| 摘要: |
| ［摘要］ 目的 观察不同静息态功能磁共振成像（fMRI）指标在反映癫痫活动时的一致性及关系。方法 回顾性收集2010年2月至2021年9月于金陵医院明确诊断为儿童失神性癫痫（CAE）的18例患儿（CAE患儿组），行同步EEG-fMRI数据采集后截取44段发放状态fMRI数据，同时纳入并采集94名正常儿童（正常对照组）的静息态fMRI数据。计算每个受试者低频振幅（ALFF）、分数低频振幅（fALFF）、局域一致性（ReHo）、功能连接密度（FCD）、长程功能连接密度（Long FCD）、短程功能连接密度（Local FCD）、流入格兰杰因果连接密度（GCD_in）、流出格兰杰因果连接密度（GCD_out）、净流入格兰杰因果连接密度（GCD_int）、Hurst指数及静息态fMRI滞后分析（RSLA），采用两样本t检验得到各指标的组间差异脑图，并计算所有组间差异脑图的空间分布频次图，将重叠最大的区域作为感兴趣区。使用Pearson相关分析分别探讨两组受试者感兴趣区内各指标的相关性。同时使用SurfStat软件包构建了广义线性模型，探讨疾病状态与各静息态fMRI指标间相关系数的交互效应。结果 各静息态fMRI指标差异脑图的空间分布频次热图显示在双侧丘脑及右侧内侧前额叶有着最大的重叠。感兴趣区内正常对照组及患儿组的各静息态fMRI指标间关系热度图模式相似，但疾病状态与各指标间相关系数的交互分析显示，在双侧丘脑，相比正常对照组，CAE患儿组耦合度增加的指标包括ALFF-fALFF、ReHo-ALFF、RSLA-GCD_int、GCD_int-ALFF、GCD_int-ReHo、GCD_in-FCD、Hurst-fALFF和GCD_int-FCD；耦合度下降的指标包括FCD-fALFF及GCD_in-GCD_out。在右侧内侧前额叶，相比正常对照组，CAE患儿组耦合度增加的指标包括GCD_in-GCD_int、RSLA-GCD_in和GCD_int-RSLA；耦合度下降的指标包括FCD-ALFF、fALFF-GCD_in、fALFF-GCD_out和GCD_in-GCD_out。结论 研究结果有助于观察CAE不同静息态指标改变的一致性，并为不同维度的静息态指标间如何相互关联提供了新的见解，进而加强对CAE病理生理机制的理解。 |
| 关键词: 儿童失神性癫痫 静息态功能磁共振成像 一致性 低频振幅 局域一致性 |
| DOI：10.3969/j.issn.1674-3806.2023.04.04 |
| 分类号:R 445.2 |
| 基金项目:国家重点研发计划项目（编号：2018YFA0701703） |
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| Concordance among resting-state fMRI indices in childhood absence epilepsy |
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YU Qian-qian, LIU Gao-ping, XU Qiang, et al.
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Department of Diagnostic Radiology, Affiliated Jinling Hospital of Medical School, Nanjing University, Nanjing 210002, China
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| Abstract: |
| ［Abstract］ Objective To observe the consistency and relationship among different resting-state functional magnetic resonance imaging(fMRI) indices in reflecting epileptic activity. Methods Eighteen children diagnosed with CAE in Jinling Hospital from February 2010 to September 2021 were retrospectively collected as the CAE child patient group, and they were scanned by using simultaneous electroencephalogram(EEG)-fMRI, and 44 fMRI data containing spike and slow-wave discharges were obtained finally. At the same time, 94 gender- and age-matched normal children who underwent resting-state fMRI examinations were collected as the normal control group. The 11 resting-state fMRI indices for each subject were calculated, including ALFF, fALFF, ReHo, FCD, Long FCD, Local FCD, GCD_in, GCD_out, GCD_int, Hurst exponent and fMRI lag analysis(RSLA). Two-sample t-test was employed to obtain the intergroup difference for each index. The spatial distribution frequency map of the intergroup difference maps for all indices were calculated, and the area with the largest overlap was considered as the region of interest. Pearson correlation analysis was used to explore the correlation between each index in the region of interest for the two groups. A generalized linear model was also constructed using the SurfStat software to investigate the interaction effect between disease state and resting-state fMRI index. Results The largest overlaps in the spatial distribution frequency map of all resting-state fMRI indices were shown in the bilateral thalamus and the right medial prefrontal lobe. The heat map pattern of the relationship between the resting-state fMRI indexes in the normal control group and the child patient group was similar in the region of interest, but the interaction analysis of between disease state and each index showed that in the bilateral thalamus, the CAE child patient group had the increased coupling degrees in CAE including ALFF-fALFF, ReHo-ALFF, RSLA-GCD_int, GCD_int-ALFF, GCD_int-ReHo, GCD_in-FCD, Hurst-fALFF and GCD_int-FCD and the decreased coupling degrees including FCD-fALFF and GCD_in-GCD_out compared with the normal control group. In the right medial prefrontal lobe, compared with the normal control group, the CAE child patient group had the increased coupling degrees in CAE including GCD_in-GCD_int, RSLA-GCD_in and GCD_int-RSLA,and the decreased coupling degrees including FCD-ALFF, fALFF-GCD_in, fALFF-GCD_out, and GCD_in-GCD_out. Conclusion Collectively, these results are helpful to observe the consistent change of different resting-state fMRI indices, and provide novel insight into how these indices are inter-related, thus enhancing the understanding of the pathophysiological mechanisms of CAE. |
| Key words: Childhood absence epilepsy(CAE) Resting-state functional magnetic resonance imaging(fMRI) Agreement Amplitude of low frequency fluctuation(ALFF) Regional homogeneity(ReHo) |
