DKI联合ALFF在全面特发性癫痫患者基底核-丘脑-皮层环路中的应用

Application of DKI and ALFF in basalganglia thalamocortical circuit of idiopathic generalized epilepsy patients

目的采用弥散峰度成像(DKI)及低频振幅(ALFF)技术观察全面特发性癫痫(IGE)患者白质纤维束以及脑功能异常的脑区。方法选取符合纳入标准的IGE患者(病例组,n=24)及与之相匹配的健康志愿者(对照组,n=24)。DKI数据分析采用基于纤维束示踪的空间统计(TBSS)方法,将相关参数值与患者病程行相关性分析;ALFF分析采用静息态脑功能数据辅助处理(DPARSF)及SPM方法。结果病例组右侧内囊前肢、左侧外囊、胼胝体膝部各向异性(FA)值较对照组显著减低(P均<0.05);两组平均弥散(MD)值差异无统计学意义(P>0.05);DKI分析发现病例组双侧前辐射冠、上辐射冠、内囊前肢、内囊后肢以及胼胝体(膝部、体部)平均峰度(MK)值显著减低(P<0.05)。FA值和MK值与病程的相关性差异无统计学意义(P>0.05)。ALFF显著升高区域为双侧额叶、双侧壳核、右侧丘脑以及左侧尾状核;ALFF显著减低区域为右侧颞叶、双侧楔前叶以及双侧枕叶。结论 DKI联合ALFF可为进一步揭示IGE的发病机制提供影像学依据。

Objective To explore idiopathic generalized epilepsy （IGE） patients white matter fibers integrity and brain dysfunction brain regions using diffusion kurtosis imaging （DKI） and amplitude of low-frequency fluctuation （ALFF） tech- nology. Methods Totally 24 IGE patients （case group） and matched 24 healthy volunteers （control group） underwent DKI and ALFF examination. DKI data were evaluated using tract-based spatial statistics （TBSS） method, and th~ the correla- tions between extracted values and duration of epilepsy were analyzed. ALFF were assessed using data processing assistant for resting-state fMRI （DPARSF） and SPM method. Results Compared to control group, fractional anisotropy （FA） de- creased in the right anterior limb of internal capsule, left external capsule and genu of corpus callosum （all P〈0.05）, whereas the differences of mean diffusivity （MD） were not statistically significant between two groups （P〈0.05）. DKI re- vealed mean kurtosis （MK） decreased in bilateral anterior corona radiation, superior corona radiation, anterior limb of in- ternal capsule, posterior limb of internal capsule, genu and body of corpus callosum in case group compared with cintrol group. No statistically correlation between FA, MK values and duration of disease were found （P〈0. 05）.Significantly in- creasing areas of ALFF in case group included bilateral frontal and putamen, right thalamus and left caudate, and the de- creasing areas included right temporal lobe, bilateral precuneus and occipital. Conclusion DKI and ALFF technology can be used to provide the basis for further study of the pathogenesis of IGE.