Small Lesion Size Is Associated with Sleep-Related Epilepsy in Focal Cortical Dysplasia Type II.
Small Lesion Size Is Associated with Sleep-Related Epilepsy in Focal Cortical Dysplasia Type II.
复制标题
II 型局灶性皮质发育不良中小病变与睡眠相关癫痫有关
DOI：
10.3389/fneur.2018.00106
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发表时间：
2018
影响因子：
3.4
通讯作者：
Wang ZI
中科院分区：
文献类型：
--
作者：
Jin B;Hu W;Ye L;Krishnan B;Aung T;Jones SE;Najm IM;Alexopoulos AV;Zhang K;Zhu J;Zhang J;Ding M;Chen Z;Wang S;Wang ZI
目的探讨局灶性皮质发育不良（FCD）II型患者睡眠相关癫痫（SRE）的影像学及临床特征。方法从三个癫痫中心收集经组织病理学证实的FCD II型患者。根据视频脑电图结果和癫痫发作史确定SRE。使用FreeSurfer进行皮质表面重建和体积计算。使用ITK-SNAP软件在T1容积MRI上手动描绘病变。病变体积通过每例患者的颅内体积进行标准化。通过基于定量（MRI报告中是否检测到病变）和定性（体积）标准设置阈值，将病变分类为小或大。结果共纳入77例患者。其中36例有SRE，41例无SRE。两组患者癫痫发作的年龄较早，癫痫发作频率较高，发作间期EEG表现为区域性，手术结果良好。小病变定义为体积<3，217 mm 3的病变。总体而言，60.9%的SRE患者（25/41）有小FCD病变，显著高于非SRE组（9/34，26.5%，p = 0.005）。通过多变量分析，小病变大小是与整个II型组中SRE显著相关的唯一预测因素（p = 0.016）。虽然有额叶FCD和SRE的患者比例高于非额叶FCD（54.5 vs. 27.3%，p = 0.043），但多变量分析未证实SRE与病变位置之间的关系。SRE组和非SRE组的丘脑体积和癫痫发作症状无统计学差异。在IIb型和IIa型亚组中，病灶大小与SRE之间的显著相关性是可重复的。SRE在II型FCD患者中很常见。小FCD II型病变与SRE显著相关。尽管我们的研究结果不能应用于整个SRE谱，但在评估SRE患者时应考虑小FCD病变的潜在存在，并且非常需要利用所有其他支持性电临床信息进行病变检测。
Objective To investigate the neuroimaging and clinical features associated with sleep-related epilepsy (SRE) in patients with focal cortical dysplasia (FCD) type II. Methods Patients with histopathologically proven FCD type II were included from three epilepsy centers. SRE was defined according to the video EEG findings and seizure history. Cortical surface reconstruction and volume calculation were performed using FreeSurfer. The lesions were manually delineated on T1 volumetric MRI using the ITK-SNAP software. The lesion volumes were normalized by the intracranial volume of each patient. The lesions were classified as small or large by placing a threshold based on quantitative (whether the lesion was detected on MRI report) and qualitative (volume) criteria. Results A total of 77 consecutive patients were included. Of them, 36 had SRE and 41 had non-SRE. An earlier age of epilepsy onset, high seizure frequency, regional interictal EEG findings, and favorable surgical outcome were characteristic in both groups. Small lesions were defined as those having a volume <3,217 mm3. In total, 60.9% of the patients with SRE (25/41) had small FCD lesion, which was significantly higher than the non-SRE group (9/34, 26.5%, p = 0.005). Small lesion size was the only predictor significantly associated with SRE in the overall type II group by multivariate analyses (p = 0.016). Although the proportion of patients who had frontal FCD and SRE was higher than non-frontal FCD (54.5 vs. 27.3%, p = 0.043), the relationship between SRE and lesion location was not confirmed by multivariate analysis. Thalamic volume and seizure semiology were not statistically different between the SRE and non-SRE group. The significant association between lesion size and SRE was reproducible in type IIb and IIa subgroups. Significance SRE is common in patients with FCD type II. Small FCD type II lesions are significantly associated with SRE. Although our findings cannot be applied to the entire spectrum of SRE, potential existence of small FCD lesions should be considered when evaluating patients with SRE, and utilization of all other supportive electroclinical information for lesion detection is highly desirable.
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影响因子：
2.2
作者：
Menezes Cordeiro I;von Ellenrieder N;Zazubovits N;Dubeau F;Gotman J;Frauscher B
通讯作者：
Frauscher B
影响因子：
5.6
作者：
Lamberts, Robert J.;Thijs, Roland D.;Sander, Josemir W.
通讯作者：
Sander, Josemir W.
影响因子：
14.5
作者：
Besson, Pierre;Andermann, Frederick;Bernasconi, Andrea
通讯作者：
Bernasconi, Andrea
DOI：
10.1016/j.nicl.2017.04.018
发表时间：
2017
期刊：
NeuroImage. Clinical
影响因子：
--
作者：
Bouet R;Mauguière F;Daligault S;Isnard J;Guenot M;Bertrand O;Jung J
通讯作者：
Jung J
影响因子：
2.5
作者：
Steriade, M;Timofeev, I;Grenier, F
通讯作者：
Grenier, F