| Objective: Our main purpose was to observe the effects of levetiracetam and oxcarbazepine on brain structure network and cognitive function of children with benign epilepsy with central-temporal spikes(BECTS),and to further explore the correlation between new antiepileptic drugs and brain fine structure.This study provides a reference for further understanding its mechanism of action and guiding clinical medication.Methods: From December 2013 to December 2017,BECTS children who were initially diagnosed in the Affiliated Hospital of North Sichuan Medical College and had not yet been treated were included as experimental subjects in this study.And then,they were divided into oxcarbazepine group(n=11)and levetiracetam group(n=10).All subjects underwent neuropsychological assessment before and 12 months after treatment,which use the Chinese revised Wechschild Intelligence Scale(WISC)to obtain FSIQ,VIQ and PIQ of the subjects.Imaging evaluation was performed using 3.0T high-resolution T1-weighted magnetic resonance imaging(3D-T1)scanning images.All data were collated and summarized.The statistical analysis was performed using SPASS 13.0.The measurement data were expressed as mean ± standard deviation(?x±s).Analysis of cognitive function changes before and after treatment by self-paired t-test.Cognitive function changes before and after treatments were analyzed by self-paired t test.All magnetic resonance images were pre-processed by statistical parameter map data package(SPM8),and then by voxel-based morphological analysis(VBM),using self-paired t-test to compare and analyze the changes of cerebral gray matter volume before and after treatment.Two-sample t-test was used to compare the changes of cerebral gray matter volume between the groups before and after treatment,and to analyze the correlation between the changed gray matter volume of the brain and the cumulative dose of drugs and neuropsychological data.Results:(1)The volume of gray matter in the left nucleus,the left middle iliac crest,and the left auxiliary acuity was significantly reduced in children with LEV,and the difference was statistically significant(p<0.05);The volume of gray matter in the left nucleus,the right cerebellum,and the left central posterior gyrus of children was significantly increased in children with OXC,and the difference was statistically significant(p<0.05).(2)Neuropsychology evaluation results: The self-controls of the two groups showed an increase in VIQ,PIQ,and FSIQ scores,but there was no statistically significant change in the scores before and after OXC treatment,while the VIQ,PIQ,and FSIQ scores in the LEV treatment group were Statistically significant before treatment(p<0.05).(3)Correlation analysis results: the increase in right cerebellar gray matter volume was significantly negatively correlated with oxcarbazepine dose(r=-0.64,p=0.034),and the increase in gray matter volume in the left occipital gyrus was significantly negatively correlated with the cumulative dose of oxcarbazepine(r=-0.739,p=0.009).Conclusion:(1)Both OXC and LEV can regulate BECTS-related brain regions,but there are differences in the action points.Levetiracetam can significantly improve brain structure development in children.The volume of brain regions in OXC group is still increasing,suggesting that brain regions are still damaged.(2)The VIQ,PIQ and FSIQ scores of the LEV group were higher than those before treatment,suggesting that LEV partially improved the cognitive function of the children.(3)The increase in the volume of the gray matter in the right cerebellum and the left occipital region was negatively correlated with the cumulative use of OXC,which may explain the improvement in brain structure to some extent. |
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