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Research ArticlePediatrics

Thalamocortical Connections and Executive Function in Pediatric Temporal and Frontal Lobe Epilepsy

N. Law, M.L. Smith and E. Widjaja
American Journal of Neuroradiology August 2018, 39 (8) 1523-1529; DOI: https://doi.org/10.3174/ajnr.A5691
N. Law
aFrom the Department of Psychology (N.L., M.L.S.), University of Toronto, Toronto, Ontario, Canada
bDepartment of Psychology (N.L., M.L.S.)
cProgram in Neurosciences and Mental Health (N.L., M.L.S.)
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M.L. Smith
aFrom the Department of Psychology (N.L., M.L.S.), University of Toronto, Toronto, Ontario, Canada
bDepartment of Psychology (N.L., M.L.S.)
cProgram in Neurosciences and Mental Health (N.L., M.L.S.)
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E. Widjaja
dDiagnostic Imaging (E.W.)
eDivision of Neurology (E.W.), Hospital for Sick Children, Toronto, Ontario, Canada.
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    Fig 1.

    Thalamocortical pathways connecting the thalamus with the frontal cortex in a healthy brain. The left thalamocortical pathway is depicted in red/yellow, and the right thalamocortical pathway is depicted in dark/light blue. Axial sections are presented as the tracts progress dorsally from the thalamus to the frontal lobe (left to right).

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    Fig 2.

    Mean composite EF factor scores for the FLE, TLE, and HC groups. Error bars represent SDs. The asterisk indicates a significant group difference (FLE < HC and FLE < TLE for EF1 and FLE < HC for EF2) at the P < .05 level. EF1 represents a mental flexibility/inhibition/switching component, while EF2 represents an attention/cognitive efficiency/problem-solving component.

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    Fig 3.

    Mean composite EF scores for the left and right FLE, left and right TLE, and HC groups. Error bars represent SDs. The asterisk indicates a significant group difference (EF1: left FLE < HC and right FLE < HC; EF2: left FLE < HC, right FLE < HC, left FLE < left TLE) at the P < .05 level. EF1 represents a mental flexibility/inhibition/switching component, while EF2 represents an attention/cognitive efficiency/problem-solving component.

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    Table 1:

    Demographic and medical variables for the HC, FLE, and TLE groups

    FLE (n = 24)TLE (n = 17)HC (n = 25)
    Sex (male/female)10:148:914:11
    Age (yr)
        Mean (SD)13.10 (3.21)14.54 (2.65)13.95 (3.20)
        Range6.96–16.9610.11–19.086.97–18.76
    Handedness (right/left)20/416/122/3
    Age at seizure onset (yr)
        Mean (SD)7.79 (4.01)8.75 (3.76)–
        Range1.00–14.401.30–15.00–
    Duration of epilepsy (yr)
        Mean (SD)5.20 (2.93)4.90 (3.62)–
        Range1.70–12.00.33–12.00–
    No. of AEDs
        Mean (SD)2.00 (.659)1.94 (.748)–
        Range1–31–3–
    Laterality of epileptogenic focus
        Left1310–
        Right94–
        Bilateral23–
    Region of epileptogenic focus (TLE)
        Mesial–3–
        Lateral–12–
        Both mesial and lateral–2–
    Region of epileptogenic focus (FLE)
        Prefrontal2––
        Inferior frontal1––
        Frontal-central9––
        Supplementary motor area3––
        Unable to localize precisely9––
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    Table 2:

    Factor structure and factor loadings (>.45 and/or highest loading) after varimax rotation of 6 measures of EF in the FLE, TLE, and HC groups (n = 55)

    EF MeasureEF1EF2
    D-KEFS Verbal Fluency Test: Letter Fluency–.596
    D-KEFS Verbal Fluency Test: Category Switching–.450
    D-KEFS Color-Word Interference Test: Inhibition.850–
    D-KEFS Color-Word Interference Test: Inhibition/Switching.912–
    D-KEFS Sorting Test: Confirmed Correct Sorts–.824
    CPT3 omission errors–.783
    • Note:—EF1 indicates executive function component factor 1; EF2, executive function component factor 2.

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American Journal of Neuroradiology: 39 (8)
American Journal of Neuroradiology
Vol. 39, Issue 8
1 Aug 2018
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Cite this article
N. Law, M.L. Smith, E. Widjaja
Thalamocortical Connections and Executive Function in Pediatric Temporal and Frontal Lobe Epilepsy
American Journal of Neuroradiology Aug 2018, 39 (8) 1523-1529; DOI: 10.3174/ajnr.A5691

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Thalamocortical Connections and Executive Function in Pediatric Temporal and Frontal Lobe Epilepsy
N. Law, M.L. Smith, E. Widjaja
American Journal of Neuroradiology Aug 2018, 39 (8) 1523-1529; DOI: 10.3174/ajnr.A5691
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