using regression analyses.Results:
While TDs exhibited normative behavioral patterns, responding slower and less accurately to emotionally conflicting stimuli (ps < .05), PWE responded similarly across conditions (ps > .05; Figure 1B). Relative to TDs, PWE showed lower source activity: at 500-600 ms post-stimulus in a left-sided cluster including the precentral gyrus and the middle cingulate (p = .026); at 800-900 ms in a right-sided cluster including the supracallosal anterior cingulate, middle cingulate, and medial superior frontal gyrus (p = .010); and at 900-1000 ms in a left-sided cluster including the dorsolateral prefrontal cortex (dlPFC) and the supracallosal and pregenual anterior cingulate (pgACC; p = .002; Fig. 1D). Regression analyses revealed the 900 ms cluster activity significantly predicted levels of anxiety overall, with the dlPFC negatively correlating with anxiety in PWE and the pgACC positively correlating with anxiety in TD (p = .019; Fig. 2).Conclusions:
Blunted brain responses to emotional conflict may suggest the presence of regional brain dysfunction in epilepsy similar to patterns seen in psychiatric disorders. Relative decreased dlPFC activity, and its negative correlation with anxiety in PWE, suggests a shared dysfunction that may predispose the brain to both disorders. These findings reveal a relationship between epilepsy and anxiety, which may improve diagnosis and treatment of both disorders if investigated further.Funding:
Jordan Elizabeth Harris Foundation