| Objectives To investigate the difference of brain metabolism between epileptic children and healthy children by Proton magnetic resonance spectroscopy(~1H-MRS).Methods Fifty-two children diagnosed with epilepsy were collected from September2020 to February 2022 in outpatient department of pediatric Neurology and ward of Tangshan Maternal and Child Health Hospital.Among them,10 children with refractory epilepsy were included in the refractory epilepsy group,and 42 children with non-refractory epilepsy were included in the epilepsy group.Twenty children with healthy physical examination were selected as the control group at the same time.All the enrolled children were examined by Video electroencephalography(VEEG),skull Magnetic resonance imaging(MRI)and~1H-MRS.Subpeak area integral ratio(relative content)of N-acetylaspartate(NAA),Creatine(Cr)and Choline(Cho)metabolites in hippocampus of all patients were detected by~1H-MRS.The values of NAA/Cho+Cr,NAA/Cr and NAA/Cho were calculated and SPSS 22.0 software was used to process the data.The measurement data conforming to normal distribution and homogeneity of variance were expressed as mean±standard deviation,and F test,T test and q test were used to analyze the data,and the Significance level wasα=0.05.Results 1 control group:there were no significant differences in relative metabolite content(NAA,Cho,Cr)and ratio(NAA/Cho+Cr,NAA/Cho,NAA/Cr)in left and right hippocampus(t=-1.26,-0.62,-0.37,t=-1.14,-1.34,-0.93,P>0.05).2 Epilepsy group:the relative content of NAA on the left was significantly higher than that on the right(t=9.38,P<0.05);the relative content of Cho on the left was higher than that on the right(t=3.76,P<0.05);and the relative content of Cr on the left was lower than that on the right(t=-4.74,P<0.05).There was no statistical difference in the ratio of metabolite relative content in left and right hippocampus(t=1.25,1.85,1.17,P>0.05).3 refractory epilepsy group:there was no statistical difference in the relative metabolite content(NAA,Cho,Cr)of left and right hippocampus(t=1.72,-1.01,-1.59,P>0.05).The ratio of metabolite relative content in the left hippocampus of refractory epilepsy group was lower than that of the right hippocampus(t=-3.20,-3.15,-3.25,P<0.05).4 The relative content of NAA in left and right hippocampus of the three groups was not identical(F=5.819,5.563,P<0.05),and the relative content of NAA in left and right hippocampus of the epilepsy group and the refractory epilepsy group was different from that of the control group(P<0.05).The relative content of Cho in the left hippocampus of the three groups was not identical(F=15.935,P<0.05),and the relative content of Cho in the right hippocampus of the three groups was no significantly different(F=1.794,P>0.05).The relative content of Cho in left hippocampus of refractory epilepsy group was different from that of control group and epilepsy group(P<0.05).The relative content of Cr in left and right hippocampus of the three groups was not identical(F=11.745,4.821,P<0.05);the relative content of Cho in left and right hippocampus of the epilepsy group was different from that of the control group(P<0.05),and the relative content of Cr in right hippocampus of the refractory epilepsy group was different from that of the control group and the epilepsy group(P<0.05);NAA/Cho+Cr in the left and right hippocampal regions of the three groups were not identical(F=17.729,4.197,P<0.05),NAA/Cho+Cr in the right hippocampus of the epilepsy group was different from that of the control group;NAA/Cho+Cr in the left hippocampus of the refractory epilepsy group was different from that of the control group(P<0.05),and NAA/Cho+Cr in the left hippocampus of the refractory epilepsy group was different from that of the epilepsy group(P<0.05).The NAA/Cho of left hippocampus was no significantly different in the three groups(F=2.252,P>0.05);NAA/Cho in the right hippocampus of the three groups were not identical(F=6.275,P<0.05);NAA/Cho in right hippocampus of epilepsy group was different from that of control group(P<0.05);NAA/Cho in left and right hippocampus of refractory epilepsy group was different from that of control group(P<0.05);NAA/Cr in the left hippocampus was not identical among the three groups(F=11.328,P<0.05);there was no statistical difference in NAA/Cr in right hippocampus among the three groups(F=1.279,P>0.05);the NAA/Cr of the left side of the refractory epilepsy group was different from that of the control group and the epilepsy group(P<0.05).Conclusions 1 There are differences in brain metabolism between epileptic children and healthy children.2 The abnormality of brain metabolism in children with refractory epilepsy was larger than that in children with non-refractory epilepsy.3 ~1H-MRS plays a certain role in diagnosing epilepsy in children and evaluating the severity of brain injury objectively.Figure7;Table13;Reference 76... |
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