2025 American Academy of Neurology Abstract Website

Objective:

To examine the relationship between heart-health, cardiorespiratory fitness and executive attention during a functional magnetic resonance imaging flanker task (fMRI-FT) in adults with idiopathic generalized epilepsy (IGE).

Background:

People with IGE suffer from comorbidities including attention impairments that may be mitigated by health and fitness. We hypothesize that increased heart-health and cardiorespiratory fitness will be associated with improved attention in adults with IGE.

Design/Methods:

Thirty-six participants with IGE (20 females; ages 18-50, mean=29.5) completed an fMRI-FT scan and cardiorespiratory fitness (VO2max) testing. Resting systolic blood pressure (sysBP) collected before MRI assessed heart-health. During fMRI-FT, participants indicated via button press if the target was incongruent (INC) or congruent (CON) relative to surrounding stimuli, and accuracy was recorded. FMRI-FT data was analyzed with AFNI. A one sample t-test covarying for seizure frequency (self-reported for all seizure types; 23 seizure-free) was conducted to create a statistical parametric map of attention-related fMRI-FT group activation. Pearson correlations assessed relationships between statistically-significant attention-related fMRI activation (corrected p<0.05), INC and CON accuracy, sysBP, and VO2max.

Results:

There was significant attention-related fMRI-FT activation in the left midline cerebellum (LCer) and right superior parietal lobule (RSPL). LCer activation showed significant correlation with CON (r=-0.539; p=0.0007) and INC (r=-0.460; p=0.0047) accuracy. RSPL activation showed significant correlation with INC (r=-0.478; p=0.0032) but not CON (r=-0.201; p=0.239) accuracy. LCer activation showed significant correlation with sysBP (r=0.353; p=0.0345) and a non-significant trend with VO2max (r=-0.281; p=0.0965).

Conclusions:

Decreased LCer activation was associated with better overall attentional performance on the fMRI-FT, while decreased RSPL was associated with improved accuracy on the more difficult INC condition. The significant relationship between decreased sysBP (indicating better heart-health) and decreased LCer activation, along with corresponding LCer relationships with fMRI-FT performance, suggest a role of these factors in potentially mitigating attention impairments in IGE. Further research is needed to better understand these relationships.