儿童难治性癫痫的脑功能网络与结构-功能耦合研究  

Study on the brain functional network and structural-functional coupling in children with drug-resistant epilepsy

作　　者：李旭虹 肖建辉 刘衡 何玉伦 冉海峰 谢雨辛 陈贵琴 余前娥 曾珍 李文富 张体江 Li Xuhong;Xiao Jianhui;Liu Heng;He Yulun;Ran Haifeng;Xie Yuxin;Chen Guiqin;Yu Qian′e;Zeng Zhen;Li Wenfu;Zhang Tijiang(Department of Radiology,the Affiliated Hospital of Zunyi Medical University,Zunyi 563000,China;Institute of Pharmaceutical Biotechnology,the Affiliated Hospital of Zunyi Medical University,Zunyi 563000,China;Department of Radiology,the Second Affiliated Hospital of Guizhou University of Chinese Medicine,Guiyang 550003,China)

机构地区：[1]遵义医科大学附属医院放射科,遵义563000 [2]遵义医科大学附属医院医药生物技术研究所,遵义563000 [3]贵州中医药大学第二附属医院放射科,贵阳550003

出　　处：《中华放射学杂志》2025年第2期184-191,共8页Chinese Journal of Radiology

基　　金：国家自然科学基金(82171919);贵州省高等学校智能医学影像工程研究中心项目(黔教技[2023]038号);贵州省教育厅高等学校科学研究项目(青年项目)(黔教技[2022]230号)。

摘　　要：目的:探讨儿童难治性癫痫(DRE)脑功能网络及结构-功能耦合改变及其与认知功能、病程和发病年龄的相关性。方法:该研究为横断面研究。前瞻性纳入2021年8月至2023年8月在遵义医科大学附属医院接受诊治的19例DRE患儿(DRE组)临床及影像资料。另收集年龄、性别相匹配的27名健康儿童为健康对照组。对所有被试者进行3D-T_(1)WI、T_(2)液体衰减反转恢复、扩散张量成像(DTI)、静息态功能磁共振(rs-fMRI)扫描和韦氏智力量表评估。采用独立样本t检验、Mann-Whitney U检验分析2组的全局、局部拓扑属性指标及全脑和模块水平的结构-功能耦合(SFC)值。采用Spearman、Pearson相关分析来评估异常的静息态功能脑网络指标与韦氏智力量表分数(言语理解指数、知觉推理指数、工作记忆指数、加工速度指数和总智商)、病程和发病年龄的相关性。结果:与健康对照组比较,DRE组言语理解指数、知觉推理指数、工作记忆指数、加工速度指数和总智商降低,差异均具有统计学意义(P<0.05)。DRE组和健康对照组脑功能网络均具有小世界属性。DRE组与健康对照组左侧苍白球节点度所有稀疏度的曲线下面积值差异有统计学意义(2.998±0.942、4.992±1.945,t=-4.07,FDR校正P<0.05)。与健康对照组比较,DRE组边缘网络(LN)内SFC降低(P<0.05),感觉运动网络(SMN)内SFC增加(P<0.05),默认网络-LN间SFC降低(P<0.05),SMN-注意网络(AN)间SFC增加(P<0.05)。2组全脑水平的SFC差异无统计学意义。相关分析显示DRE组左侧苍白球DC与加工速度指数呈负相关(r=-0.537,P=0.018),SMN-AN间SFC与发病年龄呈负相关(r=-0.537,P=0.018)。结论:左侧苍白球的DC改变可能与DRE认知功能损伤有关,为儿童DRE神经机制研究提供生物标记信息。Objective To investigate the changes in brain functional network and structural-functional network coupling in children with drug-resistant epilepsy(DRE),and to analyze their correlation with cognitive function,disease duration,and age of onset.Methods This study was a cross-sectional study.Clinical and imaging data of 19 children with DRE who received consultation and treatment at the Affiliated Hospital of Zunyi Medical University from August 2021 to August 2023(DRE group)were prospectively included.Another 27 age-and sex-matched healthy children were collected as the healthy control group.All subjects had 3D-T_(1)WI,T_(2) fluid-attenuated inversion recovery,diffusion tensor imaging(DTI),resting-state functional magnetic resonance imaging(rs-fMRI)scans and Wechsler Intelligence Scale assessments.Independent sample t-test and Mann-Whitney U test were used to analyze the global and local topological attributes,as well as the structural-functional coupling(SFC)values at the whole brain and modular levels in two groups.Correlations between abnormal resting state brain functional network indicators and the Wechsler Intelligence Scale score[verbal comprehension index(VCI),perceptual reasoning index(PRI),working memory index(WMI),processing speed index(PSI),full scale intelligence quotient(FSIQ)],disease duration and age of onset was evaluated using a Spearman or Pearson correlation analysis.Results Compared to the healthy control group,DRE group exhibited decreased VCI,PRI,WMI,PSI,FSIQ and the differences were all statistically significant(all P<0.05).Both brain functional networks had small world attributes.There was a statistically significant difference in the area under the curve of sparsity of degree centrality(DC)in the left pallidum between the DRE group and healthy control group(2.998±0.942,4.992±1.945,t=-4.07,FDR corrected P<0.05).Compared with the control group,the DRE group had decreased SFC within the limbic network(LN)(P<0.05),increased SFC within the sensorimotor(SMN)(P<0.05),decreased SFC between the

关 键 词：儿童 难治性癫痫 图论 结构-功能耦合 认知功能 

分 类 号：R74[医药卫生—神经病学与精神病学]