伴中央颞区棘波儿童良性癫痫海马功能连接改变的fMRI研究

A fMRI study of hippocampal functional connectivity changes in benign childhood epilepsy with centrotemporal spikes

目的探讨伴中央颞区棘波儿童良性癫痫(benign epilepsy with centrotemporal spikes,BECTS)海马不同分区与全脑功能连接的变化,分析其潜在的神经机制和临床指导价值。材料与方法前瞻性收集44例BECTS患儿和35例年龄、性别匹配的健康对照的脑静息态血氧水平依赖功能磁共振成像(blood oxygen level-dependent functional magnetic resonance imaging,BOLD-fMRI)数据,采用基于种子点的功能连接分析方法,分别分析前、后海马与全脑功能连接改变。结果与健康对照相比,BECTS患儿左侧前海马与右侧楔前叶、右侧顶下小叶、左侧颞中回的功能连接度降低(P<0.001);右侧前海马与左侧颞中回颞极、右侧海马旁回、右侧额中回眶部的功能连接度降低(P<0.001);左侧后海马与左侧海马、右侧顶下小叶的功能连接降低(P<0.001);右侧后海马与右侧舌状回、右侧海马旁回的功能连接度升高(P<0.001)。结论BECTS患儿海马与全脑功能连接特征发生改变,对于理解BECTS潜在的神经病理机制具有重要意义。

Objective:To detect the changes of functional connection between subregions of the hippocampus and the whole brain in children benign epilepsy with centrotemporal spikes(BECTS)and analyze the potential neural mechanism and clinical value.Materials and Methods:The resting state blood oxygen level-dependent functional magnetic resonance imaging(BOLD-fMRI)whole brain data of forty-four BECTS patients and thirty-five age-and sex-matched healthy controls were prospectively collected.Functional connectivity analysis method based on seed points was used to analyze the functional connection between the anterior and posterior hippocampus and the whole brain respectively.Results:Compared with healthy controls,functional connectivity between the left anterior hippocampus and the right precuneus,the right inferior parietal lobule,and the left middle temporal gyrus was decreased in BECTS children(P<0.001).The functional connectivity between the right anterior hippocampus and the left middle temporal gyrus temporal pole,right parahippocampal gyrus,and right middle frontal gyrus orbital was decreased(P<0.001);The functional connectivity between the left posterior hippocampus and the left hippocampus and the right inferior parietal lobule was decreased(P<0.001);The functional connectivity between the right posterior hippocampus and the right lingual gyrus and the right parahippocampal gyrus was increased(P<0.001).Conclusions:The functional connectivity between the hippocampus and the whole brain in BECTS children was changed,which had a great significance on understanding the underlying neuropathological mechanism of BECTS.