颞叶癫痫患者疾病进展相关脑网络中枢节点拓扑属性改变模式的研究  

Alterations of hubs related to disease progression in patients with temporal lobe epilepsy:a study on topological properties of brain networks

作　　者：梁秀琳[1,2] 文洪波 张庆华 刘京京 罗兵 赵蒙蒙 郑金瓯 Liang Xiulin;Wen Hongbo;Zhang Qinghua;Liu Jingjing;Luo Bing;Zhao Mengmeng;Zheng Jinou(Department of Neurology,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China;Department of Neurology,Zhongda Hospital Lishui Branch,Southeast University,Nanjing 211200,China;Department of Radiology,Zhongda Hospital Lishui Branch,Southeast University,Nanjing 211200,China)

机构地区：[1]广西医科大学第一附属医院神经内科,南宁530021 [2]东南大学附属中大医院溧水分院神经内科,南京211200 [3]东南大学附属中大医院溧水分院影像科,南京211200

出　　处：《中华神经科杂志》2023年第11期1223-1229,共7页Chinese Journal of Neurology

基　　金：南京市卫生科技发展专项基金项目(YKK22237);国家自然科学基金(81560223)。

摘　　要：目的研究颞叶癫痫疾病进展相关的脑功能网络变化及执行功能障碍的潜在神经机制。方法收集2019年12月至2021年12月从广西医科大学第一附属医院癫痫门诊招募的19例病程≤5年的颞叶癫痫患者(TLE-SD组)、24例病程>5年的颞叶癫痫患者(TLE-LD组)以及社会招募的21名性别、年龄和受教育程度相匹配的健康对照者(健康对照组)。对所有受试者评估人口统计学及临床资料,进行静息态功能磁共振和注意网络测试,采用图论方法分别计算3组受试者的功能性脑网络拓扑属性,并确定中枢节点,进行中枢节点属性的组间比较,并与执行控制功能进行相关分析。结果TLE-SD组患者中枢节点的分布模式发生改变。与TLE-LD和健康对照组相比,TLE-SD组在左额中回腹外侧区、左中央前回(上肢区)、左顶上小叶头侧、尾侧及顶叶内区、右顶上小叶尾侧、右枕外侧皮质等脑区的节点度值显著升高;TLE-SD患者在右额上回中部、左顶上小叶头侧的节点效率显著低于TLE-LD患者,在右额上回中部的节点效率显著低于健康对照组;左顶上小叶的节点网络属性与执行控制效率呈正相关;TLE-LD患者与健康对照组间比较未见显著差异。结论颞叶癫痫患者右额上回中部中枢节点首先出现破坏,背侧注意网络、左中央前回及右枕叶等脑区范围内出现新的中枢节点且过载,随着病程进展,中枢节点出现趋向于正常化的重新分配;左顶上小叶可能在颞叶癫痫患者执行控制功能损害中发挥重要的作用。Objective To investigate the alterations of brain functional network related to disease progression in patients with temporal lobe epilepsy(TLE)and the potential neural mechanism of executive dysfunction.Methods Nineteen temporal lobe epilepsy patients with a disease course of less than or equal to 5 years(TLE-SD group)and 24 temporal lobe epilepsy patients with a disease course of more than 5 years(TLE-LD group)were recruited from the Epilepsy Clinic of the First Affiliated Hospital of Guangxi Medical University from December 2019 to December 2021.At the same time,21 healthy control individuals(healthy control group)were recruited from the society and matched with gender,age,and education level.All subjects were evaluated demographic and clinical data,and performed resting state functional magnetic resonance imaging(rs-fMRI)and attention network test(ANT).The topological properties of functional brain network of 3 groups of subjects were calculated using graph theory,and then the hubs were determined.Then the inter-group comparison of hubs properties was carried out,and the correlation analysis with executive control function was performed.Results The distribution pattern of hub nodes in TLE-SD patients was changed.Compared with the TLE-LD and healthy control groups,the TLE-SD group significantly increased the nodal degree values in brain regions such as the ventrolateral area of the left middle frontal gyrus,the left anterior central gyrus(upper limb area),the cephalic and caudal areas of the left parietal lobule,as well as the inner parietal lobe area,the caudal side of the right parietal lobule,and the right lateral occipital cortex.The nodal values of the brain areas such as the lateral and parietal inner area,the caudal side of the right upper upper lobule,and the right lateral occipital cortex were significantly increased.TLE-SD patients had a significant increase in the middle of the right upper frontal gyrus and the head of the left upper upper lobule.The node efficiency was significantly lower than that

关 键 词：癫痫 颞叶 磁共振成像 中枢节点 图论 执行控制功能 

分 类 号：R742.1[医药卫生—神经病学与精神病学]