Brain & Mind Research Center, Nagoya University, Nagoya, Japan.
Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Pediatr Int. 2022 Jan;64(1):e15001. doi: 10.1111/ped.15001.
We aimed to investigate electroencephalography (EEG)-functional magnetic resonance imaging (fMRI) findings to elucidate the interictal epileptiform discharge (IED)-related functional alterations in deep brain structures and the neocortex in childhood epilepsy with centrotemporal spikes (CECTS).
Ten children with CECTS (median age 8.2 years), referred to our hospital within a year of onset, were eligible for inclusion. They underwent EEG-fMRI recording during sleep. Llongitudinal evaluations, including medical examinations, intelligence tests, and questionnaires about developmental disabilities, were performed. The initial evaluation was performed at the same time as the EEG-fMRI, and the second evaluation was performed over 2 years after the initial evaluation.
Three children were unable to maintain sleep during the EEG-fMRI recording, and the remaining seven children were eligible for further assessment. All patients showed unilateral-dominant centrotemporal spikes during scans. One patient had only positive hemodynamic responses, while the others had both positive and negative hemodynamic responses. All patients showed IED-related hemodynamic responses in the bilateral neocortex. For deep brain structures, IED-related hemodynamic responses were observed in the cingulate gyrus (n = 4), basal ganglia (n = 3), thalamus (n = 2), and default mode network (n = 1). Seizure frequencies at the second evaluation were infrequent or absent, and the longitudinal results of intelligence tests and questionnaires were within normal ranges.
We demonstrated that IEDs affect broad brain areas, including deep brain structures such as the cingulate gyrus, basal ganglia, and thalamus. Deep brain structures may play an important role in the pathophysiology of CECTS.
我们旨在通过研究脑电图（EEG）-功能磁共振成像（fMRI）结果，阐明儿童中央颞区棘波灶癫痫（CECTS）的发作间期棘波放电（IED）与深部脑结构和新皮层之间的功能变化关系。
10 名 CECTS 患儿（中位年龄 8.2 岁）符合纳入标准，均在发病后一年内入组我院。这些患儿在睡眠期间接受 EEG-fMRI 记录。进行了包括体格检查、智力测试和发育障碍问卷在内的纵向评估，初始评估与 EEG-fMRI 同时进行，第二次评估在初始评估后 2 年进行。
3 名患儿在 EEG-fMRI 记录期间无法保持睡眠，其余 7 名患儿符合进一步评估标准。所有患者在扫描时均表现为单侧优势的中央颞区棘波。1 名患者仅出现阳性血流动力学反应，而其他患者则既有阳性也有阴性血流动力学反应。所有患者的双侧新皮层均出现与 IED 相关的血流动力学反应。对于深部脑结构，在扣带回（n=4）、基底节（n=3）、丘脑（n=2）和默认模式网络（n=1）中观察到与 IED 相关的血流动力学反应。第二次评估时发作频率较少或无发作，智力测试和问卷的纵向结果均在正常范围内。
我们证明 IED 影响广泛的脑区，包括深部脑结构，如扣带回、基底节和丘脑。深部脑结构可能在 CECTS 的病理生理学中发挥重要作用。
