Sun Shan-Shan, Tian Mi-Mi, Lin Nan, Yuan Xian-Shun, Zhao Peng, Lin Xiang-Tao
Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
Department of Medical Imaging, Shandong Public Health Clinical Center, Jinan, Shandong, China.
Neuroradiology. 2023 May;65(5):945-959. doi: 10.1007/s00234-023-03137-6. Epub 2023 Mar 4.
To investigate abnormalities in cortical and subcortical structures of the brain in preschool children with MRI-negative epilepsy.
Cortical thickness, cortical mean curvature, cortical surface area, cortical volume, and volumes of subcortical structures were measured using Freesurfer software in preschool children with epilepsy and age-matched controls.
Findings showed cortical thickening in the left fusiform gyrus, left middle temporal gyrus, right suborbital sulcus, and right gyrus rectus, and cortical thinning mainly in the parietal lobe of preschool children with epilepsy compared to controls. The difference in cortical thickness in the left superior parietal lobule remained after correction for multiple comparisons and was negatively correlated with duration of epilepsy. Cortical mean curvature, surface area, and volume were mainly altered in the frontal and temporal lobes. Changes in mean curvature in the right pericallosal sulcus were positively correlated with age at seizure onset, and changes in mean curvature in the left intraparietal sulcus and transverse parietal sulcus were positively correlated with frequency of seizures. There were no significant differences in the volumes of the subcortical structures.
Changes in preschool children with epilepsy occur in the cortical rather than subcortical structures of the brain. These findings further our understanding of the effects of epilepsy in preschool children and will inform management of epilepsy in this patient population.
研究MRI检查结果为阴性的学龄前癫痫儿童大脑皮质和皮质下结构的异常情况。
使用Freesurfer软件测量癫痫学龄前儿童及年龄匹配的对照组儿童的皮质厚度、皮质平均曲率、皮质表面积、皮质体积和皮质下结构体积。
研究结果显示，与对照组相比，癫痫学龄前儿童左侧梭状回、左侧颞中回、右侧眶下沟和右侧直回出现皮质增厚，而皮质变薄主要出现在顶叶。在进行多重比较校正后，左侧顶上小叶的皮质厚度差异仍然存在，且与癫痫病程呈负相关。皮质平均曲率、表面积和体积主要在额叶和颞叶发生改变。右侧胼胝体沟的平均曲率变化与癫痫发作起始年龄呈正相关，左侧顶内沟和顶横沟的平均曲率变化与癫痫发作频率呈正相关。皮质下结构的体积没有显著差异。
癫痫学龄前儿童大脑的变化发生在皮质而非皮质下结构。这些发现加深了我们对癫痫对学龄前儿童影响的理解，并将为该患者群体的癫痫管理提供参考。
