Altered neurostructural development in magnetic resonance imaging‐negative pediatric epilepsy: A large‐scale multicenter study of 1919 children

作者：Yingfan Wang, Minghao Li, Huijun Li, W N Yu, Peilin Jiang, Xinyi Zhou, Ke Hu, Feng Yang, Jiu Chen, Ming Yang, Xiaoshan Wang · 发表于：Epilepsia · 年份：2025 · DOI：10.1002/epi.70065 · 被引用次数：2 · 研究领域：Epilepsy research and treatment、Functional Brain Connectivity Studies、Advanced MRI Techniques and Applications

OBJECTIVE: Addressing the poorly understood impact of pediatric epilepsy on neurodevelopment, this large-scale study delineates age- and sex-stratified neurostructural trajectories in magnetic resonance imaging (MRI)-negative pediatric epilepsy to identify periods of maximal developmental divergence from healthy controls. METHODS: In this multicenter, cross-sectional study, we analyzed T1-weighted MRI from 957 patients with MRI-negative epilepsy and 962 controls (aged 4-12 years). Generalized additive models for location, scale, and shape modeled sex-stratified developmental trajectories of global brain metrics. Voxel- and surface-based morphometry compared cortical morphology and regional gray matter volume (GMV) between groups across yearly age bins (familywise error-corrected p < .05). RESULTS: Compared to controls, patients showed reduced total intracranial volume, GMV, cerebrospinal fluid volume, and cortical thickness and significantly increased white matter hyperintensity burden. Key findings on developmental trajectories include an atypical trajectory of total surface area, a premature cortical thickness peak at approximately age 7 years, and a white matter hyperintensity (WMH) burden peak at approximately age 8 years. From ages 4 to 9 years, patients displayed widespread cortical morphological delays, most prominently affecting limbic and sensorimotor networks, which appeared to normalize after age 10 years. Unlike the GMV atrophy seen in adults, pediatric patients s...