ReviewImaging and genetics of language and cognition in pediatric epilepsy

This paper presents translational aspects of imaging and genetic studies of language and cognition in children with epilepsy of average intelligence. It also discusses current unanswered translational questions in each of these research areas. A brief review of multimodal imaging and language study findings shows that abnormal structure and function, as well as plasticity and reorganization in language-related cortical regions, are found both in children with epilepsy with normal language skills and in those with linguistic deficits. The review on cognition highlights that multiple domains of impaired cognition and abnormalities in brain structure and/or connectivity are evident early on in childhood epilepsy and might be specific for epilepsy syndrome. The description of state-of-the-art genetic analyses that can be used to explain the convergence of language impairment and Rolandic epilepsy includes a discussion of the methodological difficulties involved in these analyses. Two junior researchers describe how their current and planned studies address some of the unanswered translational questions regarding cognition and imaging and the genetic analysis of speech sound disorder, reading, and centrotemporal spikes in Rolandic epilepsy.This article is part of a Special Issue entitled “The Future of Translational Epilepsy Research”.

► Multimodal imaging suggests reorganization of language regions in pediatric epilepsy. ► Abnormal cognition, brain structure, and connectivity are found in new-onset epilepsy. ► Genetic analyses explain the convergence of language impairment and Rolandic epilepsy. ► Imaging and genetic biomarkers for impaired language/cognition need to be identified.