Functional Connectivity Associated with Health-Related Quality of Life in Children with Focal Epilepsy

BACKGROUND AND PURPOSE: Although functional connectivity has been linked to cognitive function in epilepsy, its relationship with physical, psychological, or social dysfunction is unknown. This study aimed to assess the relationship between network architecture from resting-state fMRI and health-related quality of life in children with medically intractable focal epilepsy.

MATERIALS AND METHODS: Forty-seven children with nonlesional focal epilepsy were included; 22 had frontal lobe epilepsy and 15 had temporal lobe epilepsy. We computed graph metrics of functional connectivity, including network segregation (clustering coefficient and modularity) and integration (characteristic path length and participation coefficient). Health-related quality of life was measured using the Quality of Life in Childhood Epilepsy questionnaire. We examined the associations between graph metrics and the Quality of Life in Childhood Epilepsy total and domains scores, with age, sex, age at seizure onset, fMRI motion, and network density as covariates.

RESULTS: There was a negative relationship between the clustering coefficient and total Quality of Life in Childhood Epilepsy score [t₍₄₀₎ = −2.0; P = .04] and social function [t₍₄₀₎ = −2.9; P = .005]. There was a positive association between the mean participation coefficient and total Quality of Life in Childhood Epilepsy score [t₍₄₀₎ = 2.2; P = .03] and cognition [t₍₄₀₎ = 3.8; P = .0004]. In temporal lobe epilepsy, there was a negative relationship between the clustering coefficient and total Quality of Life in Childhood Epilepsy score [t₍₈₎ = −2.8; P = .02] and social function [t₍₈₎ = −3.6; P = .0075] and between modularity and total Quality of Life in Childhood Epilepsy score [t₍₈₎ = −2.5; P = .04] and social function [t₍₈₎ = −4.4; P = .0021]. In frontal lobe epilepsy, there was no association between network segregation and integration and Quality of Life in Childhood Epilepsy total or domain scores.

CONCLUSIONS: Our findings indicate that there are other higher order brain functions beyond cognition, which may be linked with functional connectivity of the brain.