Abstracts

Volumetric studies in adults with temporal lobe epilepsy demonstrate reduced whole brain, gray matter and white matter volumes, bilateral frontoparietal volumes, as well as white matter volumes of frontal, temporal and parietal lobe. The few volumetric studies conducted in childhood epilepsy describe significantly reduced total brain volume in children with intractable and medically controlled epilepsy compared to normal children and in children with frontal lobe epilepsy contrasted to those with temporal lobe epilepsy., 33 CPS and 36 normal children, aged 5-16 years, completed brain MRI scans at 1.5 Tesla. Tissue was segmented and total brain, frontal lobe, frontal parcellation and temporal lobe volumes were computed. IQ scores, psychiatric diagnoses, and seizure information were also obtained on each patient., Controlling for demographic and cognitive variables, there were no significant differences in total brain, frontal, and temporal volumes of the CPS and normal groups, other than significantly larger bilateral orbital frontal white matter volumes in the CPS group. Seizure variables were differentially related to smaller total white matter, orbital frontal, and dorsolateral prefrontal volumes. The presence of a psychiatric diagnosis was also significantly associated with smaller dorsolateral prefrontal and inferior frontal volumes. IQ and age were significantly positively associated with total brain and temporal white matter volumes in the CPS group. In the normal group, however, total brain, gray matter, and white matter volumes were related to IQ, but age was unrelated to brain volumes., These findings imply that CPS might impact brain development, particularly of the orbital frontal, the dorsolateral prefrontal, and the inferior frontal regions in children with medically treated CPS. They highlight the importance of controlling for psychiatric, as well as age, IQ, and demographic variables when examining how seizure variables are related to brain development in pediatric CPS., (Supported by grant NS32070 (R.C.) and MH067187 (R.C.).)