From the Center of Cognitive and Brain Disorders, Hangzhou Normal University, 126 Wenzhou Road, Gongshu District, Hangzhou, Zhejiang 310015, China (G.J.J., Y.F.Z., W.L.); and Department of Medical Imaging, Jinling Hospital, Clinic School of Medical College, Nanjing University, Nanjing, Jiangsu, China (Z.Z., Q.X., G.L.).
Radiology. 2014 Jun;271(3):839-47. doi: 10.1148/radiol.13131638. Epub 2014 Mar 1.
To characterize interhemispheric functional and anatomic connectivity in patients with idiopathic generalized epilepsy and generalized tonic-clonic seizures (GTCS).
This retrospective study was approved by the local institutional review board and was HIPAA compliant. All participants provided written informed consent. Resting-state functional and structural magnetic resonance images were acquired in 52 patients with GTCS and 65 healthy control subjects. The functional connectivity between bilateral homotopic voxels was calculated. Homotopic regions showing abnormal functional connectivity in patients were adopted as regions of interest for an analysis of diffusion-tensor imaging tractography. The fractional anisotropy and fiber length were compared between groups. Two-sample t test and nonparametric correlation analysis were used.
Compared with control subjects, patients showed increased interhemispheric functional connectivity between the bilateral cuneus (P = .0008, corrected) and anterior cingulate cortex (P = .0003, corrected) and decreased functional connectivity between the bilateral olfactory cortex (P = .00005, corrected), inferior frontal gyrus (P = .00005, corrected), supramarginal gyrus (P = .0002, corrected), and temporal pole (P = .0003, corrected). Furthermore, the fiber length of the commissural fiber bundles connecting the bilateral anterior cingulate cortex (t = -2.30; P = .03, uncorrected) and the bilateral cuneus was shorter in patients than in control subjects (t = -3.19; P = .002, uncorrected).
Our findings show that the bilateral anterior cingulate cortex may be critical to the pathophysiology of patients with GTCS and suggest that the corresponding commissural fiber bundle in the genu of the corpus callosum is a potential target for future surgical treatment in patients with intractable GTCS.
描述特发性全面性癫痫伴全面强直-阵挛发作（GTCS）患者的大脑半球间功能和解剖连接。
这项回顾性研究获得了当地机构审查委员会的批准，并符合 HIPAA 规定。所有参与者均提供了书面知情同意书。在 52 例 GTCS 患者和 65 例健康对照者中采集了静息态功能和结构磁共振图像。计算双侧同源体素之间的功能连接。将患者中出现异常功能连接的同源区域作为扩散张量成像轨迹分析的感兴趣区。比较两组间的各向异性分数和纤维长度。采用两样本 t 检验和非参数相关性分析。
与对照组相比，患者双侧楔前叶（P =.0008，校正）和前扣带回（P =.0003，校正）之间的半球间功能连接增加，双侧嗅皮质（P =.00005，校正）、额下回（P =.00005，校正）、缘上回（P =.0002，校正）和颞极（P =.0003，校正）之间的功能连接减少。此外，连接双侧前扣带回的连合纤维束的纤维长度（t = -2.30；P =.03，未校正）在患者中比在对照组中更短（t = -3.19；P =.002，未校正）。
我们的研究结果表明双侧前扣带回可能对 GTCS 患者的病理生理学至关重要，并提示胼胝体膝部的相应连合纤维束可能是未来治疗难治性 GTCS 患者的潜在靶点。
