难治与非难治特发性全面性癫痫患者治疗前磁共振脑灰质体积差异研究

Study of the Difference in Gray Matter Volume Between Refractory and Non-Refractory Idiopathic Generalized Epilepsy Before Treatment by Using Magnetic Resonance Imaging

目的通过比较难治与非难治性特发性全面性癫痫(IGE)患者磁共振脑灰质体积差异,探讨难治性IGE的病理生理机制。方法搜集初发、未用药IGE患者75例,采集常规序列和高分辨率3D-T1WI结构像,随访患者抗癫痫治疗2年后的症状改善情况,筛选出在医师指导下严格、正规治疗的患者共45例(包括难治性癫痫患者组8例,非难治性癫痫患者组37例)纳入研究,采用两独立样本t检验比较难治与非难治组患者脑灰质体积差异。结果与非难治性癫痫组相比,难治性癫痫组左侧颞上回、右侧额下回体积减小,双侧小脑后叶体积增大。结论难治与非难治性IGE患者间存在脑结构异常,额颞叶的脑灰质损伤可能是难治性IGE发生的病理基础。

Objective To explore the pathophysiological mechanism of refractoryidiopathic generalized epilepsy(IGE)by comparing the difference of gray matter volume(GMV)of the brain in patients with refractory and non-refractory IGE.Methods Seventy-five patients of first-episode,drug-naive IGE were enrolled.Conventional MRI and 3D-T1WI were per-formed for all subjects with 3.0T MR scanner.All patients taking anti-epileptic drugs were followed up for at least 2 years.Lastly,45 patients with regular anti-epileptic therapy under the guidance of the doctor were selected,including eight refrac-tory and thirty-seven non-refractorypatients.Two-sample t-test was used to compare the difference of GMV between the two groups.Results Compared withthe non-refractory group,refractory group showed decreased GMV in the left superior tem-poral gyrus and right inferior frontal gyrus,increased GMV in bilateral posterior cerebellar lobe.Conclusion Refractory and non-refractory IGE patient groupshave subtle brain structural abnormalities,suggesting that IGE develops into refractory epilepsy may be associated with gray matter abnormalities in these brain regions.