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BioMed Research International
Volume 2015, Article ID 923861, 10 pages
Research Article

Gray and White Matter Volumes and Cognitive Dysfunction in Drug-Naïve Newly Diagnosed Pediatric Epilepsy

1Department of Neurology, Ewha Womans University School of Medicine and Ewha Medical Research Institute, Seoul 158-710, Republic of Korea
2Department of Neurology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon 630-723, Republic of Korea
3Department of Radiology, Ewha Womans University School of Medicine and Ewha Medical Research Institute, Seoul 158-710, Republic of Korea

Received 27 June 2014; Revised 20 April 2015; Accepted 21 June 2015

Academic Editor: Marco Giannelli

Copyright © 2015 Jung Hwa Lee et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Epilepsy patients often have cognitive dysfunction even at early stages of disease. We investigated the relationship between structural findings and neuropsychological status in drug-naïve newly diagnosed pediatric epilepsy patients. Thirty newly diagnosed pediatric epilepsy patients and 25 healthy control subjects aged 7~16 years were enrolled, who were assessed by the Korean version of the Wechsler Intelligence Scale for Children (K-WISC-III), the Stroop test, and the trail making test (TMT). Optimized voxel-based morphometry (VBM) was performed for both Gray Matter (GM) and White Matter (WM) volumes. Lower performance levels of verbal intelligence quotient, freedom from distractibility, and executive function were observed in epilepsy group. Interestingly, poor performance in these cognitive subdomains was correlated with regional VBM findings involving both GM and WM volumes, but with different patterns between groups. GM volumes revealed clear differences predominantly in the bilateral frontal regions. These findings indicate that certain cognitive functions may be affected in the early stage of epilepsy, not related to the long-standing epilepsy or medication, but more related to the neurocognitive developmental process in this age. Epilepsy can lead to neuroanatomical alterations in both GM and WM, which may affect cognitive functions, during early stages even before commencement of AED medication.