基于多模态神经影像学的特发性全身性儿童癫痫脑网络的研究

Epilepsy is a chronic brain disease caused by multiple reasons. This disease is characterized by excessive discharge of brain neurons suddenly, repeatedly and short of the central nervous system dysfunction. The patients have to suffer from the brain dysfunction including movement, feeling, consciousness and so on. Previous studies have showed that long-term and frequent of epileptic seizure would lead to further brain damage. The incidence of epilepsy in children is higher than adults. However, the research on child epilepsy, especially the idiopathic generalized epilepsy, have showed no abnormities in routine MRI examinations. Epilepsy effect on children's brain network and the underlying neural mechanism remains elusive. It is difficult of clinical intervention in child epilepsy. So examining the effect of idiopathic generalized epilepsy on children's brain network and exploring the neural mechanism would provide effective clinical intervention therapy and improve the quality of life in the patients. In this project, children with idiopathic generalized epilepsy would be recruited as the research objects and the multimodal MRI data (resting-state function MRI, T1 and diffusion tensor imaging) of each participant were collected. Based on the graph theory, functional and structural brain network of these patients were built and compared with a group of normal children. Comparing the brain network connectivity and topological properties differences between the groups would provide the opportunity to reveal the neural mechanisms underlying this disease and to design the effective clinical intervention therapy. In this way，this project will bring valuable signification to the scientific research and clinical treatment.

癫痫是由多种病因引起的慢性脑部疾病，以脑部神经元过度放电所致的突然、反复和短暂的中枢神经系统功能失常为特征，表现为运动、感觉、意识等功能障碍。儿童癫痫发病率较成人要高，且长期、频繁的痫性发作会导致进一步脑损伤。特发性全身性儿童癫痫，表现为难以发现致痫灶精确位置，其对大脑网络的影响以及神经机制还不明确，成为临床干预治疗的难点。因此研究特发性全身性癫痫对儿童大脑功能和结构网络的影响，探讨相应的神经机制，将为临床诊断和治疗提供客观的影像学指标。本项目以特发性全身性癫痫儿童患者为研究对象，采集患者多模态核磁共振脑成像数据（静息态，结构和弥散张量成像等），构建患者脑区间的功能连接网络和白质纤维束结构网络，并基于图论的方法研究其大脑功能和结构网络拓扑属性，通过和正常儿童组比较研究大脑网络拓扑属性的差异，从而揭示癫痫对儿童大脑网络的改变以及其行为功能失常的神经机制，具有重要的科学意义和临床指导价值。

癫痫是由多种病因引起的慢性脑部疾病，儿童癫痫发病率较成人要高。全身强直阵挛性癫痫，表现为难以发现致痫灶精确位置，其对大脑网络的影响以及神经机制还不明确，成为临床干预治疗的难点。本项目以全身强直阵挛性癫痫儿童患者为研究对象，采集患者多模态核磁共振脑成像数据（静息态和3D结构磁共振成像等），分析患者大脑自发活动和灰质体积等影像学指标的变化情况，并基于图论的方法构建患者脑区间的功能连接网络和结构共变网络。.分析结果发现儿童患者组在默认网络相关脑区大脑自发活动受到抑制而在两侧丘脑、两侧脑岛、两侧海马、右侧辅助运动区、左侧额上回、左侧颞上回和颞中回等脑区自发活动显著升高。儿童患者组在两侧丘脑、两侧颞上回、两侧海马、左侧壳核、左侧脑岛等脑区灰质体积显著降低。相关分析发现右侧丘脑分数低频振幅值与癫痫患病史显著正相关，而右侧丘脑灰质体积大小与癫痫患病史显著负相关。功能和结构网络分析都表明儿童患者和正常对照组一样，大脑网络还保持着小世界网络特性，但拓扑属性指标聚类系数和正常对照组比较显著减小。功能网络分析发现儿童患者组节点间的连边中与两侧颞中回颞极相连的部分边功能连接显著减小，两侧楔叶、楔前叶、顶上小叶、顶下小叶、右侧丘脑、颞极等脑区间的功能连接显著升高。结构网络中患者组主要的节点有左侧尾状核，右侧楔前叶，右侧梭状回，右侧眶部额中回，右侧颞下回和两侧颞极颞中回。介数中心度组间分析发现儿童患者组在两侧颞中回颞极、左侧前扣带回、左侧距状沟、右侧楔前叶、右侧丘脑、右侧颞下回等脑区节点中心度相对对照组显著升高。.功能和结构联合分析发现全身强直阵挛性癫痫儿童大脑活动和结构体积等发生显著改变，大脑网络拓扑属性有向随机化发展趋势。癫痫关键性脑区如右侧丘脑、颞中回颞极、脑岛和楔前叶等在不同分析指标中都表现出异常。这些结果为儿童全身强直阵挛性癫痫神经机制的理解提供直接的影像学基础，具有重要的科学意义和临床价值。