Objective: To study the relationship between the changes of brain network and cognition in patients with benign epilepsy of childhood with centrotemporal spikes (BECTS) by using long term video electroencephalogram (VEEG) and resting-state functional magnetic resonance imaging (RS-fMRI) technology. Methods: Eleven patients with right-handed were recruited (from April 2015 to September 2016) from epilepsy specialist outpatients and functional department of neurosurgery of Tianjin Medical University General Hospital. They all underwent the long term VEEG monitoring (one sleep cycle was included at least). According to the spike-wave index (SWI) during slow ware sleep, they were divided into two groups: SWI<50% (5 cases) and SWI≥50% (6 cases). All the patients were assessed with cognitional test including language, execution, memory and attention. They also underwent the head MRI, RS-fMRI examinations. Then the results were comparatively analysed. Results: (1)There were no statisticaly significance in sex, age, age of onset, disease course, total number of seizures, years of education (P>0.05). The Full Intelligence Quotient (FIQ) (87±18), Verbal Intelligence Quotient (VIQ) (88±15) and Performance Intelligence Quotient (PIQ) (89±20) of SWI≥50% group were lower than SWI<50% group(118±8, 114±11, 119±5) and the differences were statistically significant(P<0.05). (2)There was a negative correlation between the FIQ (P=0.002), VIQ (P=0.006), PIQ (P=0.001) and SWI. The FIQ, VIQ and PIQ had no correlation with the sex, age, age of onset, disease course, total number of seizures, years of education (P>0.05). (3)Compared with SWI<50% group, SWI≥50% group showed increased regional homogeneity (ReHo) in the bilateral precentral gyrus, premotor area and the subcortical structure, the right temporal lobe and the bilateral insular lobe(P<0.05); while they showed decreased ReHo in the posterior cingulate gyrus, right posterior inferior temporal lobe and right occipital lobe(P<0.05). Conclusion: The change of the brain network which is caused by the paradoxical and constant discharge during slow ware sleep in patients with BECTS may affect the development of cognition.
目的： 应用长程视频脑电(VEEG)及静息态功能磁共振成像(RS-fMRI)技术研究儿童良性癫痫伴中央颞区棘波(BECTS)患者脑功能网络改变与认知功能的关系。 方法： 选取于2015年4月至2016年9月就诊于天津医科大学总医院癫痫门诊及功能神经外科11例右利手BECTS患者，均行长程VEEG监测(至少包括一个完整睡眠周期)，将其按慢波睡眠期棘慢波放电指数(SWI)分为两组：SWI<50%组(5例)及SWI≥50%组(6例)。两组患者均行语言、执行、记忆及注意等认知功能测评及头MRI、RS-fMRI检查，并对其结果进行对比分析。 结果： (1)两组患者的性别、年龄、首发年龄、病程、总发作次数、受教育程度比较差异无统计学意义(P>0.05)；SWI≥50%组的总智商(FIQ)[(87±18)分]、语言智商(VIQ)[(88±15)分]、操作智商(PIQ)[(89±20)分]均低于SWI<50%组[(118±8)分、(114±11)分、(119±5)分]，差异有统计学意义(P<0.05)。(2)FIQ(P＝0.002)、VIQ(P＝0.006)、PIQ(P＝0.001)分别与SWI呈负相关，而与性别、年龄、首发年龄、病程、总发作次数、受教育程度之间无相关性(P>0.05)。(3)SWI≥50%组较SWI<50%组局部一致性(ReHo)增加的脑区包括双侧中央前回、运动前区及其皮质下结构，右侧颞叶，双侧岛叶(P<0.05)，ReHo减弱的脑区包括后扣带回、右侧颞下回后部、右侧枕叶(P<0.05)。 结论： BECTS患者慢波睡眠期持续异常放电可造成患者脑功能网络发生改变，进而影响其认知功能发育。.
Keywords: Benign epilepsy of childhood with centrotemporal spikes; Cognition; Functional magnetic resonance imaging.