Yan X X, Yu Q, Gao Y T, Li L T, Yu D H, Chen Y, Yao X J, Yang W D, Chen Z J, Yin J Z, An Y, Tan K
Department of Neurology, General Hospital, Tianjin Medical University, Tianjin 300052, China.
Zhonghua Yi Xue Za Zhi. 2017 May 23;97(19):1474-1478. doi: 10.3760/cma.j.issn.0376-2491.2017.19.010.
To study the relationship between the changes of brain network and cognition in patients with benign epilepsy of childhood with centrotemporal spikes (BECTS) by using long term video electroencephalogram (VEEG) and resting-state functional magnetic resonance imaging (RS-fMRI) technology. Eleven patients with right-handed were recruited (from April 2015 to September 2016) from epilepsy specialist outpatients and functional department of neurosurgery of Tianjin Medical University General Hospital. They all underwent the long term VEEG monitoring (one sleep cycle was included at least). According to the spike-wave index (SWI) during slow ware sleep, they were divided into two groups: SWI<50% (5 cases) and SWI≥50% (6 cases). All the patients were assessed with cognitional test including language, execution, memory and attention. They also underwent the head MRI, RS-fMRI examinations. Then the results were comparatively analysed. (1)There were no statisticaly significance in sex, age, age of onset, disease course, total number of seizures, years of education (>0.05). The Full Intelligence Quotient (FIQ) (87±18), Verbal Intelligence Quotient (VIQ) (88±15) and Performance Intelligence Quotient (PIQ) (89±20) of SWI≥50% group were lower than SWI<50% group(118±8, 114±11, 119±5) and the differences were statistically significant(<0.05). (2)There was a negative correlation between the FIQ (=0.002), VIQ (=0.006), PIQ (=0.001) and SWI. The FIQ, VIQ and PIQ had no correlation with the sex, age, age of onset, disease course, total number of seizures, years of education (>0.05). (3)Compared with SWI<50% group, SWI≥50% group showed increased regional homogeneity (ReHo) in the bilateral precentral gyrus, premotor area and the subcortical structure, the right temporal lobe and the bilateral insular lobe(<0.05); while they showed decreased ReHo in the posterior cingulate gyrus, right posterior inferior temporal lobe and right occipital lobe(<0.05). The change of the brain network which is caused by the paradoxical and constant discharge during slow ware sleep in patients with BECTS may affect the development of cognition.
采用长期视频脑电图（VEEG）和静息态功能磁共振成像（RS-fMRI）技术，研究儿童中央颞区棘波良性癫痫（BECTS）患者脑网络变化与认知功能之间的关系。选取2015年4月至2016年9月在天津医科大学总医院癫痫专科门诊及神经外科功能科就诊的11例右利手患者。所有患者均接受长期VEEG监测（至少包括一个睡眠周期）。根据慢波睡眠期棘波指数（SWI）将患者分为两组：SWI<50%组（5例）和SWI≥50%组（6例）。所有患者均接受认知测试，包括语言、执行、记忆和注意力测试。患者还接受了头部MRI、RS-fMRI检查。然后对结果进行比较分析。（1）两组患者在性别、年龄、起病年龄、病程、发作总次数、受教育年限方面差异无统计学意义（>0.05）。SWI≥50%组的全智商（FIQ）（87±18）、言语智商（VIQ）（88±15）和操作智商（PIQ）（89±20）低于SWI<50%组（118±8、114±11、119±5），差异有统计学意义（<0.05）。（2）FIQ（=0.002）、VIQ（=0.006）、PIQ（=0.001）与SWI呈负相关。FIQ、VIQ和PIQ与性别、年龄、起病年龄、病程、发作总次数、受教育年限无相关性（>0.05）。（3）与SWI<50%组相比，SWI≥50%组双侧中央前回、运动前区及皮质下结构、右侧颞叶和双侧岛叶的局部一致性（ReHo）增加（<0.05）；而后扣带回、右侧颞叶后下部和右侧枕叶ReHo降低（<0.05）。BECTS患者慢波睡眠期的矛盾性和持续性放电所引起的脑网络变化可能影响认知功能的发育。
