原发全面强直阵挛癫痫患者皮层-纹状体-丘脑-小脑网络的静息态功能MRI的对照研究  

Resting state functional magnetic resonance imaging of cortical-striatum-thalamic-cerebellar network in patients with idiopathic generalized epilepsy with generalized tonic-clonic seizure

作　　者：谢心璃 许强 张其锐 杨昉 徐银 卢光明 张志强 Xie Xinyn;Xu Qiang;Zhang Qirui;Yang Fang;Xu Yin;Lu Guangming;Zhang Zhiqiang(Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University Nanjing 210002 ,China;Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002 ,China)

机构地区：[1]解放军东部战区总医院南京大学医学院附属金陵医院医学影像科,南京210002 [2]解放军东部战区总医院南京大学医学院附属金陵医院神经内科,南京210002

出　　处：《中华解剖与临床杂志》2019年第1期32-38,共7页Chinese Journal of Anatomy and Clinics

基　　金：国家自然科学基金(81871345、81701680、81790653).

摘　　要：目的探讨应用静息态功能MRI网络技术描绘原发全面强直阵挛癫痫(IGE-GTCS)患者皮层-纹状体-丘脑-小脑网络的模式。方法前瞻性纳入2009年7月-2016年10月1GE-GTCS患者60例为IGE-GTCS组,同时纳入与IGE-GTCS组患者年龄、性别相匹配的健康志愿者60名为正常对照组:两组受试者于3T超导MR仪下行静息态功能MRI数据收集,采用北京师范大学脑影像处理分析软件DPARSF4.4完成预处理。采用皮层分区模板,将整个大脑分成额叶皮层、运动皮层、感觉皮层、顶枕皮层、颍叶皮层5个感兴趣区域(ROI),自动解剖标记模板定义丘脑、纹状体(包括尾状核、壳核、苍白球)和小脑的皮层下结构,构建皮层-皮层下核团-小脑网络。分別计算5个皮层区域与皮层下核团体素间的功能连接系数,获得系数图;并将得到的相关系数通过FisherZ转换,符合正态分布的功能连接系数图用于后续统计分析“使用SPM12软件的两样本「检验,对IGE-GTCS组与正常对照组间皮层-皮层下核团-小脑功能连接的异常进行比较,应用高斯随机场理论(GRF)进行多重比较校正,体素校正水平取P<0.01,团块校正水平取P<0.05,双尾校正;并将IGE-GTCS患者功能连接改变的区域与临床病程进行Pearson相关分析。结果因头动过大,1GE-GTCS组排除5例,最终纳入55例,男35例、女20例,年龄(25.11±6.0)岁,病程(11.3±6.6)年;正常对照组共60名,其中男37名、女23名,年龄(26.38±6.5)岁。两组受试者年龄、性别差异均无统计学意义0=1.086、X^2=0.048,P值均〉0.05)。相比于正常对照组,IGE-GTCS组功能连接结果差异均有统计学意义(GRE校正.体素水平P值均<0.01、团块水平P值均<0.05):(1)额叶皮层,与双侧小脑脚2区(左右半球体素分别为115J82,r值分别为-5.57,-3.82)、右侧苍白球(体素=28,t=-7.42)连接降低,与双侧丘脑(左右半球体素分别为121J34.t值分别为10.48916)、尾状核(左右半球体素分别为206,199,I值分Objective To investigate the cortical-cortic al-striatum-thalamus-cerebellum network in patients with idiopathic generalized epilepsy with generalized tonic-clonic seizure ( IGE-GTCS),using resting-state fMRI functional connectivity analyses. Methods Prospective study included sixty patients with IGE-GTCS was condncted from July 2009 to October 2016 in Jinling Hospital of Medical School of Nanjing University. Sixty healthy volunteers were set as controls according to age and gender. Resting-state fMRI data were collected on a 3 T MR scanner. The preprocessing was completed by DPARSF 4. 4 software of Beijing Normal University. The whole brain was divided into five regions of interest ( ROI) including frontal cortex, motor cortex, sensory cortex, parieto-occipital cortex and temporal cortex. The subcortical structures in eluding thalamus, striatum ( including caudate nucleus, putamen and pallidum ) and cerebellum were defined by automated anatomical labeling, and the cortico-subcortical nucleus-cerebellum network was constructed. The functional connectivity coefficients between five cortical regions and subcortical nuclides were calculated, and the coefficient maps were obtained. The correlation coefficients were transformed by Fisher Z transformation, and the functional connectivity coefficient maps conforming to normal distribution were used for subsequent statistical analysis. The functional connectivity changes of striatum, thalamus and cerebellum corresp on ding to different cortex areas were compared between the patients and controls by using two sample f-test. The functional connectivity changes of the patients were correlated with the clinical variable of epilepsy duration. Gauss random field ( GRF) was used to perform multiple comparison correction, the voxel P<0.01,cluster P<0.05,double tail correction. Pearson correlation analysis was performed between the change of functional connectivity and the epilepsy duration in patients with IGEGTCS. Results Five cases were excluded from the IGE-GTCS group because

关 键 词：癫痫 强直阵挛性 癫痫网络 功能连接 功能磁共振成像 

分 类 号：R743.404[医药卫生—神经病学与精神病学]