Abstracts

Rationale: Due to relatively mild seizures and the typically observed spontaneous remission during adolescence, Rolandic Epilepsy (RE) is largely considered to be a benign focal epilepsy of childhood. Recent research has come to question the benignity and the largely assumed lack of sequelae in RE in that cognitive comorbidities have been found that might persist even after the remission of seizures. With its typical onset between the age of 7-10 years, RE might critically influence the development and maturation of brain networks (BN) that are crucially involved in cognitive and psychological functioning, such as Default Mode Network (DMN), and might therefore result in an aberrant intrinsic organization of the brain with potential cognitive and behavioral consequences even after remission of seizures.Methods: Cognitive development (CD) in 10 children with RE (MeanAge = 9.76 ± 2.02 yrs., 6 male) was assessed using the Wechsler Intelligence Scale for Children-IV (WISC-IV). Parents were asked to fill in the Five Factor Questionnaire for Children (FFFK), a Big-Five inventory for the assessment of personality traits reflecting the children’s emotional and social development (ESD). A 15-minute resting state-fMRI was conducted using the following parameters: 3D MR-Encephalography sequence, TR=100 ms, TE=36 ms, 64x64x64 matrix, 3mm isotropic voxels. DMN regions of interest (ROI) were extracted according to AAL atlas (Table 1). DMN network properties were assessed using standard graph-theoretical measures (betweenness centrality (BC), degree (K), clustering coefficient (C), local/global efficiency (Eloc/Eglob)).Results: DMN’s local efficiency and clustering coefficient were positively correlated with processing speed (PS) on WISC-IV (ρ = .882; p = .002) and extraversion (EXT) ( ρ = .778; p = .008) and emotional stability (ES) (ρ = .667; p = .035) in FFFK and trended toward negative correlation with disease severity (ρ = -.588; p = .074). Earlier age at epilepsy onset tended to be associated with worse performance in verbal comprehension on WISC-IV (ρ = .655; p = .055). Individual DMN nodes also showed significant correlations with WISC-IV and FFFK scores (Table 2).Conclusions: Even if seizures are mild, children with RE may be on an elevated risk to show cognitive and behavioral variations that may be exacerbated by early epilepsy onset and high number of seizures and are associated with aberrant DMN organization. DMN connectivity might constitute a promising marker for CD and ESD in RE patients. Additionally, the use of parent questionnaires might be useful in order to identify children with an elevated risk for the development of cognitive and behavioral deficits that might endure even after the remission of seizures and who may benefit from additional intervention.