伴有中央颞区棘波的儿童良性癫痫基于体素的形态学分析及认知功能

Voxel-based morphometry and cognitive function in patients with benign epilepsy of childhood with centrotemporal spikes

目的采用神经心理学检测及基于体素的形态学分析（VBM）观察伴有中央颞区棘波的儿童良性癫痫（BECTS）患者的认知功能及大脑细微结构改变情况。方法收集2014年5月至2015年5月在川北医学院附属医院就诊的新发BECTS患者16例，同时选择性别、年龄、受教育程度与BECTS组相匹配的健康志愿者16名，所有受试者行神经心理学测评[全量表智商／总智商（full scale intelligence quotient，FSIQ）、语言智商及操作智商]及高分辨率T1加权成像扫描，对获得的数据进行比较及相关性分析。结果（1）BECTS组FSIQ（79．3±13．3）、语言智商（82．3±12．1）及操作智商（81．3±10．3）均明显低于对照组（107．0 ±6．4、101．6±6．5、114．8±6．2），差异有统计学意义（t=9．511、7．521、16．360，均P〈0．01）。（2）BECTS组在5个灰质区域显示体积明显增加：两侧壳核、两侧旁中央小叶及右侧辅助运动区，差异有统计学意义（P〈0．05，FDR校正）。（3）左侧壳核灰质体积与癫痫发病年龄呈显著负相关（r=-0．586，P=0．017）。结论（1）BECTS患者存在一定程度的认知功能损害。（2）BECTS患者大脑细微结构发生一定改变，可能与遗传因素影响了儿童的生理发育周期相关，而且其发病年龄越小，对大脑细微结构改变的影响越大。

Objective To study the changes of cognitive function and brain microstructure of patients with benign epilepsy of childhood with centrotemporal spikes （BECTS） from neuropsychological test and voxel-based morphometry. Methods Sixteen patients with BECTS and 16 healthy volunteers, who were matched in gender, age and education, were enrolled in this study from May 2014 to May 2015 in the Affiliated Hospital of North Sichuan Medical College. The cognitive function and morphometry of the subjects were evaluated by neuropsychological test （full scale intelligence quotient （FSIQ）, verbal intelligence quotient （VIQ） and performance intelligence quotient （PIQ）） and high-resolution T1 -weighted imaging scanning. Thereafter, these data were analyzed with Student＇s t test, Chi-squared test and correlation analysis. Results （1） FSIQ（79.3±13.3）, VIQ（82.3±12.1） andPIQ（81.3±10.3）ofBECTSgroup were significantly lower than the control group （ 107.0 ± 6.4, 101.6 ± 6. 5 , 114.8 ± 6. 2; t = 9. 511, 7. 521, 16. 360, all P 〈 0. 01 ）. （2） Patients with BECTS showed significantly increased gray matter volume in the bilateral putamen, paracentral lobule and right supplementary motor area （P 〈 0. 05, FDR-corrected） （3） A significant negative correlation was found between the gray matter volume of the left putamen and age of epilepsy onset （ r = - 0, 586, P = 0. 017 ）. Conclusions （ 1 ） There is a certain degree of cognitive impairment in patients with BECTS. （2） Patients with BECTS have some changes in brain microstructure. Genetic factors could indirectly influence the children＇s brain developmental trajectory, and the age of onset may be associated with the changes on the brain mierostructure.