MRI评价抗癫痫药物对原发全面性癫痫患者脑灰质结构的影响

目的 运用基于体素的形态学(VBM)分析方法,探讨抗癫痫药物(AEDs)对全面强直阵挛癫痫(GTCS)患者脑灰质结构的影响。方法 将19例服用AEDs治疗的GTCS患者(服药组)及19例未服药患者(未服药组)纳入本研究。采集3D T1数据,并采用VBM方法将患者脑灰质结构进行分割,并对分割后的灰质结构进行两样本t检验。针对服药患者,分2次分别纳入及不纳入病程作为协变量,将服药时间与全脑灰质体积进行相关分析。结果 与未服药组比较,服药组GTCS患者脑灰质体积增加的区域以双侧额叶、顶叶、颞叶、尾状核及小脑半球为主。无论是否将病程纳为协变量,双侧壳核、丘脑灰质体积与服药时间呈正相关。结论 VBM可显示AEDs对脑灰质结构造成的微细改变;AEDs对GTCS患者脑灰质结构可能具有一定的保护作用。

MRI evaluation effects of antiepileptic drugs on the brain's gray matter structures in idiopathic generalized epilepsy patients

Objective To explore the effects of antiepileptic drugs (AEDs) on the brain's gray matter structures in patients with generalized tonic colonic seizure (GTCS) based on voxel-based morphometry (VBM). Methods 3D T1 datasets were acquired from 19 patients who took AEDs and another 19 patients unmedicated. VBM analysis was used to investigate gray matter volume differences between patients who took AEDs and unmedicated with two sample t test. For patients who took AEDs, correlation analysis between gray matter volume and the medication duration was performed with and without course of disease as covariate. Results Compared with patients unmedicated, patients took AEDs showed significant increases of gray matter volume in bilateral frontal lobe, parietal lobe, temporal lobe, caudate and cerebellum. Whether the course of epilepsy disease taken as a covariate or not, the volume of bilateral putamen and thalamus was positively correlated with medication duration. Conclusion VBM can display the tiny changes in brain gray matter structures which caused by AEDs caused; AEDs may have a protective effect on cerebral gray matter structures of GTCS patients.