Caplan Rochelle, Levitt Jennifer, Siddarth Prabha, Wu Keng Nei, Gurbani Suresh, Sankar Raman, Shields W Donald
UCLA David Geffen School of Medicine, Department of Psychiatry, California, USA.
Epilepsia. 2009 Nov;50(11):2466-72. doi: 10.1111/j.1528-1167.2009.02198.x. Epub 2009 Jul 14.
This study compared frontotemporal brain volumes in children with childhood absence epilepsy (CAE) to age- and gender-matched children without epilepsy. It also examined the association of these volumes with seizure, demographic, perinatal, intelligence quotient (IQ), and psychopathology variables.
Twenty-six children with CAE, aged 7.5-11.8 years, and 37 children without epilepsy underwent brain magnetic resonance imaging (MRI) scans at 1.5 Tesla. Tissue was segmented, and total brain, frontal lobe, frontal parcellations, and temporal lobe volumes were computed. All children had IQ testing and structured psychiatric interviews. Parents provided seizure, perinatal, and behavioral information on each child.
The CAE group had significantly smaller gray matter volumes of the left orbital frontal gyrus as well as both left and right temporal lobes compared to the age- and gender-matched children without epilepsy. In the CAE group these volumes were related to age, gender, ethnicity, and pregnancy complications but not to seizure, IQ, and psychopathology variables. In the group of children without epilepsy, however, the volumes were related to IQ.
These findings suggest that CAE impacts brain development in regions implicated in behavior, cognition, and language. In addition to supporting the cortical focus theory of CAE, these findings also imply that CAE is not a benign disorder.
本研究比较了儿童失神癫痫(CAE)患儿与年龄及性别匹配的无癫痫儿童的额颞叶脑容量。研究还考察了这些脑容量与癫痫发作、人口统计学、围产期、智商(IQ)及精神病理学变量之间的关联。
26名年龄在7.5至11.8岁之间的CAE患儿和37名无癫痫儿童接受了1.5特斯拉的脑磁共振成像(MRI)扫描。对组织进行分割,并计算全脑、额叶、额叶分区及颞叶的体积。所有儿童均接受了智商测试和结构化精神科访谈。家长提供了每个孩子的癫痫发作、围产期及行为信息。
与年龄及性别匹配的无癫痫儿童相比,CAE组左侧眶额回以及左右颞叶的灰质体积显著更小。在CAE组中,这些脑容量与年龄、性别、种族及妊娠并发症有关,但与癫痫发作、智商及精神病理学变量无关。然而,在无癫痫儿童组中,脑容量与智商有关。
这些发现表明,CAE会影响与行为、认知及语言相关区域的脑发育。这些发现除了支持CAE的皮质病灶理论外,还意味着CAE并非一种良性疾病。