摘要
目的目前尚无左乙拉西坦(LEV)对儿童良性癫痫(BECTS)脑灰质重塑的研究。文中旨在通过基于体素的MRI形态学探讨LEV对伴中央颞区棘波的BECTS脑灰质结构的影响,评价LEV对BECTS的脑作用机制。方法连续纳入2014年1月至2016年9月在南京市儿童医院及南京军区南京总医院神经内科就诊的24例服用LEV的BECTS患儿(LEV组)和24例未经治疗的BECTS患儿(未服药组)。另纳入24名正常儿童(正常组)均在3T MRI仪下行三维T1加权成像,采用MRI形态学的方法计算受试者脑灰质体积,比较各组的灰质体积差异,并与癫痫病程、起病年龄及用药时间等临床指标进行相关分析。结果与正常组比较,未服药组的双侧丘脑灰质体积减少,双侧Rolandic区、前岛叶/岛盖部/三角部、左侧辅助运动区、中央旁小叶、中央前回、额上回和右侧额中回灰质体积增加;而LEV组双侧Rolandic区、额下回岛盖部及左侧辅助运动区灰质体积减少。与未服药组比较,LEV组的双侧辅助运动区、左侧中央旁小叶、中央前回、双侧前岛叶/岛盖部/三角部、左侧额上回及右侧额中回的灰质体积减少。左侧前岛叶/岛盖部的灰质体积分别与未服药组、LEV组呈正相关、负相关(r=0.394、-0.527,P<0.05)。LEV组的左侧前岛叶/岛盖部的灰质体积与其用药时间呈负相关(r=-0.527,P<0.01)。结论BECTS主要表现为丘脑灰质结构损害及癫痫相关皮层区域刺激性结构异常,LEV的抗癫痫作用可以重塑癫痫相关皮层区域及其临床症状相关脑区的灰质结构。
Objective At present,there is no study on effect of levetiracetam（ LEV） on the gray matter structure remodeling in benign epilepsy children with central temporal spikes（ BECTS）.The purpose of this study was to study the influence of LEV on the gray matter structure in BECTS and to evaluate the mechanism of LEV on the brain structure of BECTS through using voxel-based MRI morphological（ VBM） methods. Methods From January 2014 to September 2016,twenty-four BECTS treated with LEV（ LEV group）,twenty-four drug-naive BECTS（ untreated group） and twenty-four normal children（ normal group） consulted in department of Neurology,Nanjing Children’s Hospital and the Nanjing Military Region,Nanjing General Hospital were continuously included to receive three-dimensional T1-weighted imaging with 3T MRI and the gray matter volume was calculated by VBM. We compared the difference of grey matter volumes of the three groups and analyzed their correlation with epilepsy duration,age of onset and medication time and other clinical index. Results Compared with the normal group,the grey matter volume of bilateral thalamus were decreased,and the volume of bilateral Rolandic areas,anterior insula/frontal operculum/frontal triangle,left supplementary motor area,paracentral lobule,precentral gyrus,superior frontal gyrus and right middle frontal gyrus were increased in the untreated group,but the grey matter volume of the bilateral Rolandic areas,frontal operculum and left supplementary motor area were decreased in the LEV group. Compared with the untreated group,the grey matter volume of bilateral supplementary motor,left paracentral lobule,precentral gyrus,bilateral anterior insula/frontal operculum/frontal triangle,left superior frontal gyrus and right middle frontal gyrus in the LEV group were decreased. The grey matter volume of left anterior insula/frontal operculum areas was negatively correlated with the medication time in LEV group（ r =-0.527,P〈0.01）. Conclusion T The mainly representations of BECTS are thalamic gray matter damage and epileptic-related cortical area irritation structural abnormalities,but the LEV could reshape the epilepsy-related cortical area and the gray matter in the brain area associated with clinical symptoms.
出处
《医学研究生学报》
CAS
北大核心
2017年第5期502-507,共6页
Journal of Medical Postgraduates
基金
国家自然科学基金(81271553,81422022)
关键词
癫痫
磁共振成像
体素
形态学
Epilepsy
Magnetic resonance imaging
Voxel
Morphometry
作者简介
医学硕士研究生
通信彳乍者：卢光明,E-mail：cjr.luguangming@vip.163.com
