To investigate cortical changes in MRI-negative patients with focal to bilateral tonic-clonic seizures (FBTCS). High-resolution three-dimensional T1-weighted MRI were collected with a GE 3.0-T MRI scanner from 26 patients with FBTCS and 21 healthy volunteers at Nanjing Brain Hospital. Voxel-based morphometry was performed on T1-weighted MRI of all subjects. A two-sample t test was performed to compare the GMV of two groups. Age and gender were taken as covariables, so that brain regions with significant differences, as compared by two-sample t test, between the two group were obtained. These regions were extracted as the regions of interest (ROIs) used for correlation analysis between ROIs and clinical variables. There is no significant difference in GMF between two groups. In FBTCS, regions with decreased GMV are bilateral thalamus, bilateral orbitofrontal cortex, left medical cingulate gyrus, and right supplementary motor area. GMV is increased within the bilateral para-hippocampal regions (voxel-wise FDR-corrected, P < 0.05). The GMVs are significantly negatively correlated with disease duration in the left thalamus and the left para-hippocampal region (P < 0.05). Seizures may lead to the loss of neurons and the decrease of GMV in FBTCS. The increase of GMV in some regions might be due to inflammatory responses in the early stages of epileptic seizures.

中文翻译：

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MRI 阴性局灶性至双侧强直阵挛发作中灰质体积的改变。

研究 MRI 阴性的局灶性至双侧强直阵挛性癫痫发作 (FBTCS) 患者的皮质变化。使用 GE 3.0-T MRI 扫描仪采集南京脑科医院 26 名 FBTCS 患者和 21 名健康志愿者的高分辨率三维 T1 加权 MRI。对所有受试者的 T1 加权 MRI 进行基于体素的形态测量。进行双样本t检验来比较两组的GMV。以年龄和性别为协变量，通过双样本t检验，得到两组之间存在显着差异的脑区。这些区域被提取为感兴趣区域（ROI），用于 ROI 与临床变量之间的相关性分析。两组之间的GMF没有显着差异。在 FBTCS 中，GMV 降低的区域是双侧丘脑、双侧眶额皮质、左侧医学扣带回和右侧辅助运动区。双侧海马旁区域内的 GMV 增加（体素 FDR 校正，P < 0.05）。左侧丘脑和左侧海马旁区的 GMV 与病程呈显着负相关（P < 0.05）。癫痫发作可能导致 FBTCS 中神经元的丢失和 GMV 的降低。某些区域GMV的增加可能是由于癫痫发作早期的炎症反应所致。