Huang Xiang, Mao Limei, Lin Qiuxing, Huang Kailing, Li Yuming, Liu Peiwen, Cao Danyang, Li Wenhao, Li Wei, Zhao Lili, Zhou Dong, Zhang Yingying, An Dongmei
Department of Neurology, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Wuhou District, Chengdu 610041, Sichuan, China.
Department of Electroneurophysiology, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Wuhou District, Chengdu 610041, Sichuan, China.
Cereb Cortex. 2025 Aug 1;35(8). doi: 10.1093/cercor/bhaf201.
This meta-analysis aims to investigate the convergent gray matter alterations observed in idiopathic generalized epilepsy through voxel-based morphometry studies. Voxel-based morphometry studies investigating the whole-brain gray matter alterations between patients with idiopathic generalized epilepsy and healthy controls were systematically searched. A coordinate-based meta-analysis of gray matter alterations was performed utilizing the anisotropic effect size-based signed differential mapping. Subgroup analyses were also conducted to further validate these findings and identify specificities. Twenty-two studies including 913 idiopathic generalized epilepsy patients and 887 healthy controls were enrolled. Patients with idiopathic generalized epilepsy exhibited increased gray matter in the right cuneus cortex, precuneus, superior frontal gyrus, middle frontal gyrus, parahippocampal gyrus, and fusiform gyrus, while exhibiting decreased gray matter in the bilateral thalami, left caudate nucleus, and right insula. Subgroup analyses revealed overlapping gray matter alterations in the bilateral thalami, with specific involvement of frontal lobe and insula in juvenile myoclonic epilepsy, right superior temporal gyrus in generalized tonic-clonic seizures alone, and bilateral paracentral lobules in absence epilepsy. This meta-analysis identified that both cortical and subcortical structural abnormalities especially thalamo-cortical circuit was involved in patients with idiopathic generalized epilepsy, while overlapped and disassociated gray matter alterations were identified across different idiopathic generalized epilepsy subsyndromes.
本荟萃分析旨在通过基于体素的形态学研究，调查特发性全身性癫痫中观察到的灰质改变情况。系统检索了基于体素的形态学研究，这些研究调查了特发性全身性癫痫患者与健康对照者之间的全脑灰质改变。利用基于各向异性效应大小的符号差异映射，对灰质改变进行了基于坐标的荟萃分析。还进行了亚组分析，以进一步验证这些发现并确定特异性。纳入了22项研究，包括913例特发性全身性癫痫患者和887例健康对照者。特发性全身性癫痫患者右侧楔叶皮质、楔前叶、额上回、额中回、海马旁回和梭状回的灰质增加，而双侧丘脑、左侧尾状核和右侧岛叶的灰质减少。亚组分析显示双侧丘脑存在重叠的灰质改变，额叶和岛叶在青少年肌阵挛性癫痫中存在特异性受累，仅在全面性强直-阵挛发作中右侧颞上回受累，在失神癫痫中双侧中央旁小叶受累。本荟萃分析确定，皮质和皮质下结构异常，尤其是丘脑-皮质回路，在特发性全身性癫痫患者中均有涉及，同时在不同的特发性全身性癫痫亚综合征中发现了重叠和分离的灰质改变。
