3D-T₁ Weighted Imaging Study Of Cortical Structure In Conventional MRI Negative Children And Juvenile Epilepsy

Objective: The study aims to explore brain cortical morphology changes(cortical thickness,surface area,volume)based on 3D-T1 WI in children and adolescents epilepsy,and analyze the correlation between regions of interest and duration and IQ,thus providing imaging evidence to understanding the physiopathologic mechanism of cognitive dysfunctionin in children and adolescents epilepsy.Methods :19 patients(11 males,8 females)with frontal lobe epilepsy and 22 patients(8males,14 females)with temporal lobe epilepsy from the pediatric outpatient department and inpatient department in Affiliated Hospital of Zunyi Medical College from March 2015 to September 2017 were collected,and meanwhile 23 healthy children were recruited as the control group.T2-FLAIR and 3D-T1 WI were performed with GE Signa HDxt 3.0T MRI in all subjects.The subject with children and adolescents epilepsy was performed China-Wechsler Intelligence Test(suitable for 6 to 16 years)and all subjects were right handedness.Cortical thickness,surface area and volume were analyzed by Free Surfer software.Voxel were analyzed by VBM.The differences of cortical thickness,surface area and volume between patients and controls were compared based on general linear model with age and sex as covariates.Correlation of abnormalities areas and duration and IQ were analyzed by using SPSS19.0 software.In the study,the statistical significance threshold was set at P<0.05.Results: There wasn’t statistical difference in age,gender and degree of education between the control group and frontal lobe epilepsy group,temporal lobe epilepsy group(P>0.05).Compared with control group,frontal lobe epilepsy group showed decreased surface area in superior temporal,posterior central,frontal pole,superior frontal and the precuneus gurus on the left side,decreased surface area in fusiform gyrus,superior temporal gyrus,middle frontal and inferior frontal on the right side,decreased volume in superior temporal and precentral on the left side,and decreased volume in inferior frontal,middle frontal,inferior frontal and the precuneus on the right side.Frontal lobe epilepsy patients had no changed region in brain cortex thickness,and no increased surface area and volume.Compared with control group,temporal lobe epilepsy group showed increased cortex thickness in the left superior frontal,decreased surface area in superior frontal,supramarginal,parahippocampal gyrus and insula on the left side,decreased volume in transverse temporal and lingual on the left side,decreased volume in supramarginal,superior temporal and superior parital on the right side.In temporal lobe epilepsy patients,the surface area of left parahippocampal gyrus was closely relative to IQ(r = 0.426,p =0.426).VBM analysis found that,compared with control group,frontal lobe epilepsy patients showed decreased volume in inferior temporal gyrus and postcentral on the left side,and in the postcentral,claustrum and middle frontal on the right side,while temporal lobe epilepsy patients showed decreased volume in the right postcentral and inferior temporal.Conclusion: This study found that cortex thickness,surface area and volume have multiple brain abnormalities in frontal lobe epilepsy and temporal lobe epilepsy,and abnormal brain regions are not limited to a certain lobes,this may be related to the epileptiform discharge which involved the whole brain or co-existed multiple epileptiform discharge,thus providing imaging evidence to understand the pathophysiological mechanisms in frontal lobe epilepsy and temporal lobe epilepsy.