Abnormal amygdala volumes in pediatric mood-anxiety disorders and attention deficit hyperactivity disorder (ADHD), as well as high rates of these diagnoses in childhood absence epilepsy (CAE), prompted this study of amygdala volume in CAE. Twenty-six children with CAE and 23 normal children, aged 6.6-15.8 years, underwent MRI at 1.5 T. The tissue imaged with MRI was segmented, and amygdala volumes were obtained by manual tracings. There were no significant amygdala volume differences between the CAE and normal groups. Within the CAE group, however, the children with ADHD had significantly smaller amygdala volumes than the subjects with CAE with no psychopathology and those with mood/anxiety diagnoses. There was also a significant relationship between higher seizure frequency and greater amygdala asymmetry in the epilepsy group. Given ongoing development of the amygdala during late childhood and adolescence, despite the lack of significant group differences in amygdala volumes, the association of amygdala volume abnormalities with ADHD and seizure frequency implies a possible impact of the disorder on amygdala development and CAE-associated comorbidities, such as ADHD.
"FULL-LENGTH ORIGINAL RESEARCH 1997, 1998, 2000; Cormack et al., 2005; Daley et al., 2006, 2007, 2008; Guimaraes et al., 2007; Caplan et al., 2008). Similar cross-sectional investigations of children with idiopathic generalized epilepsies, including childhood absence and juvenile myoclonic epilepsy, have revealed distributed patterns of abnormality predominantly affecting thalamus and frontal lobe (Betting et al., 2006a– c; Pardoe et al., 2008; Pulsipher et al., 2009), but also with reports of abnormal volumes of the amygdala and regions of the temporal and frontal lobes (Caplan et al., 2009; Schreibman Cohen et al., 2009). Collectively, these studies clearly indicate a neurodevelopmental contribution to anatomic abnormalities that have been observed in adults with these syndromes of epilepsy (c.f., Hermann et al., 2008), but the onset and course of their emergence remains uncertain. "
[Show abstract][Hide abstract] ABSTRACT: To characterize prospective neurodevelopmental changes in brain structure in children with new and recent-onset epilepsy compared to healthy controls.
Thirty-four healthy controls (mean age 12.9 years) and 38 children with new/recent-onset idiopathic epilepsy (mean age 12.9 years) underwent 1.5 T magnetic resonance imaging (MRI) at baseline and 2 years later. Prospective changes in total cerebral and lobar gray and white matter volumes were compared within and between groups.
Prospective changes in gray matter volume were comparable for the epilepsy and control groups, with significant (p < 0.0001) reduction in total cerebral gray matter, due primarily to significant (p < 0.001) reductions in frontal and parietal gray matter. Prospective white matter volume changes differed between groups. Controls exhibited a significant (p = 0.0012) increase in total cerebral white matter volume due to significant (p < 0.001) volume increases in the frontal, parietal, and temporal lobes. In contrast, the epilepsy group exhibited nonsignificant white matter volume change in the total cerebrum (p = 0.51) as well as across all lobes (all p's > 0.06). The group by white matter volume change interactions were significant for total cerebrum (p = 0.04) and frontal lobe (p = 0.04).
Children with new and recent-onset epilepsy exhibit an altered pattern of brain development characterized by delayed age-appropriate increase in white matter volume. These findings may affect cognitive development through reduced brain connectivity and may also be related to the impairments in executive function commonly reported in this population.
[Show abstract][Hide abstract] ABSTRACT: OBJECTIVE: To investigate in the literature elements that explain the association between the attention deficit hyperactivity disorder (ADHD) and epilepsy and to provide clinical guidelines for the management of patients that share these disorders. METHODS:Review of literature of the last 10 years in MedLine and Lilacs databases. The keywords used were "attention deficit hyperactivity disorder", "ADHD" and "epilepsy. RESULTS: Symptoms of ADHD are more frequent in idiopathic epilepsies. Several factors may contribute to this comorbidity: 1) common genetic environment; 2) participation of neurotransmitters norepinephrine and dopamine in ADHD and in neuronal excitability modulation; 3) the underlying brain structural abnormalities found in epileptic patients with ADHD; 4)the chronic effects of seizures and of the epileptiform interictal EEG discharges in attention; 5) the cognitive side effects of antiepileptic drugs. CONCLUSIONS: Recents evidences suggest that seizures and ADHD may have common neurobiological bases. Researches that investigate dysfunctions in cerebral cathecholamines pathways and the role of the interictal epileptiform discharges in the generation of the sintoms are essencial to understand these mechanisms. Treatment for ADHD with stimulant drugs are safe and effective in most epileptic patients.
Jornal brasileiro de psiquiatria 12/2009; 59(2):146-155. DOI:10.1590/S0047-20852010000200011
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