结节性硬化癫痫感知网络改变的静息态功能磁共振研究  

Altered Perceptual Networks in Tuberous Sclerosis Complex Patients with Epilepsy Revealed by Resting Functional Magnetic Resonance Imaging

作　　者：杨天华[1] 鄢波[1] 罗程[2] 任洁钏[1] 龚启勇[3] 尧德中[2] 周东[1] 

机构地区：[1]四川大学华西医院神经内科,成都610041 [2]电子科技大学生命科学与技术学院 [3]四川大学华西医院放射科磁共振研究中心

出　　处：《华西医学》2014年第8期1402-1406,共5页West China Medical Journal

基　　金：国家自然科学基金(81100974)~~

摘　　要：目的应用静息态功能磁共振技术研究结节性硬化癫痫患者脑感知网络的异常。方法应用功能磁共振独立成分分析方法研究2010年6月-2012年6月收治的9例结节性硬化癫痫患者静息态脑功能感知网络,包括感觉运动网络(SMN)、视觉网络(VN)和听觉网络(AN)。同时分析感兴趣区Z值和癫痫病程及癫痫发病年龄的相关性。结果与正常对照相比,结节性硬化癫痫患者VN第一视觉皮层功能连接减低,未发现连接增强区域;AN中,左侧颞中回和颞下回连接增加,而右侧额下回连接减低;SMN中右侧额下回连接减低,右侧丘脑功能连接增强。5个感兴趣区包括3个功能网络中2个功能连接增强区域(SMN右丘脑和AN左颞叶)和3个功能连接减低的区域(VN第一视觉区、AN右额叶、SMN右额叶)Z值与癫痫发病年龄及病程无明显相关性(P>0.05)。结论结节性硬化癫痫患者感知功能网络存在改变。功能连接减低反映了结节性硬化癫痫患者感知网络的功能异常;而功能连接增强可能提示皮层网络重组的代偿机制。该研究有助于理解结节性硬化癫痫患者感知功能障碍的病理生理机制。Objective To reveal impairments in the perceptual networks in tuberous sclerosis complex（TSC） with epilepsy by functional connectivity MRI（fcMRI）. Methods The fcMRI-based independent component analysis（ICA） was used to measure the resting state functional connectivity in nine TSC patients with epilepsy recruited from June 2010 to June 2012 and perceptual networks including the sensorimotor network（SMN）, visual network（VN）, and auditory network（AN） were investigated. The correlation between Z values in regions of interest（ROIs） and age of seizure onset or duration of epilepsy were analyzed. Results Compared with the controls, the TSC patients with epilepsy presented decreased functional connectivity in primary visual cortex within the VN networks and there were no increased connectivity. Increased connectivity in left middle temporal gyrus and inferior temporal gyrus was found and decreased connectivity was detected in right inferior frontal gyrus within AN networks. Decreased connectivity was detected at the right inferior frontal gyrus and the increase in connectivity was found in right thalamus within SMN netwoks. No significant correlations were found between Z values in ROIs including the primary visual cortex within the VN, right thalamus and inferior frontal gyrus within SMN, left temporal lobe and right inferior frontal gyrus within AN and the duration of the disease or the age of onset. Conclusions Fhere is altered（both increased and decreased） functional connectivity in the perceptual networks of TSC patients with epilepsy. The decreased functional connectivity may reflect the dysfunction of correlative perceptual networks in TSC patients, and the increased functional connectivity may indicate the compensatory mechanism or reorganization of cortical networks. Our fcMRI study may contribute to the understanding of neuropathophysiological mechanisms underlying perceptual impairments in TSC patients with epilepsy.

关 键 词：结节性硬化 癫痫 感知网络 静息态网络 功能磁共振 

分 类 号：R742.1[医药卫生—神经病学与精神病学]