Kim Eun-Hee, Yum Mi-Sun, Shim Woo-Hyun, Yoon Hye-Kyung, Lee Yun-Jeong, Ko Tae-Sung
Department of Pediatrics, Asan Medical Center Children's Hospital, Republic of Korea.
Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Republic of Korea.
Seizure. 2015 Apr;27:40-6. doi: 10.1016/j.seizure.2015.02.027. Epub 2015 Mar 1.
The aim of this study was to investigate cortical thickness and gray matter volume abnormalities in benign childhood epilepsy with centrotemporal spikes (BCECTS). We additionally assessed the effects of comorbid attention-deficit/hyperactivity (ADHD) on these abnormalities.
Surface and volumetric MR imaging data of children with newly diagnosed BCECTS (n = 20, 14 males) and age-matched healthy controls (n = 20) were analyzed using FreeSurfer (version 5.3.0, https://surfer.nmr.mgh.harvard.edu). An additional comparison was performed between BCECTS children with and without ADHD (each, n = 8). A group comparison was carried out using an analysis of covariance with a value of significance set as p < 0.01 or p < 0.05.
Children with BCECTS had significantly thicker right superior frontal, superior temporal, middle temporal, and left pars triangularis cortices. Voxel-based morphometric analysis revealed significantly larger cortical gray matter volumes of the right precuneus, left orbitofrontal, pars orbitalis, precentral gyri, and bilateral putamen and the amygdala of children with BCECTS compared to healthy controls. BCECTS patients with ADHD had significantly thicker left caudal anterior and posterior cingulate gyri and a significantly larger left pars opercularis gyral volume compared to BCECTS patients without ADHD.
Children with BCECTS have thicker or larger gray matters in the corticostriatal circuitry at the onset of epilepsy. Comorbid ADHD is also associated with structural aberrations. These findings suggest structural disruptions of the brain network are associated with specific developmental electro-clinical syndromes.
本研究旨在调查伴有中央颞区棘波的儿童良性癫痫（BCECTS）的皮质厚度和灰质体积异常情况。我们还评估了共病注意力缺陷多动障碍（ADHD）对这些异常的影响。
使用FreeSurfer（版本5.3.0，https://surfer.nmr.mgh.harvard.edu）分析新诊断的BCECTS儿童（n = 20，男14例）和年龄匹配的健康对照儿童（n = 20）的表面和容积磁共振成像数据。对有和无ADHD的BCECTS儿童（每组n = 8）进行了额外比较。采用协方差分析进行组间比较，显著性水平设定为p < 0.01或p < 0.05。
BCECTS儿童右侧额上回、颞上回、颞中回和左侧三角部皮质显著增厚。基于体素的形态学分析显示，与健康对照相比，BCECTS儿童右侧楔前叶、左侧眶额回、眶部、中央前回以及双侧壳核和杏仁核的皮质灰质体积显著更大。与无ADHD的BCECTS患者相比，合并ADHD的BCECTS患者左侧尾侧前扣带回和后扣带回显著增厚，左侧岛盖部脑回体积显著增大。
BCECTS儿童在癫痫发作时皮质纹状体回路中的灰质更厚或更大。共病ADHD也与结构异常有关。这些发现表明脑网络的结构破坏与特定的发育性电临床综合征有关。
