# Speaking of Spikes: Connectivity and Language in Benign Epilepsy with Centrotemporal Spikes

> **NIH NIH K23** · STANFORD UNIVERSITY · 2021 · $194,616

## Abstract

PROJECT SUMMARY/ABSTRACT
Children with benign epilepsy with centrotemporal spikes (BECTS), the most common pediatric epilepsy
syndrome, have a mild seizure disorder but have moderate language difficulties, the pathophysiology of which
is currently unknown. Many posit that interictal epileptiform discharges (IEDs) arising from one or both motor
cortices disrupt language development, possibly by driving atypical connectivity between the motor and language
networks. Supporting this, the candidate found that response of the motor cortex to transcranial magnetic
stimulation (TMS) specifically correlates with performance on a language learning task in BECTS subjects. The
aim of the proposed studies is to use a combination of high-density EEG (HD-EEG) alone and HD-EEG paired
with TMS (TMS-EEG) to determine if IEDs disrupt language function by altering brain connectivity. The central
hypothesis is that IEDs pathologically strengthen connectivity between the motor and language regions, thus
inhibiting development of efficient connectivity within the language network. Aim 1 will define the immediate
impact of IEDs on connectivity between the motor and language regions. Aim 2 will determine if children with
BECTS have decreased connectivity within the language network compared to controls and whether disrupted
connectivity predicts language dysfunction. We do not typically treat IEDs in BECTS as medications have limited
efficacy and global neurologic impact. In contrast, repetitive trains of TMS (rTMS) have therapeutic potential for
the treatment of IEDs as rTMS induces focal changes in cortical excitability. Thus, Aim 3 will determine if rTMS
to the motor cortex reduces IED frequency and normalizes connectivity in children with BECTS.
Dr. Baumer is a pediatric epileptologist at Stanford University who is establishing herself as an investigator in
patient-oriented research. Her goal is to advance our mechanistic understanding of cognitive comorbidities in
pediatric epilepsy. Dr. Baumer’s clinical training coupled with her background in TMS and clinical research make
her ideally suited to contribute in this area. The training plan outlined in this application will allow Dr. Baumer to
develop expertise in: (1) the conceptual and practical analysis of HD-EEG and TMS-EEG data with emphasis
on connectivity analysis; (2) the design and implementation of pediatric TMS-EEG studies; and (3) the
neurodevelopment and assessment of language processing. To achieve these goals, she has assembled a
mentorship team of internationally recognized physician-scientists with expertise in the measurement and
modulation of brain connectivity as well as the neuroscience of language development. She has recruited
advisors with methodologic expertise in pediatric TMS, HD-EEG, and epilepsy research. Along with her mentors,
Dr. Baumer has chosen laboratory rotations and courses that complement her research to ensure that she
reaches her training goals. Upon conclusion of the award, Dr...

## Key facts

- **NIH application ID:** 10115149
- **Project number:** 5K23NS116110-02
- **Recipient organization:** STANFORD UNIVERSITY
- **Principal Investigator:** Fiona Mitchell Baumer
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $194,616
- **Award type:** 5
- **Project period:** 2020-04-01 → 2025-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10115149

## Citation

> US National Institutes of Health, RePORTER application 10115149, Speaking of Spikes: Connectivity and Language in Benign Epilepsy with Centrotemporal Spikes (5K23NS116110-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10115149. Licensed CC0.

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