Wan Xinyue, Yin Xuyang, Chai Xinyi, Tian Mei, Wang Jianhong, Zhang Jun
Department of Radiology, Huashan Hospital, State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China.
Human Phenome Institute, Fudan University, Shanghai, China.
J Magn Reson Imaging. 2025 Jun;61(6):2489-2500. doi: 10.1002/jmri.29678. Epub 2024 Dec 13.
Previous studies have shown neurovascular coupling (NVC) dysfunction in epilepsy, suggesting its role in the pathological mechanisms. However, it remains unclear whether NVC abnormalities exist in epilepsy of unknown etiology (EU).
To integrate multiparametric MRI to assess NVC and its relationship with cognition in early-onset and late-onset EU patients.
Prospective.
Ninety-six EU patients (46 early-onset, M/F = 20/26; 50 late-onset, M/F = 29/21) and 60 healthy controls (HCs, M/F = 25/35).
FIELD STRENGTH/SEQUENCE: 3.0 T, resting-state gradient echo-planar imaging, pseudo-continuous arterial spin labeling (pc-ASL), and T1-weighted brain volume sequence.
Functional MRI data were analyzed to assess intrinsic brain activity including amplitude of low-frequency fluctuations (ALFF), fractional ALFF (fALFF), regional homogeneity (ReHo), and functional connectivity strength (FCS), while pc-ASL provided cerebral blood flow (CBF) measurements. Coupling correlation coefficients and ratios of CBF to neural activity were calculated to evaluate global and regional NVC.
Two-sample t-test, Analysis of Variance, Kruskal-Wallis test, Chi-square test, Analysis of Covariance, family-wise error/Bonferroni correction, partial correlation analyses. Statistical significance was defined as P < 0.05.
Whole-brain analysis revealed increased ALFF values in both patient groups' left precentral and postcentral gyri. Both patient groups had lower global NVC coefficients than HCs, with reduced CBF-ALFF (0.28 vs. 0.30), CBF-fALFF (0.43 vs. 0.45), and CBF-ReHo (0.40 vs. 0.41) in early-onset patients, and lower CBF-fALFF (0.38 vs. 0.45) and CBF-ReHo (0.32 vs. 0.41) in late-onset patients. Regional analysis showed significantly decreased CBF/ALFF ratios in the left precentral and postcentral gyri (T = 3.85 to 5.33). Reduced global NVC in early-onset patients was significantly associated with poorer executive function (r = 0.323), while global coupling in late-onset patients was negatively correlated with disease duration (r = -0.348 to -0.426).
This study showed abnormal global and regional NVC in both early-onset and late-onset EU patients, emphasizing the potential role of NVC in the pathophysiological mechanisms of EU.
1 TECHNICAL EFFICACY: Stage 1.
先前的研究已表明癫痫存在神经血管耦合（NVC）功能障碍，提示其在病理机制中的作用。然而，病因不明的癫痫（EU）是否存在NVC异常仍不清楚。
整合多参数MRI以评估早发性和晚发性EU患者的NVC及其与认知的关系。
前瞻性研究。
96例EU患者（46例早发性，男/女=20/26；50例晚发性，男/女=29/21）和60名健康对照者（HCs，男/女=25/35）。
场强/序列：3.0T，静息态梯度回波平面成像、伪连续动脉自旋标记（pc-ASL）和T1加权脑容积序列。
分析功能MRI数据以评估脑内固有活动，包括低频振幅（ALFF）、ALFF分数（fALFF）、局部一致性（ReHo）和功能连接强度（FCS），而pc-ASL提供脑血流量（CBF）测量值。计算耦合相关系数和CBF与神经活动的比值以评估整体和局部NVC。
两样本t检验、方差分析、Kruskal-Wallis检验、卡方检验、协方差分析、家族误差/邦费罗尼校正、偏相关分析。统计学显著性定义为P<0.05。
全脑分析显示，两组患者的左侧中央前回和中央后回ALFF值均升高。两组患者的整体NVC系数均低于HCs，早发性患者的CBF-ALFF（0.28对0.30）、CBF-fALFF（0.43对0.45）和CBF-ReHo（0.40对0.41）降低，晚发性患者的CBF-fALFF（0.38对0.45）和CBF-ReHo（0.32对0.41）降低。局部分析显示，左侧中央前回和中央后回的CBF/ALFF比值显著降低（T=3.85至5.33）。早发性患者整体NVC降低与执行功能较差显著相关（r=0.323），而晚发性患者的整体耦合与病程呈负相关（r=-0.348至-0.426）。
本研究显示早发性和晚发性EU患者均存在整体和局部NVC异常，强调了NVC在EU病理生理机制中的潜在作用。
1 技术效能：1级
