Salimeen Mustafa Salimeen Abdelkareem, Liu Congcong, Li Xianjun, Wang Miaomiao, Singh Martha, Si Shuqing, Li Mengxuan, Cheng Yannan, Wang Xiaoyu, Zhao Huifang, Wu Fan, Zhang Yuli, Tafawa Habib, Pradhan Anuja, Yang Guanyu, Yang Jian
Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Front Neurol. 2021 Apr 21;12:595647. doi: 10.3389/fneur.2021.595647. eCollection 2021.
Simple febrile seizures (SFS) and epilepsy are common seizures in childhood. However, the mechanism underlying SFS is uncertain, and the presence of obvious variances in white matter (WM) integrity and glymphatic function between SFS and epilepsy remain unclear. Therefore, this study aimed to investigate the differences in WM integrity and glymphatic function between SFS and epilepsy. We retrospectively included 26 children with SFS, 33 children with epilepsy, and 28 controls aged 6-60 months who underwent magnetic resonance imaging (MRI). Tract-based spatial statistics (TBSS) were used to compare the diffusion tensor imaging (DTI) metrics of WM among the above-mentioned groups. T2-weighted imaging (T2WI) was used to segment the visible Virchow-Robin space (VRS) through a custom-designed automated method. VRS counts and volume were quantified and compared among the SFS, epilepsy, and control groups. Correlations of the VRS metrics and seizure duration and VRS metrics and the time interval between seizure onset and MRI scan were also investigated. In comparison with controls, children with SFS showed no significant changes in fractional anisotropy (FA), axial diffusivity (AD), or radial diffusivity (RD) in the WM ( > 0.05). Decreased FA, unchanged AD, and increased RD were observed in the epilepsy group in comparison with the SFS and control groups ( < 0.05). Meanwhile, VRS counts were higher in the SFS and epilepsy groups than in the control group (VRS_SFS, 442.42 ± 74.58, VRS_epilepsy, 629.94 ± 106.55, VRS_control, 354.14 ± 106.58; < 0.001), and similar results were found for VRS volume (VRS_SFS, 6,228.18 ± 570.74 mm, VRS_epilepsy, 9,684.84 ± 7,292.66mm, VRS_control, 4,007.22 ± 118.86 mm; < 0.001). However, VRS metrics were lower in the SFS group than in the epilepsy group ( < 0.001). In both SFS and epilepsy, VRS metrics positively correlated with seizure duration and negatively correlated with the course after seizure onset. SFS may not be associated with WM microstructural disruption; however, epilepsy is related to WM alterations. Seizures are associated with glymphatic dysfunction in either SFS or epilepsy.
单纯性热性惊厥（SFS）和癫痫是儿童期常见的惊厥性疾病。然而，SFS的潜在机制尚不确定，SFS与癫痫之间白质（WM）完整性和类淋巴功能的明显差异仍不清楚。因此，本研究旨在探讨SFS与癫痫在WM完整性和类淋巴功能方面的差异。我们回顾性纳入了26例SFS患儿、33例癫痫患儿和28例年龄在6至60个月之间接受磁共振成像（MRI）检查的对照组儿童。采用基于纤维束的空间统计学（TBSS）比较上述各组WM的扩散张量成像（DTI）指标。利用T2加权成像（T2WI）通过定制的自动化方法分割可见的Virchow-Robin间隙（VRS）。对SFS组、癫痫组和对照组的VRS计数和体积进行量化和比较。还研究了VRS指标与发作持续时间以及VRS指标与发作起始至MRI扫描时间间隔之间的相关性。与对照组相比，SFS患儿WM的各向异性分数（FA）、轴向扩散率（AD）或径向扩散率（RD）无显著变化（P>0.05）。与SFS组和对照组相比，癫痫组FA降低、AD无变化、RD升高（P<0.05）。同时，SFS组和癫痫组的VRS计数高于对照组（VRS_SFS，442.42±74.58；VRS_epilepsy，629.94±106.55；VRS_control，354.14±106.58；P<0.001），VRS体积也有类似结果（VRS_SFS，6228.18±570.74mm；VRS_epilepsy，9684.84±7292.66mm；VRS_control，4007.22±118.86mm；P<0.001）。然而，SFS组的VRS指标低于癫痫组（P<0.001）。在SFS和癫痫中，VRS指标均与发作持续时间呈正相关，与发作起始后的病程呈负相关。SFS可能与WM微观结构破坏无关；然而，癫痫与WM改变有关。SFS或癫痫中的发作均与类淋巴功能障碍有关。
