左侧颞叶癫痫患者执行功能损害与钩束弥散张量成像参数的相关性  

Magnetic resonance diffusion tensor imaging study of correlation between executive function impairment and uncinate fasciculus in left temporal lobe epilepsy

作　　者：刁丽梅[1] 陈子蓉[1] 黄东红[1] 余璐[1] 李丽萍[2] 郑金瓯[1] 

机构地区：[1]广西医科大学第一附属医院神经内科,南宁530021 [2]广东省农垦中心医院神经内科

出　　处：《中国神经精神疾病杂志》2013年第8期474-478,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：广西自然科学基金(编号:2011GXNSFA18263)

摘　　要：目的应用神经心理学方法和磁共振弥散张量成像(diffusion tensor imaging,DTI)技术研究左侧颞叶癫痫(temporal lobe epilepsy,TLE)患者执行功能损害的特点及与其双侧钩束(uncinate fasciculus,UF)DTI参数的关系。方法对14例成人左侧TLE患者(患者组)和15名健康对照者(对照组)进行执行功能的神经心理检查(包括stroop、数字广度、数字符号、连线试验及词语流畅性)评分,并对两组受试者均进行DTI扫描。结果患者组stroop错误数([7.20±3.60)vs(.1.60±0.60)]高于对照组(P<0.05),数字广度([12.30±6.20)vs(.17.60±2.10)]、数字符号([50.33±16.10)vs(.66.04±10.12)]及词语流畅性[(12.05±5.36)vs(.19.33±2.55)]均低于对照组(P<0.05),stroop反应时([23.86±10.91)vs.(16.36±6.13)]及连线试验的时间[(56.11±20.12)vs.(40.43±15.07)]均长于对照组(P<0.05)。与对照组相比,患者组左侧钩束各向异性(Fractional Anisotrophy,FA)值降低[(0.332±0.043)vs(.0.379±0.014)],差异具有统计学意义(P<0.05)。相关分析示,患者组左侧钩束FA值与词语流畅性(r=0.56,P=0.025)及数字广度(r=0.58,P=0.028)呈正相关。结论左侧TLE患者存在广泛的执行功能损害,部分执行功能的损害与左侧钩束的损害相关,左侧钩束的损害可能是部分执行功能损害的病理生理基础。Objective To study the executive function changes and its relationship with the diffusion tensor imaging （DTI） parameters of bilateral uneinate faseiculus （UF） of the patients with left temporal lobe epilepsy （TLE） using ncuro- psychological test and DTI. Methods fourteen adult patients with left TLE and 15 healthy controls were enrolled. All of the patients and controls underwent executive function tests including stroop color-word test, digit span, digit symbol, trail making test and verbal fluency. All the subjects underwent brain DTI scans. Results The stroop error number[（7.20±3.60） vs.（1.60±0.60）] were higher （P〈0.05） whereas digit span[（12.30±6.20） vs.（17.60±2.10）], digit symbol[（50.33±16.10） vs.（66.04±10.12）] and verbal fluency[（12.05±5.36） vs.（19.33±2.55）] were lower in patients than in the controls （P〈0.05）. The time of stroop and trail making test was longer in patients than in controls （P〈0,05）. The FA values of the left UF were significantly lower in patients than in controls （P〈0.001）. Correlation analysis showed that the FA values of the left UF of the patients were positively correlated with the verbal fluency （r=0.56, P=0.025） and digit span （r=0.58, P=0.028）.Conclusions （1）. The patients with left TLE have extensive impairment of executive function..（2）. There is a correlation between executive function impairment and left UF damage. （3）. The left UF damage might be part of the pathophysiological basis of executive function impairment.

关 键 词：颞叶癫痫 认知 钩束 磁共振弥散成像 

分 类 号：R742.1[医药卫生—神经病学与精神病学]