左乙拉西坦对伴中央颞区棘波的儿童良性癫痫脑活动影响的静息态功能磁共振成像评价

发布时间：2018-01-26 16:32

本文关键词： 癫痫儿童磁共振成像　出处：《中国临床医学影像杂志》2017年10期 　论文类型：期刊论文

【摘要】：目的:采用基于静息态脑功能成像的低频振荡振幅(ALFF)算法,观察左乙拉西坦(LEV)治疗对伴中央颞区棘波的儿童良性癫痫(BECTS)的脑活动影响和作用机制。方法:纳入22例服用LEV的BECTS、22例未服药的BECTS和22名年龄和性别匹配的正常儿童,均在3T MRI仪器下采集fMRI数据,经数据预处理后,应用SPM8软件的方差分析比较三组被试的ALFF改变,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 :与正常儿童对照组比较,未治疗BECTS组和LEV治疗BECTS组的双侧Rolandic区ALFF均增加,而与未治疗BECTS组比较,LEV治疗BECTS组的双侧Rolandic区ALFF减低。未治疗BECTS组左侧中央前/后回和额下回ALFF值与其病程呈正相关,LEV治疗BECTS组左侧中央前回和右侧额上回与其用药时间呈负相关,左侧楔前叶和右侧颞中回与其用药时间呈正相关。结论:未经治疗的BECTS异常放电脑区内在脑活动增加,而LEV治疗可使其脑活动减低,并且可以影响语言、注意力和默认模式网络(DMN)的相关脑区,从静息态功能成像角度证实了LEV治疗BECTS的有效性。
[Abstract]:Objective: to use the ALFFFalgorithm of low frequency oscillation amplitude based on resting brain functional imaging. Objective: to observe the effect and mechanism of levoethiracetam on brain activity in children with benign epilepsy (BECTS) with central temporal spikes. Methods: 22 patients with LEV were enrolled in this study. FMRI data were collected from 22 BECTS and 22 age-sex matched normal children under 3T MRI instrument. The data were preprocessed. The variance analysis of SPM8 software was used to compare the changes of ALFF in the three groups, and the correlation analysis was made with the clinical indexes such as the course of epilepsy, the onset age and the time of medication. Results: compared with the control group of normal children. The ALFF of bilateral Rolandic in the untreated BECTS group and the LEV treated BECTS group was increased, but compared with that in the untreated BECTS group. The ALFF of bilateral Rolandic area was decreased in BECTS group treated with LEV. The ALFF values of left precentral / posterior gyrus and inferior frontal gyrus in untreated BECTS group were positively correlated with the course of disease. There was a negative correlation between left precentral gyrus and right superior frontal gyrus in BECTS treated with LEV. There was a positive correlation between left anterior wedge lobe and right middle temporal gyrus. Conclusion: the brain activity of untreated BECTS increased in the computer area, but the brain activity was decreased after LEV treatment. And it can affect the brain regions related to language, attention and default mode network. The efficacy of LEV in the treatment of BECTS is confirmed from the viewpoint of resting functional imaging.
【作者单位】：南方医科大学附属金陵医院(南京军区南京总医院);南京市儿童医院神经内科;
【基金】：国家自然科学基金优秀青年科学基金项目资助(编号:81422022)
【分类号】：R445.2;R742.1
【正文快照】： 伴中央颞区棘波的儿童良性癫痫(Benignchildhood epilepsy with centro-temporal spikes,BECTS),又称Rolandic癫痫,是最常见的儿童癫痫综合征,发病高峰为7~10岁,表现为一侧面部抽搐、流涎等部分性发作,也可发展为全身性发作[1]。典型发作常发生在入睡后或者将醒时,EEG特征为一

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