Impaired Default Mode Network on Resting-State fMRI in Children with Medically Refractory Epilepsy

Article Figures & Data

Download figure
Open in new tab
Download powerpoint
Fig. 1.
Random-effects analysis of the DMN in controls (A) and (B) patients. C, The patients demonstrate decreased DMN connectivity in the PCC/PCUN, bilateral lateral parietal cortex, and anterior and midcingulate.
Download figure
Open in new tab
Download powerpoint
Fig. 2.
Functional connectivity within the DMN in controls (A) and patients (B). Numbers in the rectangles correspond to the average pair-wise correlation coefficients. C, Comparison of functional connectivity within the DMN in controls versus patients shows significant reduction in mPFC–right lateral parietal cortex (LPC), PCC/PCUN–right LPC, and PCC/PCUN–left LPC. Numbers in rectangles represent the P value for the comparison of the mean correlation coefficients of control and patient groups. Thick lines represent significant changes in the pair-wise correlation between controls and patients (P < .05).

Table 1:

Clinical characteristics of patients

No./Age (yr)/Sex	Location of Epilepsy	Age at Seizure Onset (yr)	Duration of Epilepsy (yr)	Antiepileptic Medications	Seizure Frequency/Week
1/15.2/F	R frontal	7	8	Lamotrigine, levetiracetam	7
2/16.3/F	R frontal paracentral	14	2.3	Carbamazepine	7
3/10.0/F	R neocortical inferior temporal	7	3	Lamotrigine, topiramate	10
4/15.3/F	R frontal paracentral	3	12.3	Carbamazepine, lamotrigine, divalproex	10
5/14.0/M	L frontal	8	6	Valproic acid, lamotrigine	20
6/10.1/F	L neocortical anterior temporal	8	2	Carbamazepine	10
7/16.2/M	L frontal paracentral	8	8	Carbamazepine, levetiracetam	10
8/14.1/M	L neocortical anterior temporal	12	2	Lamotrigine, levetiracetam	2
9/14.7/F	R hemisphere	13	1	Levetiracetam, divalproex, valproic acid	2.5
10/15.0/F	L frontal	4.5	10.5	Oxcarbazepine	40
11/14.1/F	R lateral parietal occipital	10	4	Levetiracetam, topiramate	40

Table 2:

Location of brain regions in the default mode network of the controls^{^a}

Anatomic Regions	Hemisphere	MNI Coordinates (x, y, z)	Peak T Value
Posterior cingulate cortex/precuneus	L/R	−6, −54, 28	15.87
Medial prefrontal cortex	L/R	−4, 58, −10	13.89
Lateral parietal cortex	L	−44, −62, 33	9.91
	R	42, −63, 33	10.51

Table 3:

Regions demonstrating reduced connectivity in patients relative to controls

Anatomic Regions	MNI Coordinates (x, y, and z)	Voxel Size (mm³)	Peak T Value
Right anterior cingulate	4, 40, 8	75	3.549
Right midcingulate	4, −16, 40	55	2.679
Right posterior cingulate cortex/precuneus	10, −68, 52	23	2.214
Right lateral parietal cortex	42, −52, 56	183	3.606
Left lateral parietal cortex	−36, −62, 56	142	4.187
Left posterior cingulate cortex/precuneus	0, −60, 34	91	2.682