IMAGINE-Study (Imaging in Epilepsy)
Onderzoek naar de oorzaak van geheugenproblemen en falen van medicamenteuze behandeling bij kinderen met frontaalkwab epilepsie.

Frontal lobe epilepsy, i.e. epilepsy with a frontal epileptic focus, represents a substantial proportion of all partial epilepsies. The average age at onset of frontal lobe epilepsy is between 6 and 12 years. After the diagnosis is made, the prognosis is still uncertain. Part of the children responds well to antiepileptic drug treatment, while others will become refractory and have frequent and disabling seizures. A second problem is that part of the children with frontal lobe epilepsy will suffer from cognitive impairment. The nature and severity of this impairment is highly variable, but it may seriously affect their development. Up to now, no clear patient or epilepsy-related factors responsible for refractoriness and/or cognitive decline have been identified, and structural MRI scans commonly reveal no abnormalities that may explain this, even after years of ongoing seizures. Therefore, there are no markers to recognise this patient category.In this study we investigate correlations between cognitive impairment as well as response to anti-epileptic drug treatment in children with frontal lobe epilepsy and brain microstructure, function and neuronal connectivity, by using DTI, task related fMRI, and resting state fMRI.

Based on the type of cognitive impairments frequently observed in children with frontal lobe epilepsy, functional networks in the frontal and/or temporal lobe are expected to be disrupted. Therefore we expect neuronal reorganisation especially in this early phase of the epilepsy (age 8-12 years), as this is the phase in which refractoriness and cognitive impairment develop. Recently, more advanced MRI-techniques, including diffusion tensor imaging (DTI) and functional magnetic resonance imaging (fMRI) became available. These techniques are capable of visualizing and assessing the level and integrity of functional networks. Such techniques may reveal the neuronal correlates of cognitive impairment and refractoriness on the level of microstructural and functional abnormalities.

1. Year 1: Calibration study and image data analysis of the calibration study. After analysis, inclusion and imaging of the first patients and healthy control children for the cohort study. End point: results of healthy adult volunteers from the calibration study;

2. Year 2: Inclusion and imaging of patients and healthy control children for the cohort study. Data analysis;

3. Year 3: Last year for patient inclusion and image data analysis. End point: comparison of results of healthy control children with patients and writing of first manuscripts;

4. Year 4: Further analysis and writing publications and PhD thesis.

1. All eligible children diagnosed with FLE will get a structural brain MRI scan, as well as a DTI, resting state fMRI and task related fMRI scan. Neuropsychological assessment will only be repeated if the last test was performed more than one year earlier;

2. Children of the healthy control group (matched for age) will get a neuropsychological assessment. Additionally, a structural MRI scan, as well as a DTI, resting state fMRI and task related fMRI scan will be performed.