B-0012 Language impairment and reduced structural connectivity in Rolandic epilepsy

R. Besseling, J. Jansen, W.H. Backes | Thursday, March 7, 10:30 – 12:00 / Room C

Purpose: Rolandic epilepsy (RE) is a childhood epilepsy with mild seizure semiology and epileptic discharges originating from the sensorimotor (Rolandic) area. A serious co-morbidity in RE is language impairment, for which we aim to find a correlate using structural connectivity.
Methods and Materials: Diffusion MRI was performed at 3.0 Tesla and 2×2×2 mm voxel size with b=1200 s/mm² and 66 diffusion gradient directions in 23 children with RE with proven language deficits and 23 matched controls. Constrained spherical deconvolution provided voxel-wise tract orientations and whole-brain tractography (5M streamlines). For each of the 4 Rolandic areas (bilateral pre- and postcentral gyri), the streamlines to any of the 70 regions, obtained by automatic cortical parcellation (Freesurfer), were selected from the whole-brain tractogram. For reliable connections (top 20 % of number of streamlines), connectivity was quantified by tract fractional anisotropy (FA), compared between groups, and correlated to language scores.
Results: In the left hemisphere, reduced tract FA was found for connections between the Rolandic areas and inferior frontal gyrus (Broca’s area) and supramarginal gyrus (Wernicke’s area), but not for contralateral homologue regions. For the aberrant connection between the left postcentral and inferior frontal gyrus, tract FA decreased with languages score in the RE group (p=0.04).
Conclusion: In RE structural connectivity between Rolandic and language areas is disturbed and correlates with the language dysfunction. This provides a neuronal link between the location of the epileptic discharges and the language impairment. This research was supported by the Dutch Epilepsy Foundation.

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