Takeda Kanako, Matsuda Hiroshi, Miyamoto Yusaku, Yamamoto Hitoshi
Division of Pediatrics, Kawasaki Municipal Tama Hospital, St. Marianna University School of Medicine, Japan; Department of Pediatrics, St. Marianna University School of Medicine, Japan; Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Japan.
Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Japan.
Brain Dev. 2017 Sep;39(8):678-686. doi: 10.1016/j.braindev.2017.04.010. Epub 2017 May 6.
Epilepsy is considered to arise from dysfunction in neural networks. Recent advances in neuroimaging and its analysis have made it possible to investigate both functional and structural connectivity in the brain. The aim of this study was to elucidate alterations in the structural connectivity in children with localization-related epilepsy using the mathematical method of graph theoretical analysis.
Fifteen children with localization-related epilepsy (8 female subjects; mean age, 8.5±3.5years) as an epilepsy group and 23 children without a history of seizure (12 female subjects; mean age, 8.9±3.7years) as a control group underwent three-dimensional T1-weighted brain magnetic resonance imaging (MRI). Gray matter images segmented and spatially normalized from the MRIs of both groups were analyzed using statistical parametric mapping with the Graph Analysis Toolbox. We compared global networks (global efficiency, clustering coefficient and network strength) and regional networks (betweenness centrality and clustering) between patients and controls.
The global efficiency tended to be increased (p=0.081) and the global modularity was significantly increased (p=0.017) in the epilepsy group as compared with the control group. The epilepsy group showed locally decreased betweenness centrality mainly in the bilateral cingulate gyri, right perisylvian area, and bilateral precentral gyri, and locally increased clustering in the bilateral cingulate gyri, right perisylvian area, and medial frontal lobes as compared with the control group. The epilepsy group showed higher network resilience to random attack and targeted attack than the control group. Voxel-based morphometry did not show any difference between the two groups.
We observed globally increased structural connectivity along with excessive network robustness in patients with localization-related epilepsy. Local abnormality of connectivity was observed mainly in the cingulate gyrus, perisylvian area, and precentral gyrus. This alteration in the structural connectivity without any morphometric changes may be related to the underlying epileptogenicity.
癫痫被认为源于神经网络功能障碍。神经影像学及其分析的最新进展使得研究大脑中的功能和结构连接成为可能。本研究的目的是使用图论分析的数学方法阐明定位相关癫痫患儿的结构连接变化。
15名定位相关癫痫患儿（8名女性受试者；平均年龄8.5±3.5岁）作为癫痫组，23名无癫痫发作史的儿童（12名女性受试者；平均年龄8.9±3.7岁）作为对照组，接受三维T1加权脑磁共振成像（MRI）检查。使用带有图形分析工具箱的统计参数映射对两组MRI分割并空间归一化后的灰质图像进行分析。我们比较了患者和对照组之间的全局网络（全局效率、聚类系数和网络强度）和区域网络（中介中心性和聚类）。
与对照组相比，癫痫组的全局效率有增加趋势（p = 0.081），全局模块性显著增加（p = 0.017）。与对照组相比，癫痫组主要在双侧扣带回、右侧颞周区域和双侧中央前回局部中介中心性降低，而在双侧扣带回、右侧颞周区域和内侧额叶局部聚类增加。癫痫组比对照组对随机攻击和靶向攻击具有更高的网络弹性。基于体素的形态测量学显示两组之间没有差异。
我们观察到定位相关癫痫患者的全局结构连接增加以及网络稳健性过高。连接性的局部异常主要在扣带回、颞周区域和中央前回观察到。这种结构连接的改变而无任何形态测量变化可能与潜在的致痫性有关。
