原发全面强直-阵挛型癫痫的体素形态学研究

A VOXEL-BASED MORPHOMETRIC ANALYSIS IN PATIENTS WITH EPILEPSY WITH GENERALIZED TONIC-CLONIC SEIZURES

采用基于体素形态学(voxel-based morphometry,VBM)的方法,分析了全面强直-阵挛型癫痫(epilepsy with generalized tonic clonic seizures,GTCS)患者的大脑结构异常情况。对31例临床诊断为GTCS的患者和31例正常志愿者,采集大脑三维(3-dimensional,3D)T1结构像,进行VBM全脑分析比较。通过GTCS患者组与正常对照组的比较,发现GTCS患者的双侧丘脑、双侧额叶、双侧岛叶、双侧小脑等区域的灰质体积有比较明显的减小,但没发现有意义的灰质体积增高的区域;患者双侧丘脑、左侧中央前回、左侧额内侧回、左侧额中回和其发病频率呈负相关,没有正相关的区域。结果显示,全面强直-阵挛型癫痫患者的大脑结构存在异常,说明大脑灰质体积的异常可能和全面强直-阵挛型癫痫的发病存在一定的关系。

Using voxel-based morphometry （VBM）, the authors have studied the presence of subtle structural abnormalities in patients with epilepsy with generalized tonic-clonic seizures （GTCS）. The subjects included 31 patients with GTCS and 31 healthy controls. 3-dimensional （3D） T1 images were acquired by using FSPGR sequence. Brain structural differences between patients and healthy controls were comprehensively assessed by means of VBM. Compared to healthy controls, GTCS presented decreased gray matter volume in the bilateral thalamus, frontal lobe, insula and cerebellum regions. There were no regions showing significant increased gray matter volume. Correlation analysis revealed that bilateral thalamic, left medial frontal gyrus, left middle frontal gyrus and left precentral gyrus GMV had negative correlations with the frequecy of epilepsy. This study provided evidences for cerebral structural abnormalities in the patients with GTCS. The abnormalities of cerebral gray matter volume were considered to be related to the GTCS pathophysiology.