Study Of The Rs-FMRI Amplitude Of Low-frequency Fluctuation In Drug-naive Idiopathic Epilepsy

Objective：The present study aimed to investigate whether Drug-Naive IdiopathicEpilepsy(DNIE) patients exist to the changes of brain function using rs-fMRI Amplitudeof Low Frequency Fluctuation(ALFF) method, and to analyze the correlation betweenabnormal brain regions and clinical variable(duration), improve the understanding of itspathophysiological mechanisms.Method and Materials：Forty-eight idiopathic epilepsy patients from outpatient andinpatient of affiliated hospital of Zunyi medical college during January2011andSeptember2013took part in this study, which contain drug-naive patient group14case(male7, female7), drug patient group34case(male22, female12). The patientgroups were diagnosed by high qualification neurologist and pediatricians, according tothe2005version diagnostic criteria of the International League Against Epilepsy.14sex-,age-, education level-and handedness-with the drug-Na ve group matched healthyvolunteers were recruited for normal control group, meanwhile34sex-, age-, educationlevel-and handedness-with the drug group matched health volunteers were recruited fornormal control group. All participants or guardians gave written informed consent andthe study was approved by the institutional ethical review board of Zunyi medical college.Conventional MRI and rs-fMRI were performed in all subjects by Siemens3.0T Trio ATim MR scanner, rs-fMRI data processing and analysis were performed usingDPARSF_V2.0as implemented in MATLAB7.6and SPM8software, firstly the originalimaging preprocessing (including imaging format conversion, remove first10time points,slice timing, realign, normalization, smooth, detrend and filter), and then separatelyanalyzed ALFF. Two-sample t-test was used to compare with two groups, and correlationanalysis was performed between ALFF Statistical Brain Mapping with the course of thedisease, the difference was statistically significant (p<0.05). Results：Sex, age and handedness between patient group（drug-na ve group and druggroup）and normal control group were not statistically difference (p＞0.05). All groupswere right-handedness. Compared with normal control group, DNIE group the increasedALFF was showed in the right inferior temporal gyrus, right lingual gyrus and rightcuneus, whereas decreases were observed in the right insula, left hippocampus, rightmidbrain, right middle frontal gyrus, left anterior cingulated gyrus, left cingulate gyrusand right inferior parietal lobule. Compared with drug group, DNIE group the increasedALFF was found in left inferior occipital gyrus, right middle occipital gyrus and leftmiddle occipital gyrus, whereas decreases were observed in the right inferior frontalgyrus, left insula, right superior temporal gyrus and right middle frontal gyrus. Comparedwith control group, drug idiopathic epilepsy group the increased ALFF was displayedin the left inferior temporal gyrus, left temporal lobe, left parahippocampa gyrus, leftfusiform gyrus, left cuneus, left superior frontal gyrus, right pre-central gyrus, rightsuperior frontal gyrus, right insula, right inferior frontal gyrus, right frontal lobe and rightcorpus callosum, whereas decreases were displayed in the left cerebellum posterior lobe,left medial superior frontal gyrus, right inferior parietal lobule, right precuneus and rightmedial frontal gyrus. In addition, in DNIE patients group, positive correlations wasobserved in the right cerebellum posterior lobe, left cerebellar tonsil, right lingual gyrus,left orbital gyrus, left middle occipital gyrus, left corpus callosum, left caudate nuclear,left superior frontal gyrus, left medial frontal gyrus, right precuneus and left middlefrontal gyrus, while negative correlations in the right parahippocampal, right superiortemporal gyrus, left superior temporal gyrus and right post-central gyrus with the courseof disease in DNIE patients. In drug IE patients group, positive correlations was observedin the left cerebellum anterior lobe, right para-central lobule, left pre-central gyrus, rightsuperior frontal gyrus, while negative correlations in the left fusiform gyrus, left inferiorfrontal gyrus, left middle frontal gyrus with the course of disease in drug idiopathicepilepsy patients.Conclusion：ALFF was a non-invasive approach to access the resting state cerebral functional abnormalities of idiopathic epilepsy in drug-Naive patients. The correlationsbetween ALFF and clinical variable(course of disease) provide a new insights forpathophysiological mechanism in epilepsy.