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特发性全身性癫痫患者脑灰质结构基于体素的形态学测量的研究

     

摘要

目的 运用基于体素的形态学测量(VBM)方法分析特发性全身性癫痫患者(IGE)和正常人全脑灰质体积的差异.方法采用GE 3.0T HDX 超导型磁共振扫描仪对28例IGE患者和25例正常对照进行全脑高分辨解剖像扫描.在Matlab 7.0平台上采用SPM5软件包对图像进行处理.采用双样本t检验,将P< 0.005、像素簇大小>200个体素的脑区作为有统计学差异的脑区.结果 与正常对照相比,IGE患者显示双侧大脑半球广泛脑区的灰质体积减少,包括双侧扣带回、双侧额中回、右侧额上回、右侧额叶直回、右楔叶、左侧尾状核头;与正常对照相比IGE患者灰质体积增加的脑区包括左侧颞上回、左侧屏状核、右侧豆状核.结论 VBM能揭示IGE患者存在广泛脑区灰质密度异常,灰质密度减低脑区多与认知功能相关,是引起癫痫患者认知功能下降的原因之一.%Objective To analyze the structural changes of whole brain gray matter in patients with idiopathic generalized epilepsy (IGE) by using voxel-based morphomctryf VBM). Methods Twenty eight patients with IGK and twenty five normal subjects were recruited in our study, GE 3. 0T HDX MR scanner was used to obtain T1 WI three-dimensional brain volume sequences. The data were processed with SPM5 in Matlab 7. 0. Intcr-group analysis was performed with two t-tcst, the regions in the brain that P< 0. 005, cluster size more than 200 voxels were seemed as significantly different. Results Compared to normal subjects, IGE patients showed extensive decrease of gray matter volume in widespread brain regions, including bilateral cingulatc cortex, bilateral middle frontal cortex, right superior frontal cortex, right rcctus gyrus, right cuncus, left caudate nucleus head. Compared to normal subjects, IGE patients showed increase of gray matter volume in left superior temporal gyrus, left claustrum and right lentiform nucleus. Conclusion VBM can evaluate the widespread gray matter changes in IGE, the brain regions reduced gray matter arc related to cognitive function, and may be the one of the reasons those caused cognitive function decline in epilepsy patients.

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