Wang Ziyun, Liu Weiping, Feng Ximei, Wang Qian, Ning Xun, Xing Wu
Department of Radiology, Xiangya Hospital, Central South University, Changsha, People's Republic of China.
National Clinical Research Centre for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, People's Republic of China.
Neuropsychiatr Dis Treat. 2025 May 30;21:1109-1118. doi: 10.2147/NDT.S508253. eCollection 2025.
The study aims to further investigate the relationship between the Sleep-related epilepsies (SRE) and alterations in the White Matter (WM) microstructure, as well as to explore the clinical value of diffusion tensor imaging (DTI) in patients with SRE.
DTI data were acquired for 52 patients with SRE and 74 Healthy Controls (HC), all of whom were matched for sex and age. The DTI indicators, including Fractional Anisotropy (FA), Mean Diffusivity (MD), Axial Diffusivity (AD) and Radial Diffusivity (RD), were compared between the two groups using Tract-Based Spatial Statistics (TBSS) to analyze alterations in WM microstructure. Altered WM was correlated with the age of onset and disease duration of SRE.
Compared to the HC, FA decreased in the genu of the corpus callosum (GCC) and the left anterior corona radiata (ACR_L) in SRE. Conversely, the RD of the bilateral superior corona radiata (SCR), the anterior corona radiata (ACR), the GCC, and the body of the corpus callosum (BCC) increased. Furthermore, a negative correlation was identified between the increased RD values and age of onset in SRE.
The FA and RD values derived from DTI serve as neuroimaging markers to evaluate WM damage in SRE. These findings indicate that alterations in WM microstructure within the bilateral frontal lobes and corpus callosum may contribute to a potential pathophysiological mechanism underlying seizures in SRE. Furthermore, myelin damage appears to be more severe in early-onset SRE patients, highlighting the necessity for clinical vigilance regarding WM microstructural changes in young SRE patients.
本研究旨在进一步探究睡眠相关性癫痫（SRE）与白质（WM）微观结构改变之间的关系，并探讨弥散张量成像（DTI）在SRE患者中的临床价值。
对52例SRE患者和74例健康对照者（HC）进行DTI数据采集，所有受试者均在性别和年龄上相匹配。使用基于纤维束的空间统计学（TBSS）比较两组之间的DTI指标，包括各向异性分数（FA）、平均扩散率（MD）、轴向扩散率（AD）和径向扩散率（RD），以分析WM微观结构的改变。改变的WM与SRE的发病年龄和病程相关。
与HC相比，SRE患者胼胝体膝部（GCC）和左侧放射冠前部（ACR_L）的FA降低。相反，双侧放射冠上部（SCR）、放射冠前部（ACR）、GCC和胼胝体体部（BCC）的RD增加。此外，SRE患者中增加的RD值与发病年龄之间存在负相关。
DTI得出的FA和RD值可作为评估SRE中WM损伤的神经影像学标志物。这些发现表明双侧额叶和胼胝体内WM微观结构的改变可能是SRE发作潜在病理生理机制的一部分。此外，早发性SRE患者的髓鞘损伤似乎更严重，这突出了临床对年轻SRE患者WM微观结构变化保持警惕的必要性。
