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Subcortical nuclei volumes are associated with cognition in children post-convulsive status epilepticus: results at nine years follow-up

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  • Kyle H Bennett
  • Suresh S. Pujar
  • Marina Martinos
  • Christopher A Clark
  • Michael Yoong
  • Rodney C. Scott
  • Richard Chin

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Original languageEnglish
JournalEpilepsy & Behavior
Early online date8 Jun 2020
Publication statusPublished - Sep 2020


Purpose: To investigate the relationship between subcortical nuclei volume and cognition in children post-convulsive status epilepticus (CSE). Methods: Structural T1-weighted MRI scans (Siemens Avanto, 1.5T) and neuropsychological assessments (full-scale IQ (FSIQ) and global memory scores (GMS)) were collected from subjects at a mean 8.5 years post-CSE (Prolonged Febrile Seizures, n=30; Symptomatic/Known, n=28; and Other, n=12) and from age and sex-matched healthy controls (HC). CSE subjects were stratified into those with lower cognitive ability (CSE+, n=22) and those without (CSE–, n=48). Quantitative volumetric analysis using FSL (Analysis Group, FMRIB, Oxford) provided segmented MRI brain volumes. Univariate ANCOVA was performed to compare subcortical nuclei volumes across subgroups. Multivariable linear regression was performed for each subcortical structure and for total subcortical volume (SCV) to identify significant predictors of lower cognitive ability (FSIQ<85), whilst adjusting for aetiology, age, socioeconomic status, sex, CSE duration and intracranial volume; Bonferroni correction was applied for analysis of individual subcortical nuclei. Results: Seventy subjects (11.8 ± 3.4SD years; 34 male) and 72 controls (12.1 ± 3.0SD years; 29 male) underwent analysis. Significantly smaller volumes of the left thalamus, left caudate, right caudate and SCV were found in CSE+ subjects compared to HC, after adjustment for intracranial, grey matter, or cortical/cerebellar volume. When compared to the CSE–, CSE+ subjects also had smaller volumes of the left thalamus, left pallidum and right pallidum and SCV. Individual subcortical nuclei were not associated, but SCV was associated with FSIQ (p=0.005) and GMS (p=0.014). ICV and aetiology were similarly predictive. Conclusions: Nine years post-CSE, SCV is significantly lower in children who have lower cognitive ability compared to those that do not. However, in this cohort we are unable to determine whether the relationship is independent of ICV or aetiology. Future, larger scale studies may help tease this out.

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