National Research Center for Intelligent Computing Systems, Institute of Computing Technology, Chinese Academy of Sciences, Beijing, People's Republic of China.
PLoS One. 2010 Dec 21;5(12):e15219. doi: 10.1371/journal.pone.0015219.
Although there is increasing evidence suggesting that there may be subtle abnormalities in idiopathic generalized epilepsy (IGE) patients using modern neuroimaging techniques, most of these previous studies focused on the brain grey matter, leaving the underlying white matter abnormalities in IGE largely unknown, which baffles the treatment as well as the understanding of IGE. In this work, we adopted multiple methods from different levels based on diffusion tensor imaging (DTI) to analyze the white matter abnormalities in 14 young male IGE patients with generalized tonic-clonic seizures (GTCS) only, comparing with 29 age-matched male healthy controls. First, we performed a voxel-based analysis (VBA) of the fractional anisotropy (FA) images derived from DTI. Second, we used a tract-based spatial statistics (TBSS) method to explore the alterations within the white matter skeleton of the patients. Third, we adopted region-of-interest (ROI) analyses based on the findings of VBA and TBSS to further confirm abnormal brain regions in the patients. At last, considering the convergent evidences we found by VBA, TBSS and ROI analyses, a subsequent probabilistic fiber tractography study was performed to investigate the abnormal white matter connectivity in the patients. Significantly decreased FA values were consistently observed in the cerebellum of patients, providing fresh evidence and new clues for the important role of cerebellum in IGE with GTCS.
尽管越来越多的证据表明,使用现代神经影像学技术可能会发现特发性全面性癫痫(IGE)患者存在细微的异常,但这些之前的研究大多集中在大脑灰质上,IGE 患者的白质异常情况仍知之甚少,这给治疗和理解 IGE 带来了困难。在这项工作中,我们采用了基于弥散张量成像(DTI)的不同层次的多种方法,对仅患有全面强直阵挛发作(GTCS)的 14 名年轻男性 IGE 患者的白质异常进行了分析,将其与 29 名年龄匹配的男性健康对照组进行了比较。首先,我们对来自 DTI 的分数各向异性(FA)图像进行了基于体素的分析(VBA)。其次,我们使用基于束的空间统计学(TBSS)方法来探索患者白质骨架内的变化。第三,我们根据 VBA 和 TBSS 的发现进行了基于感兴趣区(ROI)的分析,以进一步确认患者的异常脑区。最后,考虑到我们通过 VBA、TBSS 和 ROI 分析发现的趋同证据,我们进行了随后的概率纤维束追踪研究,以研究患者的异常白质连接。患者的小脑一直存在明显的 FA 值降低,为小脑在 GTCS 型 IGE 中的重要作用提供了新的证据和线索。