药物难治性婴儿痉挛症静息态脑功能局部一致性研究

Altered regional homogeneity in epileptic children with infantile spasm： A resting-state fMRI study

目的观察药物难治性婴儿痉挛症（Is）患儿脑静息态功能磁共振（rs—fMRI）的局部一致性（ReHo）值的变化，探讨Is的可能发病机制。方法回顾性纳入2014年1月至2015年12月深圳市儿童医院神经外科行术前评估的药物难治性Is患儿（Is组）11例。纳入同期年龄及性别相匹配的无神经系统疾病的患儿35例为对照组。所有患儿均行rs-fMRI检查，使用DPARSFV1．0软件对影像数据进行后处理，分析两组静息态脑功能ReHo值的差异。结果与对照组比较，Is组双侧楔前叶、枕中回，右侧颞中回、顶下小叶、距状回，左侧中央后回、中央前回、角回的ReHo值降低；而双侧脑干、海马、丘脑、岛叶，右侧前扣带回、尾状核、辅助运动区、嗅区，左侧小脑、额下回盖部的ReHo值升高，差异均有统计学意义（均P〈0．05）。Pearson相关性分析显示，右侧楔前叶和左侧顶上小叶的ReHo值越低，癫痫病程越长（r值分别为-0．973、-0．978；均P〈0．01）。结论癫痫活动对IS患儿与运动、执行及认知相关的脑区均可造成明显损害。

Objective To investigate the possible pathogenesis of infantile spasm （IS） by analyzing the changes of resting-state fMRI （rs-fMRI） regional homogeneity （ ReHo ） in preoperative IS patients. Methods From January 2014 to December 2015, a total of 11 patients of intractable IS were admitted to Neurosurgery Department of Shenzhen Children Hospital for presurgical evaluation. Besides the patients, 35 age- and sex-matched healthy subjects were enrolled into this retrospective study. In order to identify the pattern of regional synchronization in IS patients, all the children in this study received rs-fMRI scan and were analyzed by the software DPARSFV1.0. Results Compared with healthy subjects, in the IS group, decreased ReHo were shown in bilateral precunei, bilateral middle occipital gyri, right middle temporal gyms, right inferior parietal lobule, right cryptocalcarine gyrus, left central posterior gyrns, left precentral gyrus and left angular gyrus while increased ReHo were demonstrated in the right anterior cingulate gyms, bilateral brain stems, bilateral hippocampi, bilateral thalami, right caudate nucleus, left cerebellum, left pars opercularis, bilateral insula lobes, right accessory motor area and right olfactory region （both P 〈 0. 05 ）. Correlation analysis showed that lower ReHo values of the right precuneus （ r value ： - 0.973 ） and left superior parietal lobule （ r value ： - 0. 978） were associated with longer duration of epilepsy （ both P 〈 0.01 ）. Conclusion Our results suggest that IS may cause significant damage to children＇s brain areas related to motion, execution and cognition.