Resumo

Introduction: Abscence of structural abnormalities in the brain of children with epilepsy is considered to be a benign sign. However, neuropsychological disturbances have been described in these patients. Our group has shown attention deficits in patients with rolandic epilepsysy (RE), an epilepsy form with no described structural abnormality by conventional image analysis. Recently developed image analysis techniques may reveal alterations not previously seen in RE. Objective: Here we report the fMRI (and behaviour) findings of a subgroup of patients with RE. They are part of the first year analysis in a more comprehensive 2 &minusyear longitudinal study in which we aim to use functional Magnetic Resonance Imaging (fMRI), neuropsychological tests, EEG and video EEG to evaluate RE patients (CInAPCe program − FAPESP). Methods: We scanned 10 patients with RE in a 3T MRI system (acquisition parameters: TR 2000ms, TE 30ms, voxel size 3x3x3, 41 slices, 160 volumes). All stimuli (visually presented: Eloquence − Invivo; Eprime − Psylab) and subject′s responses were synchronized with image acquisition (Zurc&Zurc Ltda). The fMRI tasks were design to be used in children, resembling videogames. We used two GO − NOGO tasks presented in a parametric 30s block design: simple Visual Attention (VA) and Visual Continuous Performance (CVP) Subjects were instructed to press one button for all images, except when a picture of a "car" was followed by a "truck". Most of the conditions were valid (70%). Images were corrected for head movement, filtered (5mmFWHM) and the conditions were modeled in a General Linear Model (FSL − Oxford). Group maps were produced using a Children template (Cincinatti Children′s Hospital) and thresholded at p < 0,05 FWE corrected for multiple comparison. Results: The average response time and accuracy rate were 446ms and 74% (VA) and 423ms and 69% (VCP). Activation maps: AV: main areas include anterior cingulated, right DLPFC, borders of the right intraparietal sulcus, bilateral inferior frontal gyrus and bilateral cerebellum, VCP, the main areas include anterior cingulated, right DLPFC, borders of the right intraparietal sulcus, bilateral inferior frontal gyrus and left cerebellum. Conclusions and Perspective: The areas of activation in both paradigms are consistent with previous studies in literature. This is an important finding, since our study includes much younger subjects in a disease which can lead to cognitive impairments. In future we will hope to be able to contribute to the understanding of the impact of benign childhood epilepsy in some cognitive functions.