Wu Bixia, Zhang Gengbiao, Wang Yanting, Zheng Hongyi, Tan Hui, Zheng Wenbin
Department of Radiology, Meizhou People's Hospital, Meizhou, China.
Department of Radiology, The Second Affiliated Hospital, Shantou University Medical College, Shantou, China.
Neuroimage Rep. 2025 Jan 30;5(1):100237. doi: 10.1016/j.ynirp.2025.100237. eCollection 2025 Mar.
Based on diffusion tensor imaging (DTI) data, we used DTI-analysis along the perivascular space (DTI-ALPS) and free-water mapping to investigate the function of the glymphatic system and its relationship with clinical features among pediatric patients with magnetic resonance imaging (MRI)-negative non-lesional epilepsy (NLE).
A total of 83 NLE children (mean age 9.25 ± 4.07 years) and 45 matched healthy controls (mean age 9.36 ± 3.89 years) were recruited. All eligible patients were routinely scanned by 3.0T MRI to rule out organic lesions, and DTI data were collected at the same time. The ALPS index and fractional volume of free water in white matter (FW-WM) in the brain were calculated to analyze the differences between groups and the correlation between the corresponding parameters and clinical indicators such as age of onset, duration of the disease, seizure frequency, and seizure duration.
The NLE group had significantly lower ALPS indexes in the left (ALPS-L, F = 4.415, p = 0.038) and right (ALPS-R, F = 12.673, p = 0.001) cerebral hemispheres compared to the HC group. ALPS-L was positively correlated with age of onset (r = 0.322, p = 0.008) and negatively correlated with FW-WM (r = -0.337, p < 0.001). Free-water mapping revealed substantially higher FW-WM in the NLE group compared to the HC group (F = 4.666, p = 0.033). Additionally, FW-WM was negatively correlated with age of onset (r = -0.463, p < 0.001) and positively associated with seizure control in children with NLE (r = 0.306, p = 0.012).
Children with NLE have reduced glymphatic system function, and the underlying pathophysiologic mechanisms may be due to impaired interstitial fluid clearance and retention in the brain. DTI-ALPS and free-water mapping are useful noninvasive approaches for examining glymphatic function in children with NLE, with the FW-WM potentially serving as an imaging marker for disease progression and predicting clinical prognosis in children with NLE.
基于扩散张量成像（DTI）数据，我们采用沿血管周围间隙的DTI分析（DTI-ALPS）和自由水成像来研究小儿磁共振成像（MRI）阴性非病灶性癫痫（NLE）患者的淋巴系统功能及其与临床特征的关系。
共招募了83名NLE儿童（平均年龄9.25±4.07岁）和45名匹配的健康对照者（平均年龄9.36±3.89岁）。所有符合条件的患者均接受3.0T MRI常规扫描以排除器质性病变，并同时收集DTI数据。计算大脑中ALPS指数和白质自由水分数体积（FW-WM），以分析组间差异以及相应参数与发病年龄、病程、癫痫发作频率和发作持续时间等临床指标之间的相关性。
与健康对照组相比，NLE组左（ALPS-L，F = 4.415，p = 0.038）、右（ALPS-R，F = 12.673，p = 0.001）脑半球的ALPS指数显著降低。ALPS-L与发病年龄呈正相关（r = 0.322，p = 0.008），与FW-WM呈负相关（r = -0.337，p < 0.001）。自由水成像显示，与健康对照组相比，NLE组的FW-WM显著更高（F = 4.666，p = 0.033）。此外，FW-WM与发病年龄呈负相关（r = -0.463，p < 0.001），与NLE儿童的癫痫控制呈正相关（r = 0.306，p = 0.012）。
NLE儿童的淋巴系统功能降低，其潜在的病理生理机制可能是由于脑间质液清除和潴留受损。DTI-ALPS和自由水成像对于检查NLE儿童的淋巴功能是有用的非侵入性方法，FW-WM可能作为疾病进展的成像标志物并预测NLE儿童的临床预后。
