青少年肌阵挛性癫痫睡眠-觉醒回路中静息状态功能连通性的改变：一项基于种子的fMRI研究。

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior Pub Date : 2025-10-22 DOI:10.1016/j.yebeh.2025.110786

Jiayao Li , Danlei Wei , Wen Chai , Fangfang Xie , Xianghe Liu , Min Zhang , Sha Huang , Jinxin Peng , Jingwan Feng , Lili Long , Bo Xiao , Kangrun Wang , Yanmin Song

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引用次数: 0

摘要

目的：青少年肌阵挛性癫痫（JME）以肌阵挛性发作为特征，多发生在醒来后，睡眠剥夺是常见的诱发因素。本研究旨在探讨JME患者睡眠-觉醒回路关键区域的静息状态功能连通性（rs-FC），重点关注视交叉上核（SCN）、下丘脑后部和上行网状激活系统（ARAS）。方法：本研究纳入33例JME患者和40例年龄和性别匹配的健康对照（hc）。所有参与者都接受了睡眠和认知学习相关的神经心理学量表和静息状态功能磁共振成像（rs-fMRI），并对睡眠-觉醒回路内的区域（包括SCN、下丘脑后核和ARAS核）进行了基于种子的功能连通性分析。结果：在JME患者中，观察到rs-FC的显著改变，包括左侧SCN与左侧内侧额上回之间的连通性增加（PFDR-corr = 0.002），以及背侧被盖核（LTN）、导水管周围灰质（PAG）和臂旁复核（PBC）的连通性改变。LTN seed与JMEs患者的额叶（右侧额上回、双侧辅助运动区、双侧中央前回、双侧中央旁小叶）、顶叶（双侧中央后回、右侧顶叶上小叶）、右侧颞上回、枕叶（双侧楔叶、双侧枕上回、双侧骨裂）和中脑的簇具有显著的超连连性（pfdr - corp < 0.001）。结果显示，与hcc相比，伴有脑桥的rs-FC显著降低（PFDR-corr< 0.001）。此外，与hcc相比，PAG种子与左红核和中缝背核表现出显著的超连通性（pfdr -cor < 0.001）。最后，PBC种子显示出与脑桥的显著超连接，中脑、小脑蚓部和双侧蓝斑的rs-FC显著降低（pfdr - rr< 0.001）。结论：该研究揭示了JME患者睡眠-觉醒回路相关脑区功能连通性的显著改变，为理解觉醒后的肌阵挛性发作和睡眠剥夺引发的癫痫发作提供了有价值的信息。

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Altered resting-state functional connectivity in the sleep-wake circuit in juvenile myoclonic epilepsy: A Seed-based fMRI study

Objective

Juvenile myoclonic epilepsy (JME) is characterized by myoclonic seizures mostly occurring after awakening, and sleep deprivation is a common predisposing factor. This study aims to investigate the resting-state functional connectivity (rs-FC) of key regions in the sleep-wake circuit in patients with JME, focusing on the suprachiasmatic nucleus (SCN), posterior hypothalamus, and the ascending reticular activating system (ARAS).

Methods

This study involved 33 patients with JME and 40 age and gender-matched healthy controls (HCs). All participants underwent sleep and cognitive learning-related neuropsychological scales and resting-state functional magnetic resonance imaging (rs-fMRI), and seed-based functional connectivity analysis was performed on regions within the sleep-wake circuit, including the SCN, posterior hypothalamus, and ARAS nuclei.

Results

In patients with JME, significant alterations in rs-FC were observed, including increased connectivity between the left SCN and the left medial superior frontal gyrus (P_FDR-corr = 0.002), and altered connectivity in the laterodorsal tegmental nucleus (LTN), periaqueductal gray (PAG), and parabrachial complex (PBC). LTN seed displayed significant hyperconnectivity with the cluster in the frontal lobe (right superior frontal gyrus, bilateral supplementary motor area, bilateral precentral gyrus, bilateral paracentral lobule), the parietal lobe (bilateral postcentral gyrus, right superior parietal lobule), right superior temporal gyrus, the occipital lobe (bilateral cuneus, bilateral superior occipital gyrus, bilateral calcarine fissure), and midbrain in JMEs (P_FDR-corr

<

0.001), and revealed significantly decreased rs-FC with pons (P_FDR-corr

<

0.001) compared to HCs. Furthermore, PAG seed showed significant hyperconnectivity with the left red nucleus and the dorsal raphe nucleus (P_FDR-corr

<

0.001) compared to HCs. Lastly, PBC seed showed significant hyperconnectivity with pons, and significantly decreased rs-FC with midbrain, cerebellar vermis, and bilateral locus coeruleus (P_FDR-corr

<

0.001).

Conclusions

The study reveals significant alterations in the functional connectivity of brain regions involved in the sleep-wake circuit in patients with JME, providing valuable information for understanding myoclonic seizures after awakening and seizures triggered by sleep deprivation.

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来源期刊

Epilepsy & Behavior 医学-行为科学

CiteScore

5.40

自引率

15.40%

发文量

385

审稿时长

43 days

期刊介绍： Epilepsy & Behavior is the fastest-growing international journal uniquely devoted to the rapid dissemination of the most current information available on the behavioral aspects of seizures and epilepsy. Epilepsy & Behavior presents original peer-reviewed articles based on laboratory and clinical research. Topics are drawn from a variety of fields, including clinical neurology, neurosurgery, neuropsychiatry, neuropsychology, neurophysiology, neuropharmacology, and neuroimaging. From September 2012 Epilepsy & Behavior stopped accepting Case Reports for publication in the journal. From this date authors who submit to Epilepsy & Behavior will be offered a transfer or asked to resubmit their Case Reports to its new sister journal, Epilepsy & Behavior Case Reports.