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第41卷第12期 南京医科大学学报(自然科学版)
2021年12月 Journal of Nanjing Medical University(Natural Sciences) ·1767 ·
·临床医学·
基于AFQ技术的CAE患儿脑白质纤维完整性改变的研究
余传勇 ,邱文超 ,孙锦涛 ,高 媛 ,王小姗 1*
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南京医科大学附属脑科医院神经内科,江苏 南京 210029;淮安市第二人民医院神经内科,江苏 淮安 223300
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[摘 要] 目的:通过分析儿童失神癫痫(childhood absence epilepsy,CAE)患儿脑白质纤维完整性的改变,以探讨CAE患儿认
知损害的可能靶点。方法:选取2011年11月—2020年11月在南京市儿童院或南京脑科医院就诊的29例CAE患儿[男11例,
女18例,平均年龄(8.4±1.9)岁]和年龄、性别相匹配的24例健康儿童[男9例,女15例,平均年龄(7.9±1.4)岁]使用德国西门子
3.0T MRI仪采集所有被试的DTI及T1数据,通过AFQ软件提取出脑内20条白质纤维束,提取出每条纤维束100个等分节点上
的各向异性分数(fractional anisotropy,FA)值及平均扩散率(mean diffusivity,MD)值,定量比较其差异。统计方法采用独立样本
t检验及多重比较校正。结果:CAE患儿在大部分纤维束节点中可出现FA值下降及MD值升高,其中在弓形束及钩状束的改
变最为明显。结论:CAE患儿存在脑内白质纤维束完整性的改变,且以弓形束及钩状束损伤为著,提示CAE患儿认知损害的
靶点可能在弓形束及钩状束。
[关键词] 纤维束自动定量法;儿童失神癫痫;扩散张量成像;钩状束;弓形束
[中图分类号] R742.1 [文献标志码] A [文章编号] 1007⁃4368(2021)12⁃1767⁃07
doi:10.7655/NYDXBNS20211209
Study on the changes of white matter fiber integrity in children with CAE based on AFQ
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YU Chuanyong ,QIU Wenchao ,SUN Jintao ,GAO Yuan ,WANG Xiaoshan 1*
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1 Department of Neurology,the Affiliated Brain Hospital of Nanjing Medical University,Nanjing 210029;Department
of Neurology,Huai’an Second People’s Hospital,Huai’an 223300,China
[Abstract] Objective:This study aims to explore the possible targets of cognitive impairment in children with childhood absence
epilepsy(CAE)by analyzing the changes of white matter fiber integrity in children with CAE. Methods:From November 2011 to
November 2020,there were 29 children with CAE,11 males and 18 females,with an average age of 8.4±1.9 years,from Nanjing
Children’s Hospital or Nanjing Brain Hospital;and 24 healthy children were matched in age and sex,9 males and 15 females,with an
average age of 7.9±1.4 years old. The DTI and T1 data of all subjects were collected by Siemens 3.0T MRI. Twenty white matter fiber
bundles were extracted by AFQ,and the fractional anisotropy(FA)and mean diffusivity(MD)values on 100 equal sub⁃nodes of each
fiber bundle were extracted. The differences between CAE group and control group in each node were compared. The statistical
methods were independent sample t⁃test and multiple comparison correction. Result:The FA decreased and MD increased in most
fiber bundle nodes of CAE children,especially in uncinate and arcuate. Conclusion:The study suggests that there is a change of white
matter fiber bundle integrity in children with CAE,especially in uncinate and arcuate. The damage of uncinate and arcuate is the main
targets of cognitive impairment in CAE.
[Key words] automating fiber⁃tract quantification;childhood absence epilepsy;diffusion tensor imaging;arcuate;uncinate
[J Nanjing Med Univ,2021,41(12):1767⁃1773]
儿童失神癫痫(childhood absence epilepsy,CAE)
是最常见的儿童癫痫综合征,具有年龄依赖性,发
[基金项目] 国家自然科学基金面上项目(82071455);江苏
病高峰期为 6~7 岁,女童略多于男童 。CAE 在既
[1]
省卫生计生委科研课题面上项目(H2018062);南京市科技
局医疗卫生国际联合研发项目(201911044) 往研究中一直被认为是一种儿童良性癫痫,对行
∗ 为、认知基本无影响,但近期有越来越多的研究证
通信作者(Corresponding author),E⁃mail: lidou2005@126.com