Why Are Patients With Absence Seizures Absent? A Brain Imaging Study



Status:Completed
Conditions:Neurology
Therapuetic Areas:Neurology
Healthy:No
Age Range:6 - 18
Updated:4/21/2016
Start Date:September 2006
End Date:September 2015

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Functional Neuroimaging in Childhood Absence Epilepsy

Our study examines which different brain regions are involved in child absence seizures and
how they are related to attention and cognition.

The fundamental mechanisms of altered brain function and impaired attention in childhood
absence epilepsy (CAE) are not known. Absence seizures consist of brief 5-10 seconds
episodes of unresponsiveness, associated with a 3-4 Hz "spike-wave" discharge on
electroencephalogram (EEG). CAE affects 10-15% of children with epilepsy. In addition to the
deficit during seizures, many children also suffer from milder attention impairment between
absence episodes, which may not be due entirely to medications. Impaired attention during
and between absence seizures has a major negative impact on patient quality of life due to
deficits in school performance, potential for injuries, and social stigma.

Recent studies suggest that impaired cognition in so-called "generalized" absence seizures
may, in fact, depend on dysfunction in specific brain networks. Our central hypothesis is:
abnormal function in focal brain regions, such as the anterior cingulate/medial prefrontal
cortex and medial thalamus, causes impaired attention both during and between seizures in
CAE. If confirmed, this may lead to innovative regional therapies targeted at improving
impaired attention in CAE. Specifically, we hope to determine which specific cortical and
sub-cortical networks are selectively involved when patients show impaired attention. Using
simultaneous EEG and functional magnetic resonance imaging (fMRI), we will determine which
brain regions are involved in absence seizures while using a continuous performance task
(CPT) to test attention vigilance in the same patients. A few neuropsychology tests will
then follow. Patients will be reimbursed $100 as well as all travel and parking expenses.

For more information, please visit www.yalecae.com

Inclusion Criteria:

- Confirmed diagnosis of childhood absence epilepsy or juvenile absence epilepsy

- No other serious health problems or neurological problems

- 6 years or older

Exclusion Criteria:

- No history of myoclonic or tonic-clonic seizures
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