海马硬化型颞叶癫痫患者脑功能活动变化与警觉功能的相关性  

Correlation between changes in brain functional activity and alertness function in temporal lobe epilepsy patients with hippocampal sclerosis

作　　者：黄华春 陈子蓉[1] 黄东莹 郑金瓯[1] Huang Huachun;Chen Zirong;Huang Dongying;Zheng Jin'ou(Department of Neurology,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,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

出　　处：《中华行为医学与脑科学杂志》2024年第9期826-832,共7页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：国家自然科学基金(81560223)。

摘　　要：目的探讨伴或不伴海马硬化的颞叶癫痫(temporal lobe epilepsy,TLE)患者异常脑功能活动及警觉功能的神经机制。方法招募2016年5月至2022年11月在广西医科大学第一附属医院神经内科诊治的21例伴有海马硬化的TLE(TLE with hippocampal sclerosis,TLE-HS)患者和18例不伴有海马硬化的TLE(TLE without hippocampal sclerosis,TLE-N)患者,同时纳入了人口学资料相匹配的28例健康对照(healthy controls,HC)。67例参与者均完成了注意网络测试(attention network test,ANT)及静息态功能磁共振(resting-state functional MRI,rs-fMRI)扫描。运用REST软件进行基于单因素方差分析的分数低频振幅(fractional amplitude of low-frequency fluctuation,fALFF)和功能连接(functional connectivity,FC)分析,获得3组间自发神经元活动和功能连接异常的差异脑区。使用SPSS 26.0软件对差异脑区的fALFF/FC值与警觉网络效率进行Pearson相关分析。结果3组间警觉网络效率值差异有统计学意义(F=4.621,P=0.013),事后分析显示TLE-HS组[(59.40±22.85)ms]的警觉网络效率值显著高于HC组[(38.85±21.08)ms](Bonferroni校正,P=0.017)。fALFF分析显示,TLE-HS组(0.16±0.52)和TLE-N组(0.49±0.51)的右侧额上回fALFF值显著低于HC组(1.01±0.46),而TLE-HS组(0.60±0.55)的左侧中央前回fALFF值显著高于TLE-N组(-0.19±0.51)及HC组(-0.15±0.36)(Bonferroni校正,均P<0.05)。功能连接分析显示,TLE-HS组(0.11±0.16)和TLE-N组(0.02±0.19)的左侧额下回与右侧额上回之间的FC值显著高于HC组(-0.18±0.18);TLE-HS组的右侧缘上回(0.10±0.21)与右侧额上回之间的FC值显著高于HC组(-0.18±0.16);TLE-HS组的左侧补充运动区(0.20±0.21)与右侧额上回之间的FC值显著高于TLE-N组(-0.03±0.31)和HC组(-0.10±0.15)(Bonferroni校正,均P<0.05)。相关分析显示,TLE-HS组左侧补充运动区与右侧额上回之间的FC值与警觉网络效率呈显著正相关(r=0.436,P=0.048)。结论伴或不伴海马硬化的TLE患者均存在异常Objective To study the neural mechanism between abnormal brain functional activity and alertness function in temporal lobe epilepsy(TLE)patients with or without hippocampal sclerosis.Methods A total of 21 TLE patients with hippocampal sclerosis(TLE-HS),and 18 TLE patients without hippocampal sclerosis(TLE-N)diagnosed in the Department of Neurology of the First Affiliated Hospital of Guangxi Medical University from May 2016 to November 2022 and 28 healthy controls(HC)matched with demographic data were recruited.All the 67 participants completed the attention network test(ANT)and resting-state fMRI(rs-fMRI)scans.The REST software was used to analyze fractional amplitude of low-frequency fluctuation(fALFF)and functional connectivity(FC)based on one-way ANOVA in order to obtain differential brain regions in abnormal spontaneous neuronal activity and functional connectivity among the three groups.The SPSS 26.0 software was used to analyze the correlation between fALFF/FC values in differential brain regions and alertness network efficiency by Pearson correlation analysis.Results There was a significant difference in the alerting network effect among the three groups(F=4.621,P=0.013),and the post-hoc analysis showed that the alerting network effect in the TLE-HS group((59.40±22.85)ms)was significantly higher than that in the HC group((38.85±21.08)ms)(Bonferroni correction,P=0.017).The fALFF analysis showed that the fALFF values of the right superior frontal gyrus in the TLE-HS group(0.16±0.52)and the TLE-N group(0.49±0.51)were significantly lower than that in the HC group(1.01±0.46),while the fALFF values of the left precentral gyrus in the TLE-HS group(0.60±0.55)was significantly higher than that in the TLE-N group(-0.19±0.51)and the HC group(-0.15±0.36)(Bonferroni correction,all P<0.05).The functional connectivity analysis revealed that the FC values between the left inferior frontal gyrus and the right superior frontal gyrus in the TLE-HS group(0.11±0.16)and TLE-N group(0.02±0.19)were significantly higher

关 键 词：颞叶癫痫 海马硬化 分数低频振幅 功能连接 警觉功能 

分 类 号：R742.1[医药卫生—神经病学与精神病学]