Purpose

To investigate whether patients with benign childhood epilepsy with centrotemporal spikes (BECTS) and childhood absence epilepsy (CAE) show distinct patterns of white matter (WM) alterations and structural asymmetry compared with healthy controls and the relationship between WM alterations and epilepsy-related clinical variables.

Methods

We used automated fiber quantification to create tract profiles of fractional anisotropy (FA) and mean diffusivity (MD) in twenty-six patients with BECTS, twenty-nine patients with CAE, and twenty-four healthy controls. Group differences in FA and MD were quantified at 100 equidistant nodes along the fiber tract and these alterations and epilepsy-related clinical variables were correlated. A lateralization index (LI) representing the structural asymmetry of the fiber tract was computed and compared between both patient groups and controls.

Results

Compared with healthy controls, the BECTS group showed widespread FA reduction in 43.75% (7/16) and MD elevation in 50% (8/16) of identified fiber tracts, and the CAE group showed regional FA reduction in 31.25% (5/16) and MD elevation in 25% (4/16) of identified fiber tracts. In the BECTS group, FA and MD in the right anterior thalamic radiation positively and negatively correlated with the number of antiepileptic drugs, respectively, and MD in the right arcuate fasciculus (AF) positively correlated with seizure frequency. In the CAE group, the LI values were significantly lower in the inferior fronto-occipital fasciculus and the AF.

Conclusion

The two childhood epilepsy syndromes display different patterns of WM alterations and structural asymmetry, suggesting that neuroanatomical differences may underlie the different profiles of BECTS and CAE.

中文翻译：

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伴有中心颞叶尖峰和儿童失神性癫痫的良性儿童癫痫患者白质完整性和不对称性的改变：一项自动纤维量化纤维束成像研究

目的

研究与健康对照相比，患有中央颞叶棘波 (BECTS) 和儿童失神癫痫 (CAE) 的良性儿童癫痫患者是否表现出明显的白质 (WM) 改变和结构不对称模式，以及 WM 改变与癫痫相关临床变量之间的关系.

方法

我们使用自动纤维量化来创建 26 名 BECTS 患者、29 名 CAE 患者和 24 名健康对照的各向异性分数 (FA) 和平均扩散率 (MD) 的道谱。在沿纤维束的 100 个等距节点处量化 FA 和 MD 的组差异，并且这些改变与癫痫相关的临床变量相关。计算代表纤维束结构不对称性的侧化指数 (LI) 并在患者组和对照组之间进行比较。

结果

与健康对照组相比，BECTS 组显示 43.75% (7/16) 的广泛 FA 减少和 50% (8/16) 已识别纤维束的 MD 升高，CAE 组显示区域 FA 减少 31.25% (5/ 16) 和 25% (4/16) 已识别纤维束的 MD 升高。在 BECTS 组中，右侧前丘脑放射的 FA 和 MD 分别与抗癫痫药物的数量呈正相关和负相关，右侧弓状束 (AF) 的 MD 与癫痫发作频率呈正相关。在 CAE 组中，下额枕叶束和 AF 的 LI 值显着降低。

结论

这两种儿童癫痫综合征表现出不同的 WM 改变和结构不对称模式，表明神经解剖学差异可能是 BECTS 和 CAE 不同特征的基础。