Quantification of visible Virchow-Robin spaces for detecting the functional status of the glymphatic system in children with newly diagnosed idiopathic generalized epilepsy
Quantification of visible Virchow-Robin spaces for detecting the functional status of the glymphatic system in children with newly diagnosed idiopathic generalized epilepsy
复制标题
可见 Virchow-Robin 空间的量化，用于检测新诊断特发性全身性癫痫儿童的类淋巴系统功能状态
DOI：
10.1016/j.seizure.2020.02.015
复制
发表时间：
2020-05-01
影响因子：
3
通讯作者：
Yang, Jian
中科院分区：
文献类型：
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作者：
Liu, Congcong;Habib, Tafawa;Yang, Jian
目的：大脑淋巴系统，特别是Virchow-Robin间隙(VRS)，在清除大脑废物方面起着重要作用。特发性全身性癫痫(Ige)是一种常见的癫痫类型，与血脑屏障功能障碍、脑脊液和间质液交换异常有关。这些紊乱可能反映在淋巴系统中。因此，本研究探讨了MRI上可见的VRS与癫痫发作的关系，以检测淋巴功能的变化。方法：我们回顾了32例新诊断的IGE儿童和30名3-13岁的对照儿童。使用定制设计的自动化方法识别可见的VR。对IGE患儿和对照组的VRS计数和体积进行了量化和比较。结果：在本研究中，IGE组可见VRS计数(234.34±/-113.88比VRS_对照组，111.83+/-52.46；P<；0.001)和VRS体积(VRS_癫痫，1377.47+/-778.79 mm(3)比VRS_对照组(795.153+/-452.49 mm(3))；P=0.001)。可见VRS数目和体积与发作持续时间呈正相关(r(计数)=0.638，r(体积)=0.639；P<；0.001)，发作后随时间逐渐减少(r(计数)=-0.559，r(体积)=-0.558；P<；0.001)。结论：癫痫发作可引起VRS数目和体积的改变，其改变与发作时间和发作后病程有关。MRI上可见的VRS定量指标可能成为监测淋巴功能的潜在生物标志物。
Purpose: The cerebral glymphatic system, particularly the Virchow-Robin Spaces (VRS), plays an important role in waste clearance from the brain. Idiopathic generalized epilepsy (IGE) is a common epilepsy type associated with blood-brain-barrier dysfunction, abnormal exchange of cerebrospinal fluid and interstitial fluid. These disorders may be reflected in the glymphatic system. Therefore, this study investigated the relationships between visible VRS on MRI and seizures, to detect changes in glymphatic function.Methods: We retrospectively included 32 children with newly diagnosed IGE and 30 controls aged 3-13 years. Visible VRS were identified using a custom-designed automated method. VRS counts and volume were quantified and compared between children with IGE and controls. Meanwhile, Correlations of VRS counts and volume with seizure duration and course after seizure onset were respectively explored via Spearman's coefficient (r).Results: In this study, visible VRS counts were higher in IGE than control group (VRS_epilepsy, 234.34 +/- 113.88 vs. VRS_control, 111.83 +/- 52.46; P < 0.001), as similar results were found in VRS volume (VRS_epilepsy, 1377.47 +/- 778.79 mm(3) vs. VRS_control, 795.153 +/- 452.49 mm(3); P = 0.001). Visible VRS counts and volume positively correlated with seizure duration (r(_ counts) = 0.638, r(_ volume) = 0.639; P < 0.001) and gradually decreased with time after seizure onset (r(_ counts) = -0.559, r(_ volume) = -0.558; P < 0.001).Conclusion: Epileptic seizures can induce changes in VRS counts and volume, which were associated with seizure duration and post-onset course. Quantitative metrics of VRS visible on MRI might be potential biomarkers for monitoring glymphatic function.