Antiseizure Medications Normalize Electroencephalographic Functional Connectivity and Power in Children With Benign Epilepsy With Centrotemporal Spikes.

BACKGROUND: The decision to treat children with benign epilepsy with centrotemporal spikes (BECTS) using antiseizure medications (ASM) is controversial. Our goal is to compare the effect of ASM treatment on the alteration of electroencephalographic (EEG) functional connectivity and power across four frequency bands in children with BECTS. METHODS: Children with BECTS with two-year follow-up were retrospectively divided into ASM versus non-ASM groups. The network properties of the EEGs as based on network-based statistic and graph theory were evaluated by the following indices: global efficiency, clustering coefficient, betweenness centrality, and nodal strength in four frequency bands (delta, theta, alpha, and beta). EEG power including absolute power (AP) and relative power (RP) was analyzed in four frequency bands. RESULTS: In children with BECTS with ASM treatment, there was no significant change in EEG connectivity across all bands before and after two years of ASM. In children with BECTS without ASM treatment, there was a significant increase of global efficiency, clustering coefficient, and nodal strength but not the betweenness centrality in the delta band after two years of follow-up. A decrease in AP in the delta and theta bands and a decrease in RP in the theta band were found in the ASM group after two years of treatment. CONCLUSIONS: Our results suggest that ASM may play a role in modulating the development of increasing overall brain connectivity and in downregulating overt synaptic activity, but not intrinsic focal connectivity, in the early years of BECTS. The changes in the EEG power indicate that ASM significantly normalized slow-wave band power.

Resting-State EEG Functional Connectivity in Children with Rolandic Spikes with or without Clinical Seizures.

Alterations in dynamic brain network function are increasingly recognized in epilepsy. Benign childhood epilepsy with centrotemporal spikes (BECTS), or benign rolandic seizures, is the most common idiopathic focal epilepsy in children. In this study, we analyzed EEG functional connectivity (FC) among children with rolandic spikes with or without clinical seizures as compared to controls, to investigate the relationship between FC and clinical parameters in children with rolandic spikes. The FC analysis based on graph theory and network-based statistics in different frequency bands evaluated global efficiency, clustering coefficient, betweenness centrality, and nodal strength in four frequency bands. Similar to BECTS patients with seizures, children with rolandic spikes without seizures had significantly increased global efficiency, mean clustering coefficient, mean nodal strength, and connectivity strength, specifically in the theta frequency band at almost all proportional thresholds, compared with age-matched controls. Decreased mean betweenness centrality was only present in BECTS patients with seizures. Age at seizure onset was significantly positively associated with the strength of EEG-FC. The decreased function of betweenness centrality was only presented in BECTS patients with clinical seizures, suggesting weaker local connectivity may lower the seizure threshold. These findings may affect treatment policy in children with rolandic spikes.