Cryptogenic Epilepsy Clinical Trial
Official title:
Diffusion Tensor Imaging of the Thalamo-cortical Network in Epilepsy With Continuous Spikes and Waves During Sleep
Continuous Spikes and Waves during Sleep (CSWS) is a rare paediatric epileptic
encephalopathy. Even if the correlation between the severity of the epilepsy and the
cognitive consequences is well established, the mechanisms involved in epileptic cognitive
degradation are complex and poorly understood. In CSWS, there are many arguments for the
implication of cortical and subcortical cerebral structures. Among them the thalamus seems
to play a crucial role. In fact it is strongly implicated in the sleep and this function is
determining for learning. Moreover, it is part of the propagation pathway of generalized
forms of epilepsy like absences in animal studies. Unfortunately there is no animal model
for CSWS to confirm this theory. In human studies, few cases are caused by thalamic injuries
but most of the time conventional MRI is normal. Despite few literature on CSWS, some
studies reported abnormal functional connectivity especially in the thalamus.
The investigators hypothesize that the first utilisation of diffusion tensor imaging (DTI)
and tractography will be useful in CSWS to confirm the implication of a
cortico-thalamo-cortical network showing an abnormal structural connectivity. The
investigators will try to determinate if a particular thalamic nucleus is concerned and
demonstrate a link between the disease severity (duration and cognitive consequences) and
the importance of structural abnormalities.
Using resting state functional MRI (fMRI), the investigators will also try to investigate
the default mode network. Its implication was also suggested in the literature.
Continuous Spikes and Waves during Sleep (CSWS) is a rare paediatric epileptic
encephalopathy. Even if the correlation between the severity of the epilepsy and the
cognitive consequences is well established, the mechanisms involved in epileptic cognitive
degradation are complex and poorly understood. In CSWS, there are many arguments for the
implication of cortical and subcortical cerebral structures. Among them the thalamus seems
to play a crucial role. In fact it is strongly implicated in the sleep and this function is
determining for learning. Moreover, it is part of the propagation pathway of generalized
forms of epilepsy like absences in animal studies. Unfortunately there is no animal model
for CSWS to confirm this theory. In human studies, few cases are caused by thalamic injuries
but most of the time conventional MRI is normal. Despite few literature on CSWS, some
studies reported abnormal functional connectivity especially in the thalamus.
The investigators hypothesize that the first utilisation of diffusion tensor imaging (DTI)
and tractography will be useful in CSWS to confirm the implication of a
cortico-thalamo-cortical network showing an abnormal structural connectivity. The
investigators will try to determinate if a particular thalamic nucleus is concerned and
demonstrate a link between the disease severity (duration and cognitive consequences) and
the importance of structural abnormalities.
Using resting state functional MRI (fMRI), the investigators will also try to investigate
the default mode network. Its implication was also suggested in the literature.
;