REGULATION OF BRAIN NETWORKS BY LEVETIRACETAM AND OXCARBAZEPINE IN CHILDREN WITH BENIGN CHILDHOOD SELF-LIMITED EPILEPSY WITH CENTROTEMPORAL SPIKES (SELECTS)

Min Tu^1,2, Yuling Tan³, Shuangfeng Yang3, Chao Wu³, Xiaoming Wang³

¹North Sichuan Medical College ^{- 2}People's Hospital of Deyang City - ³Affiliated Hospital of North Sichuan 

Objective: This study aimed to investigate the effects of levetiracetam (LEV) and oxcarbazepine (OXC) on structural brain networks and cognitive function in children with Self-Limited Epilepsy with Centrotemporal Spikes (SeLECTS) .

Methods: We recruited 21 children who were newly diagnosed with SeLECTS and divided them into LEV (n=10) and OXC groups (n=11). We obtained 3.0 T high-resolution T1-weighted magnetic resonance imaging (3D-T1 MRI) and neuropsychological assessment data before and 12 months after medication. The statistical parameter map data package was used to preprocess the magnetic resonance images. Changes in cerebral gray matter volume after treatment were compared within and between groups with voxel-based morphological analyses, and correlations between cerebral gray matter volume changes and cumulative doses of the drugs were analyzed.

Results: After treatment, the gray matter volume in the left putamen, left middle temporal gyrus, and left auxiliary motor area decreased significantly in the LEV group, while the gray matter volume in the left putamen, right cerebellum, and left postcentral gyrus increased significantly in the OXC group. The increased gray matter volumes in the right cerebellum and left middle occipital gyrus were significantly negatively correlated with the cumulative dose of OXC (r=-0.64, P =0.034; and r=-0.739, P=0.009, respectively). Neuropsychological evaluation showed that verbal, performance, and full-scale intelligence quotients in both groups increased after treatment, and the increase was statistically significant in the LEV group, but not in the OXC group. 

Conclusion: Both OXC and LEV can regulate the brain regions affected in SeLECTS, but their action sites are different. LEV can significantly improve the brain structural network of children withSeLECTS , while some brain regions of children who are taking OXC may continue to suffer damage, as suggested by the increased gray matter volumes in those regions after OXC treatment. LEV can partly improve the cognitive function of children. The volume increase of the right cerebellum and left occipital gyrus gray matter was negatively correlated with the cumulative use of OXC, suggesting that OXC can improve the damage to brain structure in children with SeLECTS).