Widjaja E, Zamyadi M, Raybaud C, Snead O C, Doesburg S M, Smith M L
From the Department of Diagnostic Imaging (E.W., M.Z., C.R., S.M.D.) Division of Neurology (E.W., O.C.S.)
From the Department of Diagnostic Imaging (E.W., M.Z., C.R., S.M.D.).
AJNR Am J Neuroradiol. 2015 Jul;36(7):1362-8. doi: 10.3174/ajnr.A4265. Epub 2015 Mar 5.
Structural connectivity has been thought to be a less sensitive measure of network changes relative to functional connectivity in children with localization-related epilepsy. The aims of this study were to investigate the structural networks in children with localization-related epilepsy and to assess the relation among structural connectivity, intelligence quotient, and clinical parameters.
Forty-five children with nonlesional localization-related epilepsy and 28 healthy controls underwent DTI. Global network (network strength, clustering coefficient, characteristic path length, global efficiency, and small-world parameters), regional network (nodal efficiency), and the network-based statistic were compared between patients and controls and correlated with intelligence quotient and clinical parameters.
Patients showed disrupted global network connectivity relative to controls, including reduced network strength, increased characteristic path length and reduced global efficiency, and reduced nodal efficiency in the frontal, temporal, and occipital lobes. Connectivity in multiple subnetworks was reduced in patients, including the frontal-temporal, insula-temporal, temporal-temporal, frontal-occipital, and temporal-occipital lobes. The frontal lobe epilepsy subgroup demonstrated more areas with reduced nodal efficiency and more impaired subnetworks than the temporal lobe epilepsy subgroup. Network parameters were not significantly associated with intelligence quotient, age at seizure onset, or duration of epilepsy.
We found disruption in global and regional networks and subnetworks in children with localization-related epilepsy. Regional efficiency and subnetworks were more impaired in frontal lobe epilepsy than in temporal lobe epilepsy. Future studies are needed to evaluate the implications of disrupted networks for surgical resection and outcomes for specific epileptogenic zones and the relation of disrupted networks to more complex cognitive function.
相对于局灶性相关癫痫患儿的功能连接，结构连接一直被认为是一种对网络变化不太敏感的测量方法。本研究的目的是调查局灶性相关癫痫患儿的结构网络，并评估结构连接、智商和临床参数之间的关系。
45例非病变性局灶性相关癫痫患儿和28例健康对照者接受了弥散张量成像（DTI）。比较患者和对照者的全局网络（网络强度、聚类系数、特征路径长度、全局效率和小世界参数）、区域网络（节点效率）以及基于网络的统计量，并将其与智商和临床参数进行相关性分析。
与对照组相比，患者的全局网络连接受损，包括网络强度降低、特征路径长度增加、全局效率降低，以及额叶、颞叶和枕叶的节点效率降低。患者多个子网的连接性降低，包括额叶-颞叶、岛叶-颞叶、颞叶-颞叶、额叶-枕叶和颞叶-枕叶。额叶癫痫亚组比颞叶癫痫亚组表现出更多节点效率降低的区域和更多受损的子网。网络参数与智商、癫痫发作起始年龄或癫痫病程无显著相关性。
我们发现局灶性相关癫痫患儿的全局和区域网络及子网存在破坏。额叶癫痫的区域效率和子网受损程度比颞叶癫痫更严重。未来需要开展研究，以评估网络破坏对手术切除的影响以及特定致痫区的预后，以及网络破坏与更复杂认知功能之间的关系。
