丙泊酚wada试验与功能磁共振在癫痫语言优势侧评估中的应用  

Propofol wada test and functional magnetic resonance imaging for language dominance evaluation of temporal lobe epilepsy

作　　者：王丽敏[1] 王伟[1] 王伟民[1] 陈状[1] 李林[1] 谢学敏[1] 

机构地区：[1]广州军区广州总医院神经外科,广州510010

出　　处：《立体定向和功能性神经外科杂志》2012年第2期81-85,共5页Chinese Journal of Stereotactic and Functional Neurosurgery

基　　金：军队临床高新技术重大项目(编号:2010GXJS033);广东省科技计划项目(编号:2008A030201021)

摘　　要：目的探讨丙泊酚wada试验与fMRI在术前语言优势侧评估中的一致性与预测术后言语及整体智力变化的敏感性。方法对8名左颞叶癫痫患者术前丙泊酚Wada试验和fMRI语言优势侧结果进行比较,独立样本t检验比较两种方法判定的左侧优势组与非左侧优势组手术前后平均VIQ、FIQ变化的差异。结果两者语言优势侧判定一致率为71%,fMRI语言优势为左侧的患者术后平均FIQ、VIQ下降较非左侧组患者显著(P≤0.05),丙泊酚wada试验分组则无显著差异(P>0.05)。结论丙泊酚wada试验与fMRI在癫痫术前语言功能评估中有较高的一致性,从微创、经济和偏侧化预测的一致性及敏感性角度综合考虑,fMRI比Wada试验的优势更明显。Objective To explore the consistency and susceptibility of preoperative language dominance evaluation of temporal lobe epilepsy（TLE） patients by propofol wada test and fMRI to predict the postoperative VIQ and FIQ changed differentiately.Methods 8 left anterior temporal lobectomy（L-ATL）patients underwent preoperative language lateralization assessment by fMRI and propofol Wada testing.Compared post-preoperative Wechsler intellegence tests change of left language dominance gourp with non-left language dominance gourp by independent sample T tests.Results There was 71.4% concordance between the Wada tests and fMRI language dominance evaluation results,mostly left language dominance on fMRI and left dominance on the Wada test were each predictive of VIQ and FIQ declined.The postoperative VIQ and FIQ of left dominance group declined singnifcant than non-left dominance on fMRI（P≤0.05）neither on Wada test（P0.05）.Conclusion There is high consistency in preoperative language dominance evaluation of temporal lobe epilepsy patients using local propofol wada test and fMRI,considering more economic,minimal invasive,high consistency and susceptibility on dominance prediction for TLE patients,fMRI is more advantage than Wada test apparently.

关 键 词：颞叶癫痫 丙泊酚wada试验 FMRI 语言优势 偏侧化指数 

分 类 号：R742.1[医药卫生—神经病学与精神病学]