• Gerhard S Drenthen, Eric L A Fonseca Wald, Walter H Backes, Mariette H J A Debeij-Van Hall, Hendriksen Jos G M JGM Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands. , Albert P Aldenkamp, R Jeroen Vermeulen, Sylvia Klinkenberg, and Jansen Jacobus F A JFA 0000-0002-5271-8060 School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherland.
• School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.
• Epilepsia. 2019 Aug 1; 60 (8): 1689-1696.

ObjectiveThe frontal lobe in childhood absence epilepsy (CAE) might be affected due to the suggested involvement of the frontal lobe during absence seizures and reports on attentional deficits. Previously, subtle white matter abnormalities have been reported in CAE. However, the impact of one of the most characteristic components of the white matter, the myelin content, remains underdetermined. Therefore, this study investigated whether the myelin content in frontal areas is adversely affected in CAE compared to controls.MethodsSeventeen children with childhood absence epilepsy (mean age ± standard deviation [SD], 9.2 ± 2.1 years) and 15 age- and sex-matched controls (mean age ± SD, 9.8 ± 1.8 years) underwent neuropsychological assessment and a magnetic resonance imaging (MRI) examination. T2 relaxometry scans were used to distinguish myelin-water from tissue water and to determine the myelin-water fraction (MWF) in the frontal, temporal, parietal, occipital, and insular lobes. A linear regression model including age and sex as covariates was used to investigate group differences. Furthermore, the relationship of MWF with cognitive performance and epilepsy characteristics was determined.ResultsThe frontal lobe revealed a significantly lower myelin-water content in children with CAE compared to controls over the developmental age range of 6-12 years (5.7 ± 1.0% vs 6.6 ± 1.1%, P = 0.02). This association was not found for any of the other four lobes (P > 0.10). No significant relation was found between myelin-water content and cognitive performance or epilepsy characteristics.SignificanceThe lower frontal myelin-water content of children with CAE in comparison with healthy controls probably reflects an altered neurodevelopmental aspect in CAE, of which the underlying mechanisms still need to be unraveled.© 2019 The Authors. Epilepsia published by Wiley Periodicals, Inc. on behalf of International League Against Epilepsy.

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