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Quantitative magnetic resonance imaging evidence for altered structural remodeling of the temporal lobe in West syndrome

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      Summary

      Objective

      To explore the structure–function relation of the temporal lobe in newly diagnosed West syndrome of unknown cause ( uWS).

      Methods

      Quantitative magnetic resonance imaging (three‐dimensional [3D] structural MRI and diffusion tensor imaging [DTI]) was analyzed using voxel‐based morphometry ( VBM) and tract‐based spatial statistics ( TBSS) in 22 patients and healthy age‐matched controls. The electrophysiologic responsiveness of the temporal lobe was measured using the N100 auditory event‐related potential ( aERP) to a repeated 1,000 Hz tone. Neurocognitive function was assessed using the Bayley Scales of Infant Development, Second Edition ( BSIDII). Tests followed first‐line treatment with vigabatrin (17 patients) or high‐dose oral prednisolone (5 patients).

      Results

      Total temporal lobe volume was similar in patients and controls. Patients had a smaller temporal stem ( TS) (p < 0.0001) and planum temporale ( PT) (p = 0.029) bilaterally. TS width asymmetry with a larger right‐sided width in controls was absent in patients (p = 0.033). PT asymmetry was present in both groups, being larger on the right (p = 0.048). VBM gray matter volume was increased at the left temporal lobe (superior and middle temporal gyri, the peri‐rhinal cortex, and medial temporal lobe) (p < 0.005, family wise error‐corrected). VBM gray matter volume correlated with the duration of infantile spasms (Pearson's r = −0.630, p = 0.009). DTI metrics did not differ between patients and controls on TBSS. Mean BSIDII scores were lower (p < 0.001) and auditory N100 ERP attenuated less in patients than in controls (p = 0.002).

      Significance

      The functional networking and white matter development of the temporal lobe are impaired following infantile spasms. Treatment may promote structural plasticity within the temporal lobe following infantile spasms, manifest as increased gray matter volume on VBM. It remains to be investigated further whether this predicts patients' long‐term cognitive difficulties.

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      Most cited references 40

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      Neocortex, a new and rapidly evolving brain structure in mammals, has a similar layered architecture in species over a wide range of brain sizes. Larger brains require longer fibers to communicate between distant cortical areas; the volume of the white matter that contains long axons increases disproportionally faster than the volume of the gray matter that contains cell bodies, dendrites, and axons for local information processing, according to a power law. The theoretical analysis presented here shows how this remarkable anatomical regularity might arise naturally as a consequence of the local uniformity of the cortex and the requirement for compact arrangement of long axonal fibers. The predicted power law with an exponent of 4/3 minus a small correction for the thickness of the cortex accurately accounts for empirical data spanning several orders of magnitude in brain sizes for various mammalian species, including human and nonhuman primates.
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        This review focuses on the maturation of brain white-matter, as revealed by magnetic resonance (MR) imaging carried out in healthy subjects. The review begins with a brief description of the nature of the MR signal and its possible biological underpinnings, and proceeds with a description of MR findings obtained in newborns, infants, children and adolescents. On MR images, a significant decrease in water content leads to a decrease of longitudinal relaxation times (T1) and transverse relaxation times (T2) and consequent "adult-like" appearance of T1-weighted and T2-weighted images becomes evident towards the end of the first year of life. Owing to the onset of myelination and the related increase of lipid content, MR images gradually acquire an exquisite grey-white matter contrast in a temporal sequence reflecting the time course of myelination. Albeit less pronounced, age-related changes in white matter continue during childhood and adolescence; white matter increases its overall volume and becomes more myelinated in a region-specific fashion. Detection of more subtle changes during this "late" phase of brain development is greatly aided by computational analyses of MR images. The review also briefly outlines future directions, including the use of novel MR techniques such as diffusion tensor imaging and magnetization transfer, as well as the suggestion for the concurrent use of experimental behavioral test-batteries, with structural MR imaging, to study developmental changes in structure-function relationships.
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          The last decade has produced an explosion in neuroscience research examining young children's early processing of language. Noninvasive, safe functional brain measurements have now been proven feasible for use with children starting at birth. The phonetic level of language is especially accessible to experimental studies that document the innate state and the effect of learning on the brain. The neural signatures of learning at the phonetic level can be documented at a remarkably early point in development. Continuity in linguistic development from infants' earliest brain responses to phonetic stimuli is reflected in their language and prereading abilities in the second, third, and fifth year of life, a finding with theoretical and clinical impact. There is evidence that early mastery of the phonetic units of language requires learning in a social context. Neuroscience on early language learning is beginning to reveal the multiple brain systems that underlie the human language faculty. 2010 Elsevier Inc. All rights reserved.
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            Author and article information

            Affiliations
            [ 1 ]Young Epilepsy SurreyUnited Kingdom
            [ 2 ] Department of Clinical NeurophysiologyGreat Ormond Street Hospital for Children NHS Trust LondonUnited Kingdom
            [ 3 ] Neurosciences UnitUniversity College London Institute of Child Health LondonUnited Kingdom
            [ 4 ] The Functional Imaging LaboratoryUniversity College London LondonUnited Kingdom
            [ 5 ] Department of NeuroradiologyGreat Ormond Street Hospital for Children NHS Trust LondonUnited Kingdom
            [ 6 ] RCS Unit of BiophysicsUniversity College London Institute of Child Health LondonUnited Kingdom
            [ 7 ] Department of NeurologyGreat Ormond Street Hospital for Children NHS Trust LondonUnited Kingdom
            [ 8 ] Department of Neurological SciencesUniversity of Vermont Burlington VermontU.S.A
            [ 9 ] Centre for Developmental Cognitive NeurosciencesUniversity College London LondonUnited Kingdom
            Author notes
            [* ]Address correspondence to Tangunu Fosi, UCL Institute of Child Health, 4‐5 Long Yard, London WC1N 3LU, U.K. E‐mail: sejjtfo@ 123456ucl.ac.uk
            Journal
            Epilepsia
            Epilepsia
            10.1111/(ISSN)1528-1167
            EPI
            Epilepsia
            John Wiley and Sons Inc. (Hoboken )
            0013-9580
            1528-1167
            02 March 2015
            April 2015
            : 56
            : 4 ( doiID: 10.1111/epi.2015.56.issue-4 )
            : 608-616
            25802930 5006860 10.1111/epi.12907 EPI12907
            © 2015 The Authors. Epilepsia published by Wiley Periodicals, Inc. on behalf of International League Against Epilepsy.

            This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

            Counts
            Pages: 9
            Product
            Funding
            Funded by: Department of Health's NIHR Biomedical Research Centre
            Categories
            Full‐Length Original Research
            Full‐length Original Research
            Custom metadata
            2.0
            epi12907
            April 2015
            Converter:WILEY_ML3GV2_TO_NLMPMC version:4.9.4 mode:remove_FC converted:31.08.2016

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