颞叶内侧癫痫并抑郁病人脑功能连接密度的静息态功能磁共振成像研究  

Resting-state functional magnetic resonance imaging study of brain functional connectivity density in patients with medial temporal lobe epilepsy and depression

作　　者：刘美清 杨逸昊 王月晗 王小龙 王胜[1,4] 罗程 邹琴[3] 李其富 LIU Meiqing;YANG Yihao;WANG Yuehan;WANG Xiaolong;WANG Sheng;LUO Chen;ZOU Qin;LI Qifu(Department of Neurology,The First Affiliated Hospital of Hainan Medical University,Haikou,Hainan 570102,China;Department of Imaging,The First Affiliated Hospital of Hainan Medical University,Haikou,Hainan 570102,China;Department of Medical Psychology,The First Affiliated Hospital of Hainan Medical University,Haikou,Hainan 570102,China;Hainan Provincial Key Laboratory of Tropical Brain Research and Transformation,Haikou,Hainan 570102,China;School of Life Science and Technology,University of Electronic Science and Technology,Chengdu,Sichuan 610000,China)

机构地区：[1]海南医学院第一附属医院神经内科,海南海口570102 [2]南医学院第一附属医院影像科,海南海口570102 [3]南医学院第一附属医院医学心理学科,海南海口570102 [4]海南省热带脑科学研究与转化重点实验室,海南海口570102 [5]电子科技大学生命科学与技术学院,四川成都610000

出　　处：《安徽医药》2023年第12期2378-2383,I0001,共7页Anhui Medical and Pharmaceutical Journal

基　　金：国家自然科学基金项目(81960249);海南省自然科学基金项目(822RC832);海南省重点研发计划(ZDYF2022SHFZ109);海南省临床医学中心项目资助(2021)。

摘　　要：目的探讨颞叶内侧癫痫伴抑郁(MTLEWD)病人在静息态功能磁共振成像(rs-fMRI)中功能活动异常的脑区的特点。方法纳入2021年1—12月在海南医学院第一附属医院神经内科门诊符合国际抗癫痫联盟(ILAE)诊断分类标准的颞叶内侧癫痫病人,根据HAMD评分将病人分为MTLEWD组和颞叶内侧癫痫不伴抑郁组(MTLE组),同时纳入与病人性别、年龄相匹配的对照组。使用GE Discovery MR7503.0T设备根据预先设定参数行磁共振扫描,获取静息态功能磁共振数据。采用SPSS 22.0统计分析软件对一般人口学资料进行分析。基于MATLAB 2018平台采用DPABI软件对磁共振数据进行预处理,使用功能连接密度(FCD)分析指标对三组被试者行ANOVA分析差异有统计学意义的脑区,然后行组间两样本的t检验,根据高斯随机场(GRF)理论满足体素显著性<0.001、连续体素数量≥23,团块显著性<0.05的区域被认为差异有统计学意义。结果共纳入MTLE组病人20例,MTLEWD组病人21例,对照组25例,三组病人一般资料(年龄、性别)差异无统计学意义(P>0.05)。三组的FCD值差异的脑区主要在楔前叶、颞中回、颞下回、左侧小脑cruse1区、左侧小脑cruse2区、左侧小脑7b区、左侧小脑8区、额中回、左侧颞极(颞上回)、颞极(颞中回)等脑区。结论MTLEWD病人活动异常脑区主要集中在默认网络相关脑区及小脑,上述脑区功能紊乱与病人的抑郁症状相关;使用Rs-fMRI分析方法能够客观地对病人进行功能评价。Objective To investigate the characteristics of brain regions with abnormal functional activity in resting-state functional magnetic resonance imaging(rs-fMRI)in patients with medial temporal lobe epilepsy with depression(MTLEWD).Methods Patients with medial temporal lobe epilepsy who met the International League Against Epilepsy(ILAE)diagnostic classification criteria at the outpatient clinic of the Department of Neurology of the First Affiliated Hospital of Hainan Medical College from January to December 2021 were enrolled.According to HAMD scores,patients were divided into the medial temporal lobe epilepsy with depression(MTLEWD)group and the medial temporal lobe epilepsy(MTLE)group,and a control group matched to the patient's sex and age was included.Magnetic resonance scans were performed using a GE Discovery MR7503.0T device according to preset parameters to obtain resting-state functional magnetic resonance data.General demographic data were analyzed using SPSS 22.0 statistical analysis software.The magnetic resonance data were preprocessed using DPABI software based on the MATLAB 2018 platform,and brain regions with statistically significant differences were analyzed by ANOVA using the functional connectivity density(FCD)analysis index for the three groups of subjects.Then the t test was performed for the two-sample test between the groups,which was satisfied with voxel significance<0.001,number of consecutive voxels≥23,and clustering significance<0.05,according to the theory of Gaussian random fields(GRF).Regions with cluster significance<0.05 were considered to have statistically significant differences.Results A total of 20 patients in the MTLE group,21 patients in the MTLEWD group,and 25 patients in the control group were included,and the differences in the general information(age and sex)among the three groups were not statistically significant(P>0.05).The brain regions with different FCD values among the three groups were mainly in the precuneus,middle temporal gyrus,inferotemporal gyrus,left cere

关 键 词：静息态脑功能磁共振成像(rs-fMRI) 癫痫 颞叶 抑郁症 共病现象 功能连接密度 体积元素 

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]