fMRI联合VBM在评价颞叶癫痫警觉功能及脑结构异常的作用研究

发布时间：2018-06-26 04:21

本文选题：颞叶癫痫 + 警觉功能　；参考：《广西医科大学》2017年硕士论文

【摘要】：目的结合行为学测试,运用联合任务态功能磁共振(f MRI)和基于体素的形态学研究(VBM)的方法,探讨颞叶癫痫患者警觉功能及脑结构的损害特点及其关系。方法颞叶癫痫患者(癫痫组)21例,正常人(健康对照组)19例,均予行为学练习和测试,并进行警觉功能的任务态f MRI和3D结构像的扫描。行为学数据采用数据采用SPSS16.0软件统计分析,磁共振数据采用SPM8、Rest1.8软件统计分析。结果1、注意网络测试中TLE组双重暗示平均反应时间(638.03±78.81ms)显著长于健康对照组(584.26±88.33 ms),差异有统计学意义(t=2.035,P0.05),而警觉网络效应反应时间(RT)两组并无差异(t=0.011,P0.05)。2、任务态f MRI中警觉网络组内及组间分析:(1)健康对照组警觉效应激活脑区主要为右顶叶、右额叶、双侧颞叶,双侧枕叶、小脑等脑区激活(P0.05)。(2)TLE患者组其主要激活脑区为双侧的颞叶、右额叶、左枕叶,但总体激活的强度和范围较对照组小,且小脑、顶叶未见明显激活(P0.05)(3)组间分析两样本t检验:TLE患者组较健康对照组在右顶叶(顶下小叶)、右枕叶、小脑、左颞叶的激活明显下降(P0.05,Alphasim校正,体素152)3、VBM组间分析结果显示TLE患者组较健康对照组在右岛叶、右颞叶、右侧嗅皮层以及左颞叶、左侧楔前叶、距状回等脑区灰质体积明显减少。(P0.05,Alphasim校正,体素228)4、右侧顶下小叶与警觉网络效应RT呈中等程度负相关关系(r=-0.449,p0.05),其余脑区相关分析未见有统计学意义。结论1、颞叶癫痫患者警觉网络脑区的激活明显下降,具有右侧偏性,可能是TLE患者警觉功能下降的基础。2、右顶叶(顶下小叶)是警觉脑功能网络中的一个重要节点。3、TLE患者灰质减少的脑区主要集中在内侧颞叶的海马旁回,以及颞叶以外的右额叶嗅皮层、左枕叶的距状回、左楔叶等。4、警觉激活下降的区域主要为内侧颞叶以远端的顶枕叶为主,而VBM下降的区域以颞叶及其邻近的额叶为主。二者大部分不重叠。
[Abstract]:Objective to investigate the characteristics and relationship between alertness and brain structure in patients with temporal lobe epilepsy by means of combined task state functional magnetic resonance imaging (fMRI) and voxel based morphologic study (VBM). Methods Twenty one patients with temporal lobe epilepsy (epileptic group) and 19 normal subjects (healthy control group) were examined with behavioral exercises and tests, and the task-based fMRI and 3D structural images of alertness were performed. The behavioral data were analyzed by SPSS 16.0 software, and the magnetic resonance data by SPM8 / Rest1.8 software. Results 1. The average response time (638.03 卤78.81ms) of the TLE group was significantly longer than that of the healthy control group (584.26 卤88.33 ms), while the alert network response time (RT) was not different between the two groups (t 0.011 P 0.05). Intra-group and inter-group analysis: (1) the right parietal lobe was the main brain area activated by alerting effect in healthy control group. In the right frontal lobe, bilateral temporal lobe, bilateral occipital lobe, and cerebellar area activation (P0.05). (2), the main activation areas were bilateral temporal lobe, right frontal lobe, left occipital lobe, but the overall activation intensity and range were smaller than those in the control group. There was no significant activation in the parietal lobe (P0.05) (3) the activation of the right parietal lobe, the right occipital lobe, the cerebellum and the left temporal lobe was significantly decreased (P0.05 Alphasim correction) in the TLE group compared with the healthy control group. The volume of gray matter in the right insular lobe, the right temporal lobe, the right olfactory cortex and the left temporal lobe, the left anterior cuneate lobe and the talar gyrus were significantly decreased in the TLE group than in the healthy control group. The correlation between right inferior parietal lobule and alert network effect RT was negatively correlated (r = -0.449, p 0.05). No significant correlation was found in other brain regions. Conclusion 1. The activation of the alert network area in patients with temporal lobe epilepsy was significantly decreased, and the right side of the brain was deviated. The right parietal lobe (inferior parietal lobule) is an important node in the alerting brain function network. The decreased gray matter of TLE patients is mainly concentrated in the parahippocampal gyrus of the medial temporal lobe. Besides, the olfactory cortex of the right frontal lobe, the talus gyrus of the left occipital lobe, the left cuneiform lobe, etc. 4. The medial temporal lobe with the distal parietal occipital lobe, the medial temporal lobe with the medial temporal lobe, and the region with VBM decreased mainly in the temporal lobe and its adjacent frontal lobe. Most of the two do not overlap.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.2;R742.1

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