Li Yihan, Sun Yulei, Niu Kai, Wang Pengfei, Xiang Jing, Chen Qiqi, Hu Zheng, Wang Xiaoshan
Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, China.
MEG Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45220, USA.
Epilepsy Behav. 2020 Nov;112:107363. doi: 10.1016/j.yebeh.2020.107363. Epub 2020 Aug 25.
Our aim was to explore the pathophysiological mechanism of cognitive function changes in early untreated children with benign childhood epilepsy with centrotemporal spikes (BECTS).
Magnetoencephalography (MEG) was performed in 33 children with BECTS and 18 healthy children. Wechsler Intelligence Scale for Children, fourth edition (WISC-IV) was used to divide children with BECTS into two groups. Normal cognitive function was defined as a full-scale intelligence quotient (FSIQ) of >80, while decreased cognitive function was defined as a FSIQ of <80. Accumulated source imaging was used to evaluate the neuromagnetic source activity in multifrequency bands.
Of the 33 patients with early untreated BECTS, a total of 17 had a FSIQ of <80 and 16 had FSIQ of >80. The course of epilepsy and number of seizures in the FSIQ <80 group were higher than that in the FSIQ >80 group. Our MEG results showed that in the 4-8 Hz frequency band, both patient groups had inactivation of the posterior cingulate cortex (PCC) region compared with the healthy control group. In the 30-80 Hz frequency band, the FSIQ <80 group showed inactivation of the PCC region compared with both the healthy control group and the FSIQ >80 group. In the 80-250 Hz frequency band, the FSIQ <80 group had inactivated of the medial frontal cortex (MFC) region compared with the healthy control group. In the 30-80 Hz frequency band, the strength of neuromagnetic source in patients with BECTS with FSIQ <80 was higher than that in the FSIQ >80 group and the healthy control group.
The magnetic source inactivation of the MFC and PCC regions during the interictal time may be the reason for cognitive decline in early untreated children with BECTS. Children with BECTS with cognitive decline had a longer course of epilepsy and more seizures. The magnetic source localization in the 4-8 Hz frequency band may be a new imaging marker for the diagnosis of new BECTS.
我们的目的是探讨未经治疗的早期儿童良性中央颞区棘波癫痫(BECTS)认知功能变化的病理生理机制。
对33例BECTS患儿和18例健康儿童进行了脑磁图(MEG)检查。采用韦氏儿童智力量表第四版(WISC-IV)将BECTS患儿分为两组。正常认知功能定义为全量表智商(FSIQ)>80,而认知功能下降定义为FSIQ<80。采用累积源成像评估多频段神经磁源活动。
在33例未经治疗的早期BECTS患者中,共有17例FSIQ<80,16例FSIQ>80。FSIQ<80组的癫痫病程和发作次数高于FSIQ>80组。我们的MEG结果显示,在4-8Hz频段,与健康对照组相比,两组患者的后扣带回皮质(PCC)区域均失活。在30-80Hz频段,与健康对照组和FSIQ>80组相比,FSIQ<80组的PCC区域失活。在80-250Hz频段,与健康对照组相比,FSIQ<80组的内侧额叶皮质(MFC)区域失活。在30-80Hz频段,FSIQ<80的BECTS患者神经磁源强度高于FSIQ>80组和健康对照组。
发作间期MFC和PCC区域的磁源失活可能是未经治疗的早期BECTS儿童认知功能下降的原因。认知功能下降的BECTS患儿癫痫病程更长,发作次数更多。4-8Hz频段的磁源定位可能是诊断新发BECTS的一种新的影像学标志物。