伴有中央颞区棘波的儿童良性癫痫同步脑电图-功能磁共振研究

An EEG-fMRI study of centrotemporal spikes patients with benign childhood epilepsy

目的研究伴有中央颞区棘波的儿童良性癫痫（BCECTS）患者发作间期棘波相关的血氧依赖水平（BOLD）变化情况。方法选择海南医学院附属医院神经内科自2010年1月至2011年12月收治的频繁出现发作间期放电的BCECTS患者进行同步脑电图（EEG）联合功能磁共振（EEG—fMRI）扫描、将离线EEG滤波后确定棘波的时间点，采用统计参数图软件（SPM）提供的经典血氧动力学函数（HRF）模型计算棘波相关的BOLD变化。结果共纳入6例BCECTS患者，常规EEG显示频繁出现发作间期中央区和中颞区棘波。EEG-fMRI扫描时1例未见放电，获得5例患者5个序列的fMRI数据，5个序列均出现BOLD激活信号，两侧中央颞区同时出现激活信号2例，单侧中央颞区出现激活信号3例，4例最大激活区位于中央一中颞区，1例位于枕叶。5例在中央颞区外的其他脑区具有激活信号。结论中央颞区可能是BCECTS的致痫灶，致痫灶与其他部位共同构成的神经网络可能与BCECTS的发生相关。

Objective To study the blood oxygen dependent level （BOLD） changes associated with interictal spikes in benign childhood epilepsy patients with centrotemporal spikes （BCECTS）. Methods BCECTS patients with frequent interictal spikes, admitted to our hsopital from Junary 2010 to December 2011, were included in our study; all the patients were performed simultaneous EEG combined fimctional magnetic resonance imaging （EEG-fMRI）. The off-line EEG was filtered to find the time of spikes discharges, and then, the spike-related BOLD changes were calculated with the classic oxygen dynamics reaction function （HRF） model in statistical parametric mapping （SPM） software. Results Six patients with BCECTS were included with frequent spikes in the centrotemporal area in conventional EEG. One patient did not show spike discharge in EEG-fMRI scanning. Five patients showed BOLD signal changes in 5 sessions of fMRI. Activation signals were revealed in bilateral central temporal region in 2 sessions and in unilateral central temporal region in 3 sessions. The maximum activations were located in the centrotemporal area in 4 sessions and one session in the occipital lobe. The activation signals were observed in the other brain regions besides the central temporal regions in all the 5 patients. Conclusion The central temporal region may be the epileptogenic zone of BCECTS; the epileptogenic zone and other brain structures may contribute to the neural network of BCECTS.