School for Mental Health and Neuroscience, Maastricht University Medical Center, P. Debyelaan 25, Maastricht, The Netherlands.
Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, P. Debyelaan 25, Maastricht, The Netherlands.
J Neuroimaging. 2020 May;30(3):308-314. doi: 10.1111/jon.12707. Epub 2020 Apr 7.
The process of myelination starts in utero around 20 weeks of gestation and continues through adulthood. We first set out to characterize the maturation of the tract-specific myelin content in healthy subjects from childhood (7-12 years) into adulthood (18-32 years). Second, we apply the resulting development graph to children with childhood absence epilepsy (CAE), a pediatric epilepsy that was previously characterized by changes in myelin content.
In a prospective cross-sectional study, 15 healthy children (7-12 years), 14 healthy adult participants (18-32 years) and 17 children with a clinical diagnosis of CAE (6-12 years) were included. For each participant, diffusion weighted images were acquired to reconstruct bundles of white matter tracts and multi-echo multi-slice GRASE images were acquired for myelin-water estimation. Subsequently, a tract-specific myelin development graph was constructed using the percentual difference in myelin-water content from childhood (12 year) to adulthood (25 year).
The graph revealed myelination patterns, where tracts in the central regions myelinate prior to peripheral tracts and intra-hemispheric tracts as well as tracts in the left hemisphere myelinate prior to inter-hemispheric tracts and tracts in the right hemisphere, respectively. No significant differences were found in myelin-water content between children with CAE and healthy children for neither the early developing tracts, nor the tracts that develop in a later stage. However, the difference between the myelin-water of late and early developing tracts is significantly smaller in the children with CAE.
These results indicate that CAE is associated with widespread neurodevelopmental myelin differences.
髓鞘形成过程始于妊娠 20 周左右的胎儿期，并持续到成年期。我们首先旨在描述健康受试者从儿童期（7-12 岁）到成年期（18-32 岁）的特定于束的髓鞘含量的成熟情况。其次，我们将得到的发育图应用于儿童失神癫痫（CAE），这是一种以前表现为髓鞘含量变化的儿科癫痫。
在一项前瞻性的横断面研究中，纳入了 15 名健康儿童（7-12 岁）、14 名健康成年参与者（18-32 岁）和 17 名患有临床诊断的 CAE 的儿童（6-12 岁）。对于每个参与者，都采集了扩散加权图像以重建白质束，并采集了多回波多切片 GRASE 图像以进行髓鞘水估计。随后，使用髓鞘水含量在儿童期（12 岁）到成年期（25 岁）之间的百分比差异构建了特定于束的髓鞘发育图。
该图揭示了髓鞘形成模式，其中中央区域的束比周围区域、半球内束以及左侧半球的束比右侧半球的束更早髓鞘化。在 CAE 患儿和健康儿童中，无论是早期发育的束还是后期发育的束，其髓鞘水含量均无显著差异。然而，在 CAE 患儿中，晚期和早期发育束之间的差异明显较小。
这些结果表明 CAE 与广泛的神经发育性髓鞘差异有关。
