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[不同发作类型的MRI阴性癫痫患者的灰质损伤]

[Impairments of gray matter in MRI-negative epileptic patients with different seizure types].

作者信息

Quan W, Xu Q, Yang F, Chen G H, Lin Z X, Zhang Q R, Xiao J H, Lu G M, Zhang Z Q

机构信息

Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing General Hospital, Nanjing 210002, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2017 Dec 5;97(45):3524-3528. doi: 10.3760/cma.j.issn.0376-2491.2017.45.002.

Abstract

To investigate the damage of gray matter structure in MRI-negative epilepsy patients with different symptoms by voxel-based morphometry (VBM). From June, 2009 to October, 2016, ninety MRI-negative epilepsy patients and thirty-five healthy volunteers underwent the 3T magnetic resonance imaging scan in Nanjing General Hospital. The patients were divided into three groups, including idiopathic generalized tonic-clonic seizure (I-GTCS), secondarily generalized tonic-clonic seizure (S-GTCS), and partial seizure (PS) according to different symptoms. The three-dimensional high-resolution T1 structural MRI data was obtained for the voxel-based morphometry. Data of gray matter structure from four groups were compared using one-way analysis of variance (ANOVA). An independent-sample test was performed in order to compare gray matter volume of the three patient groups with controls respectively. According the results of ANOVA, impaired brain regions were selected as regions of interest in order to carry out correlation analysis between gray matter volume and disease duration. ANOVA showed significant differences in gray matter structure of bilateral thalamus and frontal lobe between four groups (alphasim correction, <0.01). Independent-sample test showed that the volume of bilateral thalamus and frontal lobe decreased in all three patients groups (alphasim correction, <0.01) .The volume of bilateral thalamus showed significantly negatively correlation with disease duration in I-GTCS patients (=-0.466, <0.01). Generalized seizures and partial seizures all can cause damage to the gray matter structure, especially in thalamus and frontal lobe. The impairments of thalamus and frontal lobe in patients with different seizure types are different with the progression of disease, which suggests that influences of different epilepsy seizures on the thalamo-cortical network are different.

摘要

采用基于体素的形态学测量(VBM)方法,研究不同症状的MRI阴性癫痫患者灰质结构的损伤情况。2009年6月至2016年10月,90例MRI阴性癫痫患者和35名健康志愿者在南京总医院接受3T磁共振成像扫描。根据不同症状,将患者分为三组,包括特发性全面强直阵挛发作(I-GTCS)、继发性全面强直阵挛发作(S-GTCS)和部分性发作(PS)。获取三维高分辨率T1结构MRI数据用于基于体素的形态学测量。采用单因素方差分析(ANOVA)比较四组的灰质结构数据。进行独立样本检验,以分别比较三组患者与对照组的灰质体积。根据ANOVA结果,选择受损脑区作为感兴趣区,进行灰质体积与病程的相关性分析。ANOVA显示四组之间双侧丘脑和额叶的灰质结构存在显著差异(Alphasim校正,<0.01)。独立样本检验显示,三组患者双侧丘脑和额叶体积均减小(Alphasim校正,<0.01)。I-GTCS患者双侧丘脑体积与病程呈显著负相关(r=-0.466,<0.01)。全面性发作和部分性发作均可导致灰质结构损伤,尤其是丘脑和额叶。不同发作类型患者丘脑和额叶的损伤随疾病进展而不同,这表明不同类型癫痫发作对丘脑-皮质网络的影响不同。

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