Epilepsy Center, Department of Neurology, West China Hospital, Sichuan University, Chengdu, PR China.
Department of Neurology, Fourth Affiliated Hospital, School of Medicine, Zhejiang University, Yiwu, PR China.
Sci Rep. 2018 Apr 9;8(1):5689. doi: 10.1038/s41598-018-23336-z.
The aim of the current study was to find the epileptic focus and examine its causal relationship to other brain regions in children with new-onset benign childhood epilepsy with centrotemporal spikes (BECTS). Resting-state functional magnetic resonance imaging (fMRI) was performed in 66 children with BECTS and 37 matched control children. We compared the amplitude of low frequency fluctuation (ALFF) signals between the two groups to find the potential epileptogenic zone (EZ), then used Granger causality analysis (GCA) to explore the causal effects of EZ on the whole brain. Children with BECTS had significantly increased ALFF in the right Broca's area, and decreased ALFF in bilateral fusiform gyrus. The patients also showed increased driving effect from the EZ in Broca's area to the right prefrontal lobe, and decreased effects to the frontal lobe and posterior parts of the language network. The causal effect on left Wernicke's area negatively correlated with verbal IQ (VIQ) score. Our research on new-onset BECTS patients illustrates a possible compensatory mechanism in the language network at early stages of BECTS, and the negative correlation of GCA and VIQ suggest the disturbance of epileptiform activity on language. These findings shed light on the mechanisms of and language dysfunction in BECTS.
本研究旨在寻找新诊断的伴中央颞区棘波的良性儿童癫痫（BECTS）患儿的癫痫灶，并探讨其与其他脑区的因果关系。对 66 例 BECTS 患儿和 37 例匹配的对照患儿进行静息态功能磁共振成像（fMRI）检查。我们比较了两组之间低频振幅（ALFF）信号的差异，以寻找潜在的致痫区（EZ），然后使用格兰杰因果分析（GCA）来探讨 EZ 对全脑的因果影响。BECTS 患儿右侧布罗卡区的 ALFF 显著增加，双侧梭状回的 ALFF 降低。患者还表现出 EZ 对右侧前额叶的驱动作用增加，对额叶和语言网络后部的作用减弱。对左侧韦尼克区的因果作用与言语智商（VIQ）得分呈负相关。我们对新诊断的 BECTS 患儿的研究说明了在 BECTS 的早期阶段语言网络中可能存在一种代偿机制，而 GCA 与 VIQ 的负相关提示了癫痫样活动对语言的干扰。这些发现为 BECTS 的发病机制和语言功能障碍提供了线索。
