青少年肌阵挛性癫痫初诊患者的fMRI研究  

Functional magnetic resonance imaging of newly diagnosed juvenile myoclonic epilepsy

作　　者：王天成[1] 凡振玉[1] 王学峰[2] 刘光耀[3] 宋文君[1] 刘亚青[1] 武治军 石蓓[1] 

机构地区：[1]兰州大学第二医院癫痫中心,兰州730030 [2]重庆医科大学附属第一医院神经内科,重庆400042 [3]兰州大学第二医院核磁共振科,兰州730030

出　　处：《第三军医大学学报》2015年第20期2080-2085,共6页Journal of Third Military Medical University

基　　金：甘肃省自然科学基金(1107RJZA095)~~

摘　　要：目的运用f MRI研究新诊断青少年肌阵挛性癫痫患者静息态下的神经网络,探讨其认知功能损伤的病理生理机制。方法对纳入研究的23例新诊断JME患者及23例健康对照组进行全脑rs-f MRI数据采集,采用f ALFF法分析JME患者及健康对照组静息态下脑功能活动特点,并构建脑功能网络分析JME患者的脑网络异常;同时采集JME患者及健康对照组的全脑3D T1WI图像,采用基于曲面的皮层形态学方法,观察JME患者及健康对照组皮层厚度的差异。结果与健康对照组相比较,JME患者f ALFF减低的区域主要分布于左侧内侧额上回、右侧顶下小叶脑区,f ALFF增高的区域主要分布于右侧梭状回、左侧中央前回、左侧中央后回。Re Ho值增加的脑区为左侧颞下回、右侧中央前回,Re Ho值降低的脑区为左侧前扣带回、左侧额叶中部。左眶额部Hub节点消失。皮层厚度减少的区域位于右角回、右颞中回及右颞下回。差异具有统计学意义(P<0.01)。结论新诊断青少年肌阵挛性癫痫患者静息态下存在一个额颞叶丘脑皮层网络,这个病理性神经网络对于正常的生理性神经网络功能构成抑制甚至破坏,导致了JME患者在记忆力、注意力和执行能力上的障碍。Objective To research the resting-state neutral networks in the newly diagnosed juvenile myoclonic epilepsy （JME） by functional magnetic resonance imaging （fMRI） and explore the pathophysiological mechanism of cognitive impairment. Methods Twenty-three JME patients and twenty- three healthy controls were recruited, and the whole brain data wove collected by resting-state fMRI. Fractional amplitude of low frequency fluctuation （fALFF） was used to analyze the resting-state brain activity in the JME patients and healthy controls, and the brain function networks were constructed to analyze abnormal brain networks in the JME patients. The whole brain 3D T1WI images of the ,IME patients and healthy controls were also collected, and the cortex thickness difference between the JME patients and healthy controls was observed with curved surface-based cortex morphology method. Results Compared with the healthy controls, the JME patients had lower fALFF values at the left medial superior frontal gyrus and right inferior parietal lobule, and higher fALFF values at the right fusiform, left precentral gyrus, and left postcentral gyrus. The higher regional homogeneity （ReHo） values were distributed at the left inferior temporal gyrus and right precentral gyrus, while the lower ReHo values were distributed at the left anterior cingulate cortex and left frontal central. The left orbital frontal Hub region disappeared. The cortical thickness of the right angular gyrus, right middle temporal gyrus and right inferior temporal gyrus was decreased. The differences were statistically significant （P 〈 O. Ol ）. Conclusion The frontotemporal thalamocortical network appears in the newly diagnosed JME patients in the resting state, and this pathological neural network suppresses or even destroys the function of normal physiological neural networks, leading to cognitive impairment in memory, attention and execution.

关 键 词：青少年肌阵挛性癫痫 功能核磁共振 静息态 神经网络 

分 类 号：R445.2[医药卫生—影像医学与核医学] R741.02[医药卫生—诊断学]