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目的儿童失神癫痫(Childhood absence epilepsy,CAE)是一种很常见的特发性癫痫,少有研究此类患者的大脑结构变化,尤其是默认模式网络脑区的脑结构是否存在异常改变。弥散张量成像技术可以用来定量评估脑结构的改变。研究将利用该技术探讨CAE患儿的脑结构改变。方法收集2014年10月-2016年4月于南京脑科医院神经内科就诊的14例CAE患儿和13名性别、年龄匹配的健康对照组弥散张量成像数据。基于体素对弥散张量数据进行分析处理,并对组间资料进行统计比较。提取组间比较存在显著性差异脑区的弥散张量参数,将参数与患儿的临床资料做相关性分析。结果患儿组的表观弥散系数在左内侧前额叶出现了显著性增高(P=0.042),而部分各向异性明显降低的脑区主要位于左侧楔前叶(P=0.010)。相关性分析结果显示,左内侧前额叶的表观弥散系数与患儿的病程存在正相关(R=0.80,P=0.001)。但部分各向异性与病程和发病频率无相关性。结论 CAE患儿的默认模式网络脑区存在结构异常,这将有助于进一步理解CAE患儿神经损伤的病理机制以及癫痫活动对他们的长期影响。
AIM: Childhood absence epilepsy (CAE) is a common idiopathic epilepsy and few studies have investigated the structural changes in the brains of these patients, in particular whether there is an abnormal change in the brain structure of the brain in the default model network. Diffusion tensor imaging can be used to quantitatively assess brain structural changes. The study will use the technology to explore brain structural changes in children with CAE. Methods The data of diffusion tensor imaging in 14 CAE children and 13 healthy controls of age-matched healthy group from October 2014 to April 2016 in neurology department of Nanjing Brain Hospital were collected. Dispersion tensor data were analyzed and processed based on voxel, and the data between groups were statistically compared. There were significant differences in diffusion tensor parameters of brain regions between the extracted groups, and the correlation between the parameters and the clinical data of the children was analyzed. Results The apparent diffuse coefficient of the children group was significantly increased in the left medial prefrontal cortex (P = 0.042), whereas the part of the brain with significantly reduced anisotropy was mainly located in the left precordial wedge (P = 0.010). Correlation analysis showed that the apparent diffusion coefficient of the left medial prefrontal lobe had a positive correlation with the course of the disease in children (R = 0.80, P = 0.001). However, there is no correlation between the partial anisotropy and the course of disease and the frequency of the disease. Conclusion There is structural abnormality in the default model network brain area of CAE children, which will help to further understand the pathological mechanism of nerve injury in children with CAE and the long-term effects of epilepsy on them.