Kim Eun Hee, Shim Woo Hyun, Lee Jin Seong, Yoon Hee Mang, Ko Tae Sung, Yum Mi Sun
Department of Pediatrics, Sejong Chungnam National University Hospital, Chungnam National University College of Medicine, Sejong, Korea.
Department of Pediatrics, CHA Gangnam Medical Center, CHA University, Seoul, Korea.
J Clin Neurol. 2020 Oct;16(4):573-580. doi: 10.3988/jcn.2020.16.4.573.
Recent quantitative neuroimaging studies of childhood absence epilepsy (CAE) have identified various structural abnormalities that might be involved in the onset of absence seizure and associated cognitive and behavioral functions. However, the neuroanatomical alterations specific to CAE remain unclear, and so this study investigated the regional alterations of brain structures associated with newly diagnosed CAE.
Surface and volumetric magnetic resonance imaging data of patients with newly diagnosed CAE (=18) and age-matched healthy controls (=18) were analyzed using Free-Surfer software. A group comparison using analysis of covariance was performed with significance criteria of <0.05 and <0.01 in global and regional analyses, respectively.
Compared with control subjects, the patients with CAE had smaller total and regional volumes of cortical gray-matter (GM) in the right rostral middle frontal, right lateral orbitofrontal, and left rostral middle frontal regions, as well as in the right precentral, right superior, middle, left middle, and inferior temporal gyri. The cortex in the right posterior cingulate gyrus and left medial occipital region was significantly thicker in patients with CAE than in controls.
Patients with CAE showed a reduced bilateral frontotemporal cortical GM volume and an increased posterior medial cortical thickness, which are associated with the default mode network. These structural changes can be suggested as the neural basis of the absence seizures and neuropsychiatric comorbidities in CAE.
近期关于儿童失神癫痫(CAE)的定量神经影像学研究已确定了各种可能与失神发作的起始以及相关认知和行为功能有关的结构异常。然而,CAE特有的神经解剖学改变仍不明确,因此本研究调查了与新诊断的CAE相关的脑结构区域改变。
使用Free-Surfer软件分析新诊断的CAE患者(n = 18)和年龄匹配的健康对照者(n = 18)的表面和容积磁共振成像数据。在整体和区域分析中分别采用协方差分析进行组间比较,显著性标准分别为P < 0.05和P < 0.01。
与对照组相比,CAE患者在右侧额中回前部、右侧眶额外侧、左侧额中回前部以及右侧中央前回、右侧颞上回、颞中回、左侧颞中回和颞下回的皮质灰质(GM)总体积和区域体积较小。CAE患者右侧后扣带回和左侧枕内侧区域的皮质明显比对照组厚。
CAE患者表现出双侧额颞叶皮质GM体积减少以及后内侧皮质厚度增加,这与默认模式网络有关。这些结构变化可被认为是CAE失神发作和神经精神共病的神经基础。