Roca Pauline, Mellerio Charles, Chassoux Francine, Rivière Denis, Cachia Arnaud, Charron Sylvain, Lion Stéphanie, Mangin Jean-François, Devaux Bertrand, Meder Jean-François, Oppenheim Catherine
Department of Neuroimaging, Sainte-Anne Hospital Center, Université Paris Descartes Sorbonne Paris Cité, Center for Psychiatry & Neurosciences, UMR 894 INSERM, Paris, France.
Department of Neurosurgery, Sainte-Anne Hospital Center, Université Paris Descartes Sorbonne Paris Cité, Paris, France.
PLoS One. 2015 Mar 30;10(3):e0122252. doi: 10.1371/journal.pone.0122252. eCollection 2015.
Focal cortical dysplasias (FCDs) are mainly located in the frontal region, with a particular tropism for the central sulcus. Up to 30% of lesions are undetected (magnetic resonance [MR]-negative FCD patients) or belatedly diagnosed by visual analysis of MR images. We propose an automated sulcus-based method to analyze abnormal sulcal patterns associated with central FCD, taking into account the normal interindividual sulcal variability.
We retrospectively studied 29 right-handed patients with FCD in the central region (including 12 MR negative histologically-confirmed cases) and 29 right-handed controls. The analysis of sulcal abnormalities from T1-weighted MR imaging (MRI) was performed using a graph-based representation of the cortical folds and an automated sulci recognition system, providing a new quantitative criterion to describe sulcal patterns, termed sulcus energy.
Group analysis showed that the central sulcus in the hemisphere ipsilateral to the FCD exhibited an abnormal sulcal pattern compared with controls (p = 0.032). FCDs were associated with abnormal patterns of the central sulci compared with controls (p = 0.006), a result that remained significant when MR-negative and MR-positive patients were considered separately, while the effects of sex, age and MR-field were not significant. At the individual level, sulcus energy alone failed to detect the FCD lesion. We found, however, a significant association between maximum z-scores and the site of FCD (p = 0.0046) which remained significant in MR-negative (p = 0.024) but not in MR-positive patients (p = 0.058). The maximum z-score pointed to an FCD sulcus in four MR-negative and five MR-positive patients.
We identified abnormal sulcal patterns in patients with FCD of the central region compared with healthy controls. The abnormal sulcal patterns ipsilateral to the FCD and the link between sulcus energy and the FCD location strengthen the interest of sulcal abnormalities in FCD patients.
局灶性皮质发育异常（FCD）主要位于额叶区域，对中央沟有特殊的趋向性。高达30%的病变未被检测到（磁共振成像[MR]阴性的FCD患者）或通过MR图像的视觉分析被延迟诊断。我们提出一种基于脑沟的自动化方法，以分析与中央FCD相关的异常脑沟模式，同时考虑到个体间正常的脑沟变异性。
我们回顾性研究了29例右侧中央区FCD患者（包括12例经组织学证实的MR阴性病例）和29例右侧对照者。使用基于图形的皮质褶皱表示法和自动脑沟识别系统对T1加权磁共振成像（MRI）的脑沟异常进行分析，提供了一种新的定量标准来描述脑沟模式，称为脑沟能量。
组间分析显示，与对照组相比，FCD同侧半球的中央沟表现出异常的脑沟模式（p = 0.032）。与对照组相比，FCD与中央脑沟的异常模式相关（p = 0.006），当分别考虑MR阴性和MR阳性患者时，该结果仍然显著，而性别、年龄和MR场强的影响不显著。在个体水平上，仅脑沟能量未能检测到FCD病变。然而，我们发现最大z值与FCD部位之间存在显著关联（p = 0.0046），在MR阴性患者中该关联仍然显著（p = 0.024），但在MR阳性患者中不显著（p = 0.058）。最大z值在4例MR阴性和5例MR阳性患者中指向FCD脑沟。
与健康对照相比，我们在中央区FCD患者中识别出异常的脑沟模式。FCD同侧的异常脑沟模式以及脑沟能量与FCD位置之间的联系增强了对FCD患者脑沟异常的关注。
