Authors :
Presenting Author: Yuping Wang, PhD – Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
Yiran Duan, MD – Department of Neurology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Yicong Lin, PhD – China Association Against Epilepsy
Jia Chen, MD – Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
Rationale: Self-limited epilepsy with centrotemporal spikes (SeLECTS) and epileptic encephalopathy with spike-and-wave activation in sleep (EE-SWAS) are the most common epilepsy syndromes in childhood but remain source location undetermined. We assessed the sources of the epileptiform discharges in SeLECTS and EE-SWAS using magnetoencephalography (MEG).
Methods: We recruited 69 participants with SeLECTS and EE-SWAS in this prospective MEG based study, which included 52 patients with self-limited epilepsy with centrotemporal spikes (SeLECTS), 12 patients with atypical benign partial epilepsy (ABPE), 3 patients with Landau–Kleffner syndrome (LKS) and 2 patients with epileptic encephalopathy with continuous spike-and-waves during sleep (CSWS). Ten epileptiform discharges collected independently from each patient was performed by MEG source analysis. The
source localization of the distributed source model was obtained by using standardized low resolution electromagnetic brain tomography (sLORETA). The spike source density was quantified into amplitude, and the source location was carried out according to the Desikan-Killiany atlas. Then, the relationship between the distribution of spike source in brain and clinical manifestations was analyzed.
Results: The source locations of epilepsy discharge in SeLECTS and EE-SWAS (including ABPE, LKS, CSWS) were significantly different. The current source density of CSWS was stronger in frontal lobe, insula and anterior cingulate gyrus, while that of ABPE was stronger in frontal lobe, while that of SeLECTS and LKS were stronger in temporal lobe. The overall energy of the current source was obviously different in SeLECT and EE-SWAS. The overall discharge source energy was the largest in CSWS, followed by ABPE, SeLECTS, and LKS, which is consistent with the spread and expand of EEG.
Conclusions: The study provided novel findings regarding origin of sources of epileptiform discharges in SeLECTS and EE-SWAS. These spike source density distributions could explain the centrotemporal discharge characteristics, cognitive and neuropsychological characteristics in different subtypes of EE-SWAS.
Funding: Beijing Natural Science Foundation [Grant No. Z200024]