Abnormal Cortical Thickness in Epilepsy Compared to Simple Febrile Seizures in Children: Voxel-Based Morphometric Study

Author(s): Mustafa Salimeen Abdelkareem Salimeen, Congcong Liu, Miaomiao Wang, Lu Gao, Xianjun Li, Jian Yang

Abstract Background and Aim: Epilepsy is currently considered a common neurological disease associated with excessive neuronal damage. Recent functional MRI studies indicate that frontal cortex activity occurs before thalamic involvement in epileptic discharges, implying that the frontal cortex may play a role in childhood seizures. Therefore, this study aimed to investigate differences in gray matter (GM) structural alteration between epilepsy and simple febrile seizures (simple FS).

Material and Methods: In this retrospectively, we includeed 34 children with epilepsy, 27 children with simple FS, and 29 controls aged 6–60 months with magnetic resonance imaging (MRI). Voxel-Based morphometry (VBM) was used to compare GM voxel among the above groups. T13D-weighted images were used to segment GM through a custom-designed automated method.

Results: GM cortical reduction was significantly detected in the right precentral gyrus, right middle frontal gyrus, right frontal gyrus (opercular), right frontal gyrus (medial), bilateral orbitofrontal cortex (medial), and bilateral anterior cingulate gyrus in the epilepsy group (P < 0.05). There were no deep nuclei volume changes in the epilepsy group than in control (P > 0.05). Compared to controls, there was no significant change in GM deep nuclei or cortical thickness of children with simple FS (P > 0.05).

Conclusions: VBM is an effective method to differentiate epilepsy from simple FS. In the epilepsy group, the diseases' initiation started from cortical neurons; deep nuclei were not involved. Simple FS cannot cause deep GM volume reduction or cortical thickness changes and is expected to have a good outcome.

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