静息态功能MRI对儿童及青少年难治性颞叶癫痫脑动态功能连接研究  

A resting-state functional MRI study of brain dynamic functional connectivity in children and adolescents with drug-resistant temporal lobe epilepsy

作　　者：何玉伦 冉海峰 谢雨辛 李清会 胡杰 陈贵琴 张体江 He Yulun;Ran Haifeng;Xie Yuxin;Li Qinghui;Hu Jie;Chen Guiqin;Zhang Tijiang(Department of Radiology,Affiliated Hospital of Zunyi Medical University,Zunyi Guizhou 563003,China)

机构地区：[1]遵义医科大学附属医院放射科,贵州遵义563003

出　　处：《遵义医科大学学报》2024年第4期392-400,共9页Journal of Zunyi Medical University

基　　金：国家自然科学基金面上项目(NO:82171919);贵州省高等学校智能医学影像工程研究中心[NO:黔教技(2023)038]。

摘　　要：目的 探讨常规MRI阴性的儿童及青少年难治性颞叶癫痫(DRTLE)脑动态功能连接(dFC)和认知改变关系。方法 对41例DRTLE和35例对照组进行韦氏儿童智力量表测评,所有受试对象均进行T_(2)-FLAIR、3D-T_(1)WI和rs-fMRI图像采集,通过独立成分分析和滑动时间窗方法,双样本t检验比较两组的dFC、时间参数指标差异,Spearman分析具有组间差异的时间参数指标与DRTLE组发病年龄、病程、发作频率和智力评分的相关性。结果 与对照组比较,DRTLE组脑dFC在4个状态差异具有统计学意义(q<0.05,FDR校正)。组间比较发现,DRTLE患者脑dFC在状态2连接减弱,状态1、3、4连接增强;时间分数和平均滞留时间均在状态1~3有差异,转换次数在组间比较未见差异;DRTLE组智力评分低于正常对照组。相关分析发现状态1的时间分数与病程呈负相关(r=-0.337,P=0.031)、平均滞留时间与病程呈正相关(r=0.401,P=0.009),状态1的平均滞留时间和言语智商、知觉推理呈负相关(r=-0.323,P=0.039;r=-0.323,P=0.040)。结论 本研究发现DRTLE存在脑dFC异常且与病程和认知功能相关,提示dFC指标变化或许可作为DRTLE认知功能改变及神经机制研究的一种潜在生物标志物。Objective To investigate the relationship between dynamic functional connectivity(dFC) and cognitive changes in children and adolescents with drug-resistant temporal lobe epilepsy(DRTLE) where conventional MRI results are negative.Methods A total of 41 DRTLE patients and 35 healthy controls underwent assessment using the Wechsler Intelligence Scale for Children and imaging with T_2-fluid attenuated inversion recovery,three-dimension T_(1) weighted imaging,and resting state functional magnetic resonance imaging.Through independent component analysis and sliding time window methods,two-sample t-tests were used to compare the differences in dFC and temporal properties between the two groups.Additionally,correlation analyses were conducted between altered temporal properties and the age at onset,duration,seizure frequency,and intelligence scores.Results Compared to the healthy control group,the patient group demonstrated statistically significant differences in dFC across four states(q< 0.05,FDR corrected).Between-group comparison:DRTLE patients exhibited weakened dFC in state 2 and increased connectivity in states 1,3,and 4;Furthermore,fraction time and mean dwell time differed between states 1-3,while the number of transitions did not differ between groups;The DRTLE group had lower intelligence scores compared to the healthy control group.Correlation analysis revealed a negative correlation between the fraction time in state 1 and the duration(r=-0.337,P=0.031),a positive correlation between mean dwell time and the duration of the disease(r=0.401,P=0.009),and negative correlations between mean dwell time in state 1 and verbal comprehension and perceptual reasoning(r=-0.323,P=0.039;r=-0.323,P=0.040).Conclusion The findings suggest that altered dynamic function connectivity in DRTLE is associated with the duration of the disease and cognitive function.Changes in dynamic brain network properties may serve as potential biomarkers for studying cognitive changes and neural mechanisms in DRTLE.

关 键 词：难治性癫痫 功能磁共振 动态脑网络 独立成分分析 滑动时间窗 

分 类 号：R742.1[医药卫生—神经病学与精神病学]