White matter microstructural integrity in SeLECTS: a diffusion tensor imaging study of cognitive and behavioral correlates.

Objective

To investigate white-matter microstructure in children with self-limited epilepsy with centrotemporal spikes (SeLECTS) using diffusion tensor imaging (DTI).

Methods

This comparative cohort included 26 patients with SeLECTS and 23 age-matched healthy controls. White-matter microstructure was analyzed using a multimodal approach, combining DTI (TRACULA-based tractography) with electroencephalography (EEG), neuropsychological, and psychiatric assessments. Cognitive and behavioral functions were assessed using the Bender-Visual-Motor-Gestalt Test (BVMG), Wechsler Intelligence Scale for Children-Fourth Edition, Trail Making Test, verbal fluency test, Behavior Rating Inventory of Executive Function (BRIEF), and Turgay-ADHD scale. DTI data were acquired on a 3.0-T-MRI scanner. Group differences in DTI parameters and exploratory associations between DTI metrics-fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) -and neuropsychological or behavioral measures were examined.

Results

SeLECTS patients demonstrated nominally lower FA values in the superior longitudinal fasciculus (SLF) and arcuate fasciculus (AF) compared with controls. Nominal associations were observed between BVMG rotation and perseveration errors and FA values in the corpus callosum body. Although full-scale intelligence quotient was lower in the patient group, subscale differences were not significant. Nominal associations were also observed between BRIEF Organization of Materials scores and DTI measures, including FA and RD in the corpus callosum. However, none of the tract-behavior associations remained statistically significant after Benjamini-Hochberg false discovery rate correction.

Conclusion

This study identified nominal differences in white-matter microstructure and exploratory tract-behavior associations in children with SeLECTS using a multimodal approach (DTI, EEG, and neuropsychological tests). These tract-behavior associations should be considered hypothesis-generating. Integrating DTI with neuropsychological assessments may help identify potential cognitive and behavioral correlates of SeLECTS and inform future longitudinal research.