Neuhaus Elisabeth, Bitzer Felix, Held Nina R, Bauer Tobias, Gaubatz Jennifer, von Wrede Randi, Baumgartner Tobias, Rácz Atilla, Becker Vitali, Surges Rainer, Rüber Theodor
Department of Epileptology, University Hospital Bonn, Bonn, Germany.
Department of Neurology, Epilepsy Center Frankfurt Rhine-Main, Goethe University Frankfurt, Frankfurt am Main, Germany.
J Neuroimaging. 2024 Jan-Feb;34(1):55-60. doi: 10.1111/jon.13164. Epub 2023 Oct 15.
Voxel-based morphometry (VBM) studies of people with focal epilepsies revealed gray matter (GM) alterations in brain regions involved in cardiorespiratory regulation, which have been linked to the risk of sudden unexpected death in epilepsy (SUDEP). It remains unclear whether the type and localization of epileptogenic lesions influence the occurrence of such alterations.
To test the hypothesis that VBM alterations of autonomic network regions are independent of epileptogenic lesions and that they reveal structural underpinnings of SUDEP risk, VBM was performed in 100 people with focal epilepsies without an epileptogenic lesion identifiable on MRI (mean age ± standard deviation = 35 ± 11 years, 56 female). The group was further stratified in high (sample size n = 29) and low risk of SUDEP (n = 71). GM volumes were compared between these two subgroups and to 100 matched controls.
People with epilepsy displayed higher GM volume in both amygdalae and parahippocampal gyri and lower GM volume in the cerebellum and occipital (p<.05, familywise error corrected). There were no significant volumetric differences between high and low SUDEP risk subgroups.
Our findings confirm that autonomic networks are structurally altered in people with focal epilepsy and they question VBM as a suitable method to show structural correlates of the SUDEP risk score.
基于体素的形态学测量（VBM）研究发现，局灶性癫痫患者在参与心肺调节的脑区存在灰质（GM）改变，这与癫痫性猝死（SUDEP）风险相关。目前尚不清楚致痫性病变的类型和定位是否会影响此类改变的发生。
为检验自主神经网络区域的VBM改变独立于致痫性病变且揭示SUDEP风险的结构基础这一假设，对100例MRI上未发现致痫性病变的局灶性癫痫患者进行了VBM检查（平均年龄±标准差 = 35 ± 11岁，56例女性）。该组进一步分为高SUDEP风险组（样本量n = 29）和低SUDEP风险组（n = 71）。比较了这两个亚组与100例匹配对照的GM体积。
癫痫患者双侧杏仁核和海马旁回的GM体积较高，小脑和枕叶的GM体积较低（p<.05，经家族性误差校正）。高SUDEP风险亚组和低SUDEP风险亚组之间的体积无显著差异。
我们的研究结果证实，局灶性癫痫患者的自主神经网络在结构上发生了改变，并且对VBM作为显示SUDEP风险评分结构相关性的合适方法提出了质疑。
