左乙拉西坦对伴中央颞区棘波的儿童良性癫痫脑灰质结构重塑的评价

发布时间：2018-01-29 04:29

本文关键词： 癫痫磁共振成像体素形态学　出处：《医学研究生学报》2017年05期 　论文类型：期刊论文

【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,P0.05)。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,P0.01)。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。
[Abstract]:Objective at present, there is no levoethoxetam (Levo) in the treatment of benign epilepsy in children (BECTS). The aim of this study was to investigate the effect of LEV on the gray matter structure of BECTS with central temporal spikes by means of voxel based MRI morphology. Methods from January 2014 to September 2016, 24 patients who were admitted to Nanjing Children's Hospital and Department of Neurology, Nanjing General Hospital of Nanjing military region received L. BECTS of EV (. LEV group) and 24 untreated BECTS children (no medication group), and 24 normal children (normal group) were all performed 3D T 1 weighted imaging on 3T MRI instrument. The gray matter volume of the subjects was calculated by MRI morphology, and the difference of gray matter volume in each group was compared with that of epilepsy. Results compared with the normal group, the bilateral thalamic gray matter volume decreased, bilateral Rolandic area, anterior insular lobe / tegmental part / triangle in the control group were compared with those in the control group. The volume of gray matter increased in the left auxiliary motor area, paracentral lobules, precentral gyrus, superior frontal gyrus and right middle frontal gyrus. However, the volume of gray matter in the bilateral Rolandic area, the inferior frontal gyrus and the left auxiliary motor area in the LEV group was decreased. Compared with the control group, the bilateral auxiliary motor area and the left central paracentral lobules in the LEV group were significantly lower than those in the control group. The volume of gray matter in precentral gyrus, bilateral anterior insular lobe / cap / triangle, left superior frontal gyrus and right middle frontal gyrus decreased. There was a negative correlation between the volume of gray matter in the left anterior insular / cap of the left island and the time of medication in the 0.394- 0.527 P0.05. LEV group, and there was a negative correlation between the volume of gray matter in the left anterior islet / cap and the drug use time. Conclusion BECTS is mainly characterized by the damage of gray matter structure of thalamus and the abnormal irritative structure of epileptic-related cortical region. The antiepileptic effect of LEV can reshape the gray matter structure of epileptogenic cortical region and clinical symptom related brain area.
【作者单位】：南方医科大学金陵医院(南京总医院)医学影像科;南方医科大学金陵医院(南京总医院)神经内科;南京市儿童医院神经内科;
【基金】：国家自然科学基金(81271553,81422022)
【分类号】：R742.1;R445.2
【正文快照】： 0引言伴中央颞区棘波的儿童良性癫痫(benign child-hood epilepsy with centro-temporal spikes,BECTS)是一种最常见的儿童癫痫综合征,发病高峰为7~10岁[1]。既往多认为BECTS是一种良性的癫痫,但近来研究表明其神经心理方面的预后却并不乐观,BECTS可有记忆、语言障碍和执行控

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