A Preliminary Study On The Characteristics Of Brain Function Changes In Patients With Idiopathic Generalized Epilepsy Combined With DKI And 3D-ASL Imaging

Objective:Diffusion kurtosis imaging(DKI)and three-dimensional pseudo-continuous arterial spin labeling imaging(3D-pCASL)were used to investigate the microstructure changes of white matter and interictal cerebral blood flow in patients with idiopathic generalized epilepsy based on ROI,and to explore the pathogenesis and pathophysiological changes of IGE from the perspective of microstructure changes of white matter and abnormal perfusion of cerebral blood flow,so as to provide functional neuroimaging basis for the selection of potential therapeutic targets for IGE.Methods:The whole brain 3DT1,T2 FLAIR,ASL and DKI data of 20 patients with idiopathic generalized epilepsy((IGE))and 20 healthy volunteers matched with sex,age and education were collected.The quality of life of patients with epilepsy was evaluated by quality of life score(QOLIE-31)scale.The parameter maps of DKI and CBF were calculated.The differences of DKI and CBF parameters between the two groups were compared by two sample T test.Pearson correlation analysis was used to analyze the correlation between the parameters of different brain regions and the quality of life score(QOLIE-31)of patients with epilepsy.Results:1.Compared with the healthy control group,themean kurtosis(MK),axial kurtosis(AK)and radial kurtosis(RK)in multiple white matter regions of IGE patients decreased,while the mean diffusivity(MD)and FA of kurtosis(FAK)increased.There was no significant difference in fractional anisotropy(FA),axial diffusivity(AD)and radial diffusivity(RD)in the selected white matter brain regions(P>0,05).The increased brain area of FAK was left inferior longitudinal fasciculus(ILF),The increased brain area of MD was left Superior corona radiata and bilateral Superior fronto occipital fasciculus.The decreased brain area of AK was right inferior longitudinal fasciculus(ILF),left Superior corona radiata,Anterior corona radiata,left Superior fronto occipital fasciculus and fornix.The decreased brain area of RK was uncinate fasciculus.The decreased brain area of MK was right Superior corona radiata and left uncinate fasciculus.2.ASL Compared with HC group,CBF in right Frontal superior gyrus,bilateral Frontal middle gyrus,bilateral Frontal inferior gyrus,left Frontal inferior orbital gyrus,left Frontal superior Medial gyrus,left occipital inferior gyrus,left thalamusin IGE group decreased.3.Correlation analysis Pearson correlation analysis showed that there was a positive correlation between MK and QOLIE-31 in left heschl gyrus(R=0.52,P=0.018).It was found that there was no correlation between CBF and the score of QOLIE-31.Conclusions:? we can find microstructure changes of asymmetric white matter in patients with IGE Quantitatively based on DKI,which may provide complementary or richer information with epilepsy electrophysiology,and there is a correlation between part of brain white matter and QOLIE-31 score,suggesting that the damage of microstructure of brain white matter has a certain effect on the quality of life of patients with IGE.?ASL can quantitatively reflect the characteristics of interictal decreased cerebral blood flow perfusion and its distribution in thalamus and frontal lobe in patients with IGE.?The combination of DKI and ASL may help to further understand the pathophysiological mechanism of IGE from the point of view of white matter injury and interictal decrease of cerebral blood flow.