BECT患儿语言功能磁共振网络连接研究

Benign childhood epilepsy with centrotemporal spikes (BECT) is the most common epilepsy syndrome of childhood and can be associated with language difficulties. The exact profile of these difficulties and their neurofunctional underpinnings, however, are not yet clear. To investigate the neuronal mechanisms underlying neuropsychological language impairment, activation maps and functional connectivity networks will be studied by fMRI of language in patients with Benign childhood epilepsy with centrotemporal spikes. Ten BECT children accord with diagnostic criteria and ten healthy control subjects will be investigated.The language IQ, total IQ score and sleeeping video EEG will be obtained for all subjects. All subjects will be finished the resting state fMRI data collection, the fMRI scanning while performing a words reading task or semantic judge task as stimulating patterns, in order to activate the corresponding brain areas. Use SPM2 software analyzes the data, and concludes the resting state fMRI function connection, two languages task fMRI activing maps, the whole brain function connection maps of BECT patients and healthy control subjects. The differences of the resting state fMRI function connection, two languages task fMRI activing maps, the whole brain function connection maps and fMRI language network connection in BECT patients and healthy control subjects will be analysised adopting the independent sample and two sample t-test. we will compared the whole brain function connection maps and fMRI language network connection before and after of six month pharmacologically treat. And the functional connectivity for each task of BECT children will be correlated with spike wave index during sleeping

儿童良性癫痫伴中央颞区棘波（benign children epilepsy with centro-temporal spikes,BECT）是儿童期最常见的癫痫综合症之一。BECT病人在语言功能方面存在缺陷,但是患儿语言缺陷的机制目前并不清楚。为了研究患儿语言损伤的机制，本研究对BECT患儿的功能磁共振语言激活图及语言功能连接进行分析。本研究选择 10 例符合诊断标准的BECT患儿及 10例年龄性别匹配的健康对照组，对研究对象完成静息态功能磁共振数据采集、夜间视频脑电图监测，以及词语阅读任务和语义判定任务作为刺激模式的语言功能磁共振数据采集，以实现脑内相应功能区激活。了解两组儿童静息态功能磁共振功能连接、两种语言任务的功能磁共振激活图、功能连接图以及功能磁共振语言网络连接的差异；了解BECT患儿夜间棘波放电指数与与语言功能连接强度变化的相关性。

本研究中被试分为两组。BECT组为符合BECT诊断标准的BECT儿童(N=37)，年龄范围7.1-13.5岁（平均9.8±1.5岁）及年龄、性别及受教育程度均匹配的正常对照组(N=25)，年龄范围7.6-12.4岁（平均10.0±1.5岁）。神经心理学测试显示患儿的言语智商明显低于正常对照组的言语智商，支持了以往关于BECT患儿存在语言能力缺陷的观点。两组儿童分别进行动词产生及同音辨认两种语言任务。BECT组执行语言任务的激活图模式与正常对照组有显著差异，BECT组在完成语言任务时，运用了与正常对照组不同的脑区。这反应了BECT患儿的语言区产生了迁移，支持BECT患儿的语言区、语言功能、认知能力产生了重塑的观点。本研究同时使用低频振荡振幅(ALFF)和Granger因果分析进行了两组被试的静息态功能磁共振研究。发现相对于正常对照组，BECTS组在右侧中央后回及双侧距状回ALFF明显增高(P＜0.05,经过较正)。而ALFF在左侧前扣带回、双侧尾状核及小脑明显减低(P＜0.05, 经过较正)。BECT患儿的言语智商与左侧基底节ALFF成负相关。从中央前回对额下回 (BA 45/46)的驱动与BECT患儿的病程呈负相关。我们的这项研究为癫痫波的发放可能导致BECT患儿的语言功能障碍提供了新的证据。