Department of Radiology, Government Medical College Hospital, Trivandrum, Kerala, India.
Department of Neurology, SCTIMST, Trivandrum, Kerala, India.
J Neuroradiol. 2018 Oct;45(6):380-385. doi: 10.1016/j.neurad.2018.02.005. Epub 2018 Mar 2.
Children of Women with Epilepsy with antenatal exposure to antiepileptic drugs (CAED) have reduced neuropsychological functions. We aimed to explore the anatomical basis for this impairment by comparing the brain volumes of CAED with that of matched healthy children without antenatal AED exposure (COAED).
CAED aged 8-12 years were recruited from the Kerala Registry of epilepsy and pregnancy that prospectively follows up children of women with epilepsy and COAED from children attending the imaging department for minor illnesses. Maternal clinical details and the neuropsychological data including IQ of CAED and COAED were obtained. Total intracranial volume (TBV), grey matter volume (GMV), white matter volume (WMV) and volumes of deep grey matter were measured by Voxel Based Morphometry.
We studied 30 CAED (mean age 10.8+1.11 years) and 35 COAED (mean age 10.64+1.26). The antenatal AED exposure for the CAED was monotherapy for 8 children and polytherapy for 22 children. The CAED had significantly lower (P<0.001) IQ (77.5+13.8), TBV(1259.55±169.85mL) and GMV (672.51±85.42 mL) compared to the IQ (87.0+13.5), TBV(1405.37±161mL) and GMV (745.427±86.69 mL) of COAED. CAED had lower volumes for Lt Inferior Triangular Gyrus, and hippocampi on both sides, when compared to COAED. Group analysis CAED showed less GMV (P<0.05) for left inferior and middle frontal gyri relative to COAED.
These observations point towards an anatomical basis of lower GMV for the lower neuropsychological functions in children with antenatal AED exposure.
产前暴露于抗癫痫药物（AED）的癫痫女性所生孩子的神经认知功能降低。我们旨在通过比较产前 AED 暴露的 CAED 与未暴露于产前 AED 的匹配健康儿童（COAED）的脑容量，来探索这种损害的解剖学基础。
我们从前瞻性随访癫痫女性孩子的喀拉拉邦癫痫与妊娠登记处招募了 8-12 岁的 CAED，以及从儿科影像部门就诊的患有小病的儿童中招募了 COAED。我们获得了 CAED 和 COAED 的母亲临床详情以及神经心理学数据，包括智商。我们通过基于体素的形态测量法测量了总颅内体积（TBV）、灰质体积（GMV）、白质体积（WMV）和深部灰质体积。
我们研究了 30 名 CAED（平均年龄 10.8+1.11 岁）和 35 名 COAED（平均年龄 10.64+1.26 岁）。CAED 的产前 AED 暴露为 8 名儿童的单药治疗和 22 名儿童的多药治疗。CAED 的智商（77.5+13.8）、TBV（1259.55±169.85mL）和 GMV（672.51±85.42mL）明显低于 COAED 的智商（87.0+13.5）、TBV（1405.37±161mL）和 GMV（745.427±86.69mL）（均 P<0.001）。与 COAED 相比，CAED 的左侧下三角回和双侧海马的体积更小。CAED 的左侧额下回和额中回的 GMV 也较 COAED 减少（P<0.05）。
这些观察结果表明，产前 AED 暴露的儿童神经认知功能较低可能与 GMV 减少有关。
