低频振幅算法功能磁共振成像对不同病因内侧颞叶癫癇的研究  

An fMRI study of mesial temporal lobe epilepsy with different pathological basis using amplitude of low-frequency fluctuation analysis

作　　者：魏渭[1,2] 张志强[1,2] 许强[1,2] 黄育斌[1,2] 卢光明[1,2] 谭启富[3] 

机构地区：[1]南京大学医学院附属金陵医院影像科 [2]南京军区南京总医院医学影像科,210002 [3]南京大学医学院附属金陵医院神经外科,210002

出　　处：《中国现代神经疾病杂志》2014年第11期959-965,共7页Chinese Journal of Contemporary Neurology and Neurosurgery

基　　金：国家自然科学基金资助项目(项目编号:81271553)~~

摘　　要：目的研究不同病理基础内侧颞叶癫癇患者异常脑功能活动分布模式的差异,探讨异常活动脑区在内侧颞叶癫癇发病过程中的病理生理学机制。方法采用基于低频振幅(ALFF)的静息态f MRI技术,分别对30例单侧海马硬化性内侧颞叶癫癇(m TLE-HS)和30例单侧占位性内侧颞叶癫癇(m TLE-OL)患者进行研究,并与30例性别和年龄相匹配的正常对照者进行比较。经代价函数预处理图像后,REST软件计算全脑低频振幅均值并作归一化处理获得m ALFF值,两样本t检验依次对3组被试m ALFF值进行比较,对比m TLE-HS和m TLE-OL颞叶外脑区m ALFF值变化,并分析m ALFF值改变脑区与癫癇病程之间关联性。结果静息态下,m TLE-HS组和m TLE-OL组患者均呈现颞叶外m ALFF值改变,但异常脑区分布模式不同。与m TLE-HS组相比,m TLE-OL组患者m ALFF值增强区域位于双侧顶下叶、楔前叶、角回、扣带中后回和对侧颞中回;m ALFF值减弱区域为对侧中央后回、双侧枕中回和小脑(均P<0.05,Alpha Sim校正),提示m TLE-HS较m TLE-OL脑默认网络受抑制程度更为严重。m TLE-HS患者局部m ALFF值与癫癇病程无明显关联性,而m TLE-OL患者双侧扣带中后回m ALFF值与病程呈正相关(r=0.687,P=0.000),双侧前扣带回与病程呈负相关(r=-0.621,P=0.000)。结论不同病理基础内侧颞叶癫癇存在不同的异常脑功能活动分布模式,提示二者潜在的病理生理学机制可能不同,验证了m TLE-HS是一种特异性癫癇类型。Objective To study the distinction of abnormal brain activity in mesial temporal lobeepilepsy（m TLE） with hippocampal sclerosis（HS） or other pathogical basis, and to discuss their underlyingpathophysiological mechanism in m TLE.MethodsThirty m TLE patients with unilateral hippocampalsclerosis（m TLE- HS） and 30 m TLE patients with occupying lesion in unilateral temporal lobe（m TLE- OL）were investigated by comparing with 30 age- and sex- matched healthy subjects. MRI data were collectedusing a Siemens 3.0T scanner, and all of the participants were studied using amplitude of low- frequencyfluctuation（ALFF） analysis of resting state f MRI. A cost- function modification was used for imagepreprocessing, then the difference of extratemporal m ALFF changes between the two groups of m TLEpatients were analyzed with two-sample t test, and the correlation between m ALFF and epilepsy duration ofm TLE were also investigated.ResultsIn the resting state, m TLE-HS patients and m TLE-OL patients allshowed significant changes in m ALFF in extratemporal structures, but the distribution patterns of changesin brain were different. Compared with m TLE- HS, the m TLE- OL patients showed increased m ALFF inbilateral inferior parietal lobes, precuneus, angular gyrus, middle and posterior cingulate gyrus and contralateral middle temporal gyrus, while m ALFF reducing was observed in contralateral postcentral gyrus,bilateral middle occipital gyrus and cerebellum（P 〈 0.05, Alpha Sim corrected）, that is to say, the defaultmode network（DMN） in m TLE- HS were inhibited more seriously than in m TLE- OL patients. Correlationanalysis showed that no significant correlation was found between m ALFF and epilepsy duration in m TLE-HS patients; m ALFF in bilateral middle and posterior cingulate gyrus was positively correlated withepilepsy duration in m TLE- OL patients（r = 0.687, P = 0.000）, while m ALFF in bilateral anterior cingulategyrus was negatively correlated with epilepsy duration（r =- 0.621, P = 0.000）.Con

关 键 词：癫癎 颞叶 磁共振成像 海马 

分 类 号：R742.1[医药卫生—神经病学与精神病学]