原发全面强直阵挛型癫痫合并睡眠障碍患者的脑血流灌注特点

Characteristics of cerebral blood perfusion in patients with idiopathic generalized epilepsy with generalized tonic-colonic seizure combined with sleep disorders

目的研究原发全面强直阵挛型癫痫(idiopathic generalized epilepsy with generalized tonic-colonic seizure,IGE-GTCS)合并睡眠障碍患者及未合并睡眠障碍IGE-GTCS患者的脑血流灌注特点。方法收集2021年12月至2022年12月就诊于宁夏医科大学总医院神经内科癫痫门诊并诊断为IGE-GTCS患者62例。根据有无睡眠障碍将患者分为IGE-GTCS合并睡眠障碍组和IGE-GTCS未合并睡眠障碍组。另收集年龄、性别、受教育程度与病例组相匹配、接受颅脑CT或磁共振检查的体检者及其他无神经系统疾病患者16名纳入对照组。采用手动勾画方法检测3组受试者脑部不同部位感兴趣区(region of interest,ROI)的脑血流量(cerebral blood flow,CBF)差异。结果IGE-GTCS合并睡眠障碍组、未合并睡眠障碍组及对照组左侧额叶、左侧丘脑及左侧海马结构CBF比较差异有统计学意义(均P<0.05)。两两比较结果显示,与对照组比较,IGE-GTCS合并睡眠障碍组左侧额叶、左侧丘脑及左侧海马ROI CBF降低(均P<0.05),未合并睡眠障碍组左侧额叶、左侧丘脑ROI CBF降低(均P<0.05);与IGE-GTCS未合并睡眠障碍组比较,合并睡眠障碍组左侧海马结构ROI CBF减少(P<0.05)。结论IGE-GTCS合并睡眠障碍患者及未合并睡眠障碍患者CBF异常存在差异,这将有助于进一步从脑功能角度理解IGE-GTCS合并睡眠障碍的病理生理机制。

Objective To study the characteristics of cerebral blood perfusion in patients with idiopathic generalized epilepsy with generalized tonic-colonic seizure(IGE-GTCS)combined with sleep disorders and without sleep disorders.Methods A total of 62 patients diagnosed with IGE-GTCS admitted to the Epilepsy Clinic of the Department of Neurology,Ningxia Medical University General Hospital from December 2021 to December 2022 were collected.According to the presence or absence of sleep disorders,the patients were divided into IGE-GTCS with sleep disorder group and IGE-GTCS without sleep disorder group.In addition,16 age,gender,and education matched participants,who received brain CT or magnetic resonance imaging and other patients without neurological diseases were included in the control group.The difference of cerebral blood flow(CBF)in different areas of region of interest(ROI)of the three groups was detected by manual mapping method.Results There were significant differences in CBF of left frontal lobe,left thalamus and left hippocampus between IGE-GTCS group with sleep disorder,IGE-GTCS without sleep disorder group,and control group(all P<0.05).Pair-to-pair comparison showed that compared with the control group,the ROI CBF of the left frontal lobe,left thalamus and left hippocampus in the IGE-GTCS group combined with sleep disorders was decreased(all P<0.05),and the ROI CBF of the left frontal lobe and left thalamus in the group without sleep disorders was decreased(all P<0.05).Compared with IGE-GTCS group without sleep disorders,the left hippocampal structure ROI CBF decreased in the group with sleep disorders(P<0.05).Conclusions The abnormal CBF of IGE-GTCS patients with and without sleep disorders was different,which may be helpful to further understand the pathophysiological mechanism of IGE-GTCS patients with sleep disorders from the perspective of brain function.