隐源性婴儿痉挛患儿脑磁共振形态学定量分析

Brain Voxel-based morphometry study in cryptogenic infantile spasms.

目的通过定量分析隐源性婴儿痉挛患儿脑灰质结构,寻找其发病原因和探讨发病机制。方法使用无创性的MR形态学定量对比分析技术,对2003-10—2004-10北京儿童医院23例隐源性婴儿痉挛(观察组)和27例同龄健康儿童(对照组)脑部高分辨解剖成像,进行灰质浓度的测定,比较两组之间的差异。结果两组灰质浓度比较,观察组在右额上回(10区)和中回(9区)、左额下回(47区)和上回(9、10区)、左额内侧(10区)、右颞上回(22、38区)、左颞中回(21区)以及右侧海马(36区)等灰质浓度减低,差异有显著性意义,P<0·001(未校正);双侧颞下回(20区)、左侧中央前回(6区)和左海马(36区)研究组灰质浓度增高,差异有显著性意义,P<0·001(未校正)。结论隐源性婴儿痉挛患儿额叶和颞叶灰质浓度明显减低,以额叶和颞叶为主的皮层发育不良可能是患儿致病的主要原因;在发病机制中皮层异常是发病的起源。

Objective To determine whether cryptogenic infantile spasms had abnormal structural grey matter. To reveal the etiology of cryptogenic infantile spasms and investigate the pathogenesis. Methods From October 2003 to October 2004 ,we performed a voxel-based morphometric { VBM） study of brain grey matter concentration in cryptogenic infantile spasms（ n = 23） and healthy control subjects （ n = 27） to identify difference in grey matter concentration between groups. Results VBM analysis identified significant decreases in grey matter concentration in the cryptogenic infantile spasms group compared with the normal control group at the uncorrected voxel level （ P 〈 0. 001 ） in right superior frontal gyrus（ Bradmann 10 ） , right middle frontal gyrus （ Bradmann 9 ） , left inferior frontal gyrus （ Bradmann 47 ） , left superior frontal gyrus（ Bradmann 9/10） ,left medial frontal gyrus（ Bradmann 10） ,right superior temporal gyrus （ Bradmann 22/ 38） ,left middle temporal gyrus （ Bradmann 21） and right hippocampal （ Bradmann 36）. Grey matter concentration increased in the bilateral inferior temporal gyrus （ Bradmann20） ,left anterior central gyrus （ Bradmann6） and left hippocampal （ Bradmann 36） was detected in the cryptogenic infantile spasms groups at the uncorrected voxel level （ P 〈 0. 001 ）. Conclusion There are significant decreases in grey matter concentration in cryptogenic IS. There is dysplasia in the frontal and temporal lobe cortex in infants with IS,which might be the etiological origin and possible mechanism for cryptogenic IS in the studied group.