摘要
目的儿童失神癫痫(Childhood absence epilepsy,CAE)是一种很常见的特发性癫痫,少有研究此类患者的大脑结构变化,尤其是默认模式网络脑区的脑结构是否存在异常改变。弥散张量成像技术可以用来定量评估脑结构的改变。研究将利用该技术探讨CAE患儿的脑结构改变。方法收集2014年10月-2016年4月于南京脑科医院神经内科就诊的14例CAE患儿和13名性别、年龄匹配的健康对照组弥散张量成像数据。基于体素对弥散张量数据进行分析处理,并对组间资料进行统计比较。提取组间比较存在显著性差异脑区的弥散张量参数,将参数与患儿的临床资料做相关性分析。结果患儿组的表观弥散系数在左内侧前额叶出现了显著性增高(P=0.042),而部分各向异性明显降低的脑区主要位于左侧楔前叶(P=0.010)。相关性分析结果显示,左内侧前额叶的表观弥散系数与患儿的病程存在正相关(R=0.80,P=0.001)。但部分各向异性与病程和发病频率无相关性。结论 CAE患儿的默认模式网络脑区存在结构异常,这将有助于进一步理解CAE患儿神经损伤的病理机制以及癫痫活动对他们的长期影响。
Objective Childhood absence epilepsy( CAE) is a common syndrome of idiopathic generalized epilepsy. However,little is known about the brain structural changes in this type of epilepsy,especially in the default mode network( DMN) regions. Diffusion tensor imaging( DTI) is a noninvasive techniques that can be used to quantitatively explore structural characteristics of brain. This study aims at using the DTI technique to quantify structural abnormalities of DMN nodes in CAE patients. Method DTI data were obtained in 14 CAE patients and 13 age-and gender-matched healthy controls. The data were analyzed using voxel-based analysis( VBA) and statistically compared between patients and controls. For the regions with significant difference in group comparison,their DTI metrics were further analyzed with clinical symptoms using Pearson's correlation. Results Patients showed significant increase of apparent diffusion coefficient( ADC) in left medial prefrontal cortex( MPFC)( P = 0. 042),while fractional anisotropy( FA)value was significantly decreased in left precuneus( P = 0. 010). In correlation analysis,ADC value from left MPFC was positively associated with duration of epilepsy. Neither the disease duration nor the seizure frequency showed significant correlation with FA values. Conclusion The findings indicate that structural impairments exist in DMN regions in children suffering from absence epilepsy. This may contribute to understanding the pathological mechanisms and chronic neurological deficits of this disorder.
出处
《癫痫杂志》
2017年第3期187-192,共6页
Journal of Epilepsy
基金
国家自然科学基金(81471324)
关键词
儿童失神癫痫
弥散张量成像
基于体素分析
默认模式网络
Childhood absence epilepsy
Diffusion tensor imaging
Voxel-based analysis
Default mode network
