Braga Aline M da S, Fujisao Elaine K, Verdade Roberto C, Paschoalato Rômulo P, Paschoalato Ricardo P, Yamashita Seizo, Betting Luiz E
Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, São Paulo State University, UNESP, Botucatu, SP, Brazil.
Department of Tropical Diseases and Diagnostic Imaging, Botucatu Medical School, São Paulo State University, UNESP, Botucatu, SP, Brazil.
Epilepsia. 2015 Nov;56(11):1803-11. doi: 10.1111/epi.13205. Epub 2015 Sep 28.
Studies using quantitative neuroimaging have shown subtle abnormalities in patients with idiopathic generalized epilepsy (IGE). These findings have several locations, but the midline parasagittal structures are most commonly implicated. The cingulate cortex is related and may be involved. The objective of the current investigation was to perform a comprehensive analysis of the cingulate cortex using multiple quantitative structural neuroimaging techniques.
Thirty-two patients (18 women, 30 ± 10 years) and 36 controls (18 women, 32 ± 11 years) were imaged by 3 Tesla magnetic resonance imaging (MRI). A volumetric three-dimensional (3D) sequence was acquired and used for this investigation. Regions-of-interest were selected and voxel-based morphometry (VBM) analyses compared the cingulate cortex of the two groups using Statistical Parametric Mapping (SPM8) and VBM8 software. Cortical analyses of the cingulate gyrus was performed using Freesurfer. Images were submitted to automatic processing using built-in routines and recommendations. Structural parameters were extracted for individual analyses, and comparisons between groups were restricted to the cingulate gyrus. Finally, shape analyses was performed on the anterior rostral, anterior caudal, posterior, and isthmus cingulate using spherical harmonic description (SPHARM).
VBM analyses of cingulate gyrus showed areas of gray matter atrophy, mainly in the anterior cingulate gyrus (972 mm(3) ) and the isthmus (168 mm(3) ). Individual analyses of the cingulate cortex were similar between patients with IGE and controls. Surface-based comparisons revealed abnormalities located mainly in the posterior cingulate cortex (718.12 mm(2) ). Shape analyses demonstrated a predominance of anterior and posterior cingulate abnormalities.
This study suggests that patients with IGE have structural abnormalities in the cingulate gyrus mainly localized at the anterior and posterior portions. This finding is subtle and variable among patients.
使用定量神经影像学的研究表明，特发性全身性癫痫（IGE）患者存在细微异常。这些发现分布在多个部位，但矢状旁中线结构最为常见。扣带回皮质与之相关且可能受累。本研究的目的是使用多种定量结构神经影像学技术对扣带回皮质进行全面分析。
32例患者（18名女性，年龄30±10岁）和36名对照者（18名女性，年龄32±11岁）接受了3特斯拉磁共振成像（MRI）检查。采集了容积三维（3D）序列并用于本研究。选择感兴趣区域，基于体素的形态学测量（VBM）分析使用统计参数映射（SPM8）和VBM8软件比较两组的扣带回皮质。使用Freesurfer对扣带回进行皮质分析。图像使用内置程序和建议进行自动处理。提取结构参数进行个体分析，组间比较仅限于扣带回。最后，使用球谐描述（SPHARM）对扣带回的喙前部、尾前部、后部和峡部进行形状分析。
扣带回的VBM分析显示灰质萎缩区域，主要位于前扣带回（972立方毫米）和峡部（168立方毫米）。IGE患者和对照者之间扣带回皮质的个体分析相似。基于表面的比较显示异常主要位于后扣带回皮质（718.12平方毫米）。形状分析表明前扣带回和后扣带回异常占主导。
本研究表明，IGE患者的扣带回存在结构异常，主要位于前部和后部。这一发现很细微，且在患者之间存在差异。
