基于动态因果模型研究小脑在癫痫发作间期痫样放电中的作用  

Research on the Role of Cerebellum in Interictal Epiletiform Discharges Based on Dynamic Causal Modelling

作　　者：朱建国[1] 卢光明[2] 张志强[2] 田蕾[3] 钟元[2] 孙康健[3] 王中秋[2] 

机构地区：[1]南京医科大学第二附属医院影像科,210011 [2]南京军区南京总医院影像科,210002 [3]南京军区南京总医院神经外科,210002

出　　处：《临床放射学杂志》2009年第10期1345-1348,共4页Journal of Clinical Radiology

基　　金：国家自然科学基金面上项目(编号:30470510)

摘　　要：目的采用脑电功能磁共振同步联合成像(electroencephalogram-functional MRI,EEG-fMRI)方法,观察癫痫发作间期痫样放电时脑活动情况,探讨小脑在痫样放电中的作用及神经机制。资料与方法10例复杂部分性发作癫痫患者,行EEG-fMRI,以发作间期痫样放电的相关设计模式对功能磁共振成像(fMRI)数据进行分析,对比观察痫样放电引起的大脑皮层及小脑活动情况,采用动态因果模型(dynamic causal modelling,DCM),观察两者之间功能连接和因果关系。结果发作间期痫样放电时,在大脑皮层广泛激活的基础上,小脑半球的代谢活动也明显增强,其中8例小脑的最大激活点位于小脑半球皮层,2例位于小脑蚓部。皮层与小脑之间存在可靠的双向功能连接。结论发作间期痫样放电时,大脑皮层中的癫痫灶通过皮层下的神经核团与小脑之间形成往返神经环路;小脑在癫痫的发放和传播中起重要的调节作用。Objective To observe the brain activity in interictal epiletiform discharges（IEDs）using EEG fMRI,and discuss the role of the cerebellum in IEDs.Materials and Methods 10 patients with complex partial epilepsy underwent EEG synchronization functional magnetic resonance imaging examination.The IEDs onset time detected with EEG was set as the time parameters in an event-related paradigm of functional MRI.The changes of brain and cerebellum activity caused by IEDs were analyzed.Dynamic causal modelling（DCM）was used to evaluate the intrinsic connectivity between cerebral cortex and cerebellum,and observe causal relationship between them.Results In interictal epiletiform discharges,cerebellar hemisphere and the basal ganglia nuclei metabolic activities increased on the cerebral cortex activation wide basis.There was an effective double-way connected network between cerebral cortex and cerebellum.Conclus-ion There is a neural circuits between cerebral cortex and cerebellum through subcortical nuclei neurons in IEDs,cerebellum make an important regulatory role in the epileptic release and dissemination.

关 键 词：癫痫 功能磁共振成像 动态因果模型 小脑 发作间期痫样放电 

分 类 号：R742.1[医药卫生—神经病学与精神病学]