How seizures affect brain wiring in children with focal epilepsy
Impact of Epileptic Discharge on the Structural Connectivity of the Developing Brain: Combination of Intracerebral Stereotactic Electroencephalography Recording and Diffusion Tensor Imaging in Children With Drug-resistant Focal Epilepsy
This project tests whether ongoing seizures change the brain's white-matter wiring in children with drug-resistant focal epilepsy who are being evaluated for surgery.
Quick facts
| Study type | Observational |
|---|---|
| Enrollment | 82 (estimated) |
| Ages | 18 Months to 16 Years |
| Sex | All |
| Sponsor | Fondation Ophtalmologique Adolphe de Rothschild Research network |
| Locations | 1 site (Paris) |
| Trial ID | NCT03268824 on ClinicalTrials.gov |
What this trial studies
This observational study combines intracerebral stereotactic EEG (SEEG) recordings with diffusion-weighted MRI tractography in children undergoing presurgical evaluation for drug-resistant focal epilepsy. Diffusion MRI is acquired before electrode implantation to map white-matter fibers, and SEEG recordings are used to compute an epileptogenicity index for each contact to quantify local seizure discharge intensity. Locally, the study correlates regions of reduced structural connectivity with epileptogenicity at nearby contacts; globally, it compares left and right hemisphere fiber patterns to probe preservation of language lateralization. A control group without drug-resistant focal epilepsy is included to help distinguish seizure-related changes from developmental or congenital differences.
Who should consider this trial
Good fit: Ideal candidates are children with drug-resistant focal epilepsy who are undergoing presurgical intracerebral electrode evaluation, can tolerate MRI, speak French, and do not have severe intellectual disability, multi-lobar or bihemispheric epilepsy, major sensory loss, or congenital connectivity disorders.
Not a fit: Children with IQ below 50, contraindications to MRI, bi-hemispheric or multi-lobar epilepsy, congenital brain connectivity disorders, autism, or major sensory impairments are unlikely to benefit from this protocol.
Why it matters
Potential benefit: If ongoing seizure-related changes to brain connections are demonstrated, the findings could help guide surgical targeting and explain cognitive problems, potentially improving surgical outcomes and long-term development.
How similar studies have performed: Prior diffusion tractography studies have shown widespread connectivity alterations in focal epilepsy, but directly linking those changes to intracerebral seizure activity using combined SEEG-DWI methods is relatively novel and not yet proven.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: \- Drug resistant focal epilepsy Inclusion Criteria for control patients: \- without drug resistant focal epilepsy Exclusion Criteria: * Severe mental retardation (IQ \< 50) * Lack of French-language skills * Contraindications to MRI * Bi-hemispherical epilepsy or affecting multiple lobes Exclusion Criteria for control patients: * Severe mental retardation (IQ \< 50) * Lack of French-language skills * Contraindications to MRI * Congenital pathology altering cerebral connectivity * Parenchymal brain lesions * Unilateral or bilateral blindness * Unilateral or bilateral deafness * Autistic disorders
Where this trial is running
Paris
- Fondation Ophtalmologique A. de Rothschild — Paris, France (Recruiting)
Study contacts
- Principal investigator: Vera Dinkelacker, MD PhD — Fondation Ophtalmologique A. de Rothschild
- Study coordinator: Laurence Salomon, MD PhD
- Email: lsalomon@for.paris
- Phone: 0148036431
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.