基于功能磁共振的脑网络连接在癫痫及其共病中的应用与研究进展  

Research progress in brain connectivity based on functional magnetic resonance approaches to the pathophysiology and comorbidity of epilepsy

作　　者：刘文钰[1] 赵晨阳 肖风来[1] 张颖颖[1] 李维[1] 张鹤声 吴欣桐[1] 李劲梅[1] 周东[1] LIU Wen Yu;ZHAO ChenYang;XIAO FengLai;ZHANG YingYing;LI Wei;ZHANG HeSheng;WU XinTong;LI JinMei;ZHOU Dong(Department of Neurology,West China Hospital of Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院神经内科,成都610041

出　　处：《中国科学：生命科学》2022年第11期1660-1670,共11页Scientia Sinica(Vitae)

基　　金：国家自然科学基金(批准号:81901320,81871017,U21A20393);四川省自然科学基金(批准号:2019YFH0196);成都市科技局项目(批准号:2019-YF09-00215-SN,2021-YF05-00846-SN);四川大学华西医院学科卓越发展1·3·5工程项目(批准号:ZYGD20011)资助。

摘　　要：癫痫是由于脑自稳态网络系统被破坏而发生的,已被公认为是一种脑网络疾病,异常网络在癫痫的产生及发展过程中起到关键作用.基于功能磁共振的脑连接方法是探索癫痫网络复杂影像的理想技术.当前多模态功能磁共振研究,包括脑功能连接网络、结构网络及纤维束连接网络等,对认识理解局灶性癫痫、特发性全面性癫痫和特定癫痫综合征的癫痫网络及其共病的发病机制产生了里程碑式的推动作用.近期,越来越多的研究致力于发现异常脑网络在各类癫痫的病理生理机制中的作用,及其与临床预后的关系,脑网络连接方法在定位癫痫网络和病灶方面显示出良好前景.此外,人们更加关注癫痫对共病网络的有害影响,以解释认知缺陷和精神症状;抗癫痫药物治疗的功能影像研究也获得了有关药物副作用和药物治疗后异常网络功能重建的信息.手术作为难治性癫痫的主要治疗手段,癫痫影像学研究对于探索影响手术疗效的因素及发展可靠易行的疗效预测方法具有重要意义,但目前尚需大型的临床研究和足够长时间的随访进一步验证其有效性及准确性.Epilepsy results from disruption of the homeostatic network system in the brain and has been recognized as a brain network disorder.Abnormal networks play a key role in the occurrence and development of epilepsy.Functional magnetic resonance-based approaches to brain connectivity are ideal techniques for exploring the complex images of epilepsy networks.The human brain networks primarily include the intrinsic connectivity network,the morphometric structural network,and the diffusion tractography-based anatomical connectivity network.Studies have provided insight into the physiopathogenesis of the epileptic network underlying focal epilepsy,genetic generalized epilepsy,and specific epileptic syndromes.Many recent studies have investigated the role of abnormal brain networks in the pathophysiological mechanisms of various types of epilepsy and their relationship with clinical prognosis to discover targets for clinical intervention and prognosis prediction and have shown promise in localizing epilepsy networks and lesions.Additionally,an increasing number of studies have focused on the deleterious effects of epilepsy on other brain networks to help explain cognitive deficits and psychiatric symptoms.Anti-epileptic treatment studies have yielded information about the side effects and restoration of functional abnormalities after using drugs.Moreover,surgery is the main treatment method for refractory epilepsy.Imaging studies are of great significance for exploring the factors that affect the outcome of surgery and developing reliable and feasible efficacy prediction tools.However,large-scale clinical studies with long-term follow-ups are still needed to further verify its effectiveness and accuracy.

关 键 词：癫痫 功能磁共振 脑网络 

分 类 号：R445.2[医药卫生—影像医学与核医学] R742.1[医药卫生—诊断学]