Park Kang Min, Lee Byung In, Shin Kyong Jin, Ha Sam Yeol, Park JinSe, Kim Si Eun, Kim Sung Eun
Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
J Clin Neurol. 2019 Jan;15(1):68-76. doi: 10.3988/jcn.2019.15.1.68.
There is accumulating evidence that epilepsy is caused by network dysfunction. We evaluated the hub reorganization of subcortical structures in patients with focal epilepsy using graph theoretical analysis based on diffusion-tensor imaging (DTI). In addition, we investigated differences in the values of diffusion tensors and scalars, fractional anisotropy (FA), and mean diffusivity (MD) of subcortical structures between patients with focal epilepsy and healthy subjects.
One hundred patients with focal epilepsy and normal magnetic resonance imaging (MRI) findings and 80 age- and sex-matched healthy subjects were recruited prospectively. All subjects underwent DTI to obtain data suitable for graph theoretical analysis. We investigated the differences in the node strength, cluster coefficient, eigenvector centrality, page-rank centrality measures, FA, and MD of subcortical structures between patients with epilepsy and healthy subjects.
After performing multiple corrections, the cluster coefficient and the eigenvector centrality of the globus pallidus were higher in patients with epilepsy than in healthy subjects (=0.006 and =0.008, respectively). In addition, the strength and the page-rank centrality of the globus pallidus tended to be higher in patients with epilepsy than in healthy subjects (=0.092 and =0.032, respectively). The cluster coefficient of the putamen was lower in patients with epilepsy than in healthy subjects (=0.004). The FA values of the caudate nucleus and thalamus were significantly lower in patients with epilepsy than in healthy subjects (=0.009 and =0.007, respectively), whereas the MD value of the thalamus was higher than that in healthy subjects (=0.005).
We discovered the presence of hub reorganization of subcortical structures in focal epilepsy patients with normal MRI findings, suggesting that subcortical structures play a pivotal role as a hub in the epilepsy network. These findings further reinforce the idea that epilepsy is a network disease.
越来越多的证据表明癫痫是由网络功能障碍引起的。我们使用基于扩散张量成像（DTI）的图论分析方法，评估局灶性癫痫患者皮质下结构的枢纽重组情况。此外，我们还研究了局灶性癫痫患者与健康受试者之间皮质下结构的扩散张量和标量值、分数各向异性（FA）和平均扩散率（MD）的差异。
前瞻性招募了100例局灶性癫痫且磁共振成像（MRI）结果正常的患者以及80例年龄和性别匹配的健康受试者。所有受试者均接受DTI检查以获取适合图论分析的数据。我们研究了癫痫患者与健康受试者之间皮质下结构的节点强度、聚类系数、特征向量中心性、页面排名中心性指标、FA和MD的差异。
经过多重校正后，癫痫患者苍白球的聚类系数和特征向量中心性高于健康受试者（分别为=0.006和=0.008）。此外，癫痫患者苍白球的强度和页面排名中心性也倾向于高于健康受试者（分别为=0.092和=0.032）。癫痫患者壳核的聚类系数低于健康受试者（=0.004）。癫痫患者尾状核和丘脑的FA值显著低于健康受试者（分别为=0.009和=0.007），而丘脑的MD值高于健康受试者（=0.005）。
我们发现MRI结果正常的局灶性癫痫患者存在皮质下结构的枢纽重组，这表明皮质下结构在癫痫网络中作为枢纽发挥关键作用。这些发现进一步强化了癫痫是一种网络疾病的观点。
