Cortical and thalamic resting-state functional connectivity is altered in childhood absence epilepsy

Purpose: Functional imaging studies have identified a common network of brain regions that activate and deactivate during the generalised spike wave (GSW) discharges of childhood absence epilepsy (CAE). Functional connectivity within this network is also altered during the resting state. In this study our aim was to assess functional connectivity throughout the whole brain of patients with CAE. Methods: We studied a group of eleven patients with untreated CAE and eleven matched controls using resting-state fMRI. We measured functional connectivity between every pair of voxels and generated images of whole-brain functional connectivity by counting the number of functional connections of each voxel. Key findings: There were marked differences between CAE patients and controls in whole brain functional connectivity. The patients had decreased connectivity in the thalamus and basal ganglia and increased connectivity in the medial occipital cortex. Significance: These findings suggest enduring changes in function of the thalamus and the cortex in CAE patients even when there is no GSW activity. These human functional connectivity data support the findings in animal models of involvement of cortex as well as thalamus in absence epilepsy. (C) 2012 Elsevier B.V. All rights reserved.