多静息态fMRI指标及同步EEG-fMRI对Rolandic癫痫活动检测能力的对比研究  

Comparation of detection ability in Rolandic epileptic activity between multiple resting state fMRI indicators and EEG-fMRI

作　　者：张子璇 张其锐 刘高平 许强 谢心瑀 张志强 ZHANG Zi-xuan;ZHANG Qi-rui;LIU Gao-ping(Department of Radiology,Department of Diagnostic Radiology,General Hospital of Eastern Theater Command,Nanjing 210002,China)

机构地区：[1]东部战区总医院放射诊断科,南京210002

出　　处：《放射学实践》2023年第3期257-262,共6页Radiologic Practice

基　　金：国家自然科学基金重大项目-分项目(81790653);国家自然科学基金面上项目(81871345);国家重点研发计划(2018YFA0701703)。

摘　　要：目的:对比观察多个静息态fMRI指标相比同步脑电图-功能磁共振成像(EEG-fMRI)对Rolandic癫痫个体癫痫活动的检测能力。方法:回顾性分析31例Rolandic癫痫患儿同步EEG-fMRI数据以及性别年龄匹配的40例正常儿童静息态fMRI数据;计算患儿与对照组的低频振荡幅度(ALFF)及功能连接密度(FCD)静息态指标。采用广义线性模型(GLM)获得间期痫样放电(IEDs)相关fMRI激活。采用两样本t检验比较患者组与对照组的ALFF和FCD脑活动差异(高斯随机场校正,体素水平P<0.01,簇水平P<0.05),选取EEG-fMRI定义的癫痫活动灶区为感兴趣区,使用Spearman相关性分析计算感兴趣区内ALFF和FCD与EEG-fMRI的相关性,观察静息态fMRI指标与癫痫放电次数的相关性。结果:EEG-fMRI的主要激活位于双侧Rolandic区、楔叶、左侧感觉运动区;ALFF显著激活的区域主要位于双侧Rolandic区、感觉运动区;降低的区域主要为默认模式网络。FCD激活的脑区主要位于左侧尾状核,降低的脑区则主要为双侧丘脑。组水平上Spearman相关分析结果显示,ALFF与EEG-fMRI呈正相关(r=0.206,P<0.001)。FCD与EEG-fMRI无明显相关性(r=0.07,P<0.01)。跨受试者的相关分析显示,在癫痫活动灶区ALFF仍与EEG-fMRI明显相关(r=0.50,P<0.01),且其ALFF值与间期放电频数相关(r=0.35,P=0.05)。结论:ALFF与EEG-fMRI定义的癫痫活动灶有很高的一致性,FCD与EEG-fMRI的空间耦合较低。静息态fMRI的ALFF指标对于Rolandic癫痫具有间期癫痫活动定位的潜力。Objective:The ability of multiple resting state fMRI indicators to detect epileptic activity in Rolandic epilepsy patients was compared with simultaneous electroencephalogram and functional MRI(EEG-fMRI).Methods:The simultaneous EEG-fMRI data of 31 Rolandic epilepsy children and the resting state fMRI data of 40 control subjects matched by sex and age were retrospectively analyzed.Voxel-wise whole-brain analysis was performed to generate clusters for amplitude of low-frequency fluctuations(ALFF)and functional connectivity density(FCD).The GLM was estimated for each fMRI data voxel,and the resulting statistical parametric map showed brain regions with hemodynamic fluctuations significantly related to IEDs.Differences in ALFF and FCD between patients and the control group were employed by voxel wise two-sample t-tests(GRF correction,voxel-P<0.01,cluster-P<0.05),which were co-registered with the EEG-fMRI defined epileptic activity to evaluate their spatial overlap.Correlation analyses were conducted for epileptic discharges and fMRI metrics.Results:EEG-fMRI analysis revealed that IEDs-associated activation was detected in the bilateral Rolandic cortices,cuneus and left sensorimotor area.Compared with the controls,the patient groups bilaterally showed ALFF increases in Rolandic cortices,sensorimotor area,and FCD increased in left caudate nucleus,the regions showing decreased ALFF in bilaterally DMN regions and decreased FCD in bilateral thalamus.Positive correlation between ALFF and EEG-fMRI(r=0.206,P<0.001)while no correlation between FCD and EEG-fMRI(r=0.07,P<0.01)at group level.Across-subject correlation analyses between ALFF and EEG-fMRI also revealed positive correlation in the epileptic activity zone defined by EEG-fMRI(r=0.50,P<0.01).Furthermore,the numbers of IEDs in epileptic activity zone(ipsilateral to the epileptogenic side defined by EEG-fMRI)showed positive correlation with ALFF(r=0.35,P=0.05).Conclusion:ALFF has high concordance rate with EEG-fMRI defined seizure onset zone at individual-patient level

关 键 词：Rolandic癫痫 同步脑电-功能磁共振成像 低频波动振幅 功能连接密度 

分 类 号：R445.2[医药卫生—影像医学与核医学] R742.1[医药卫生—诊断学]