基于结构磁共振的儿童伴海马硬化内侧颞叶癫痫的脑形态学和脑连接网络研究

发布时间：2018-04-21 22:13

本文选题：结构磁共振 + 脑灰质体积　；参考：《深圳大学》2017年硕士论文

【摘要】：目的:内侧颞叶癫痫(mesial temporal lobe epilepsy,MTLE)是一种常见的难治性癫痫,其中海马硬化(hippocampal sclerosis,HS)被认为是引发MTLE最常见的因素。伴海马硬化的内侧颞叶癫痫(mesial temporal lobe epilepsy with hippocampal sclerosis,MTLE-HS)的长期发作引起患者相关脑结构的变化,对患者大脑发育将造成严重的影响,甚至引起患者记忆空间分辨等功能缺陷。因此,研究MTLE-HS患者的脑结构变化对了解MTLE-HS的内在病理机制很有意义。方法:我们收集13例左侧伴海马硬化的内侧颞叶癫痫(left mesial temporal lobe with hippocampal sclerosis,LMTLE-HS)、6例右侧伴海马硬化的内侧颞叶癫痫(right mesial temporal lobe with hippocampal sclerosis,RMTLE-HS)的儿童患者,和20例性别比例、年龄无显著差异的健康儿童的T1加权三维磁化强度预备梯度回波序列磁共振图像。我们采用基于体素的形态学方法(voxel-based morphology,VBM),、基于表面的形态学方法(surface-based morphology,SBM),和基于图论(graph-based theory)的脑网络连接方法分别对LMTLE-HS/RMTLE-HS的灰质体积、皮层厚度和结构网络进行统计分析,然后对以上相关形态学参数进行组间比较,分析患儿相对于正常儿童的形态学异常。结果:VBM研究发现,LMTLE-HS在左侧海马旁回、杏仁核、颞中回、颞上回、额中回和双侧小脑等区域均表现出灰质体积增大,在同侧中央后回等区域表现出灰质体积萎缩。RMTLE-HS在同侧海马旁回、额中回和顶下回表现出灰质体积增大,并且在对侧额叶、中央前回和顶上小叶表现灰质体积萎缩。SBM研究发现,LMTLE-HS组在左侧额中回的皮层厚度变薄,右侧颞下回的皮层厚度变厚。RMTLE-HS组在左侧顶叶腹侧、额中回、额上回、矩状皮层、右侧顶上回、枕叶腹侧、中央后回和中央旁回、顶后回、中央后回皮层厚度变薄。脑结构网络分析发现,LMTLE-HS/RMTLE-HS组的小世界属性,网络属性和网络稳定性都遭到破坏,表现出较低的聚类属性、较长的最短路径长度、较低的全局效率和局部效率,并且在面对外来随机和目的边、节点攻击时表现出较低的网络稳定性。结论:MTLE-HS患者的形态学结构表现异常,脑网络拓扑结构遭到破坏,LMTLE-HS和RMTLE-HS表现出不同的形态学结构和脑拓扑网络。本研究从脑形态学和脑连接网络层面上揭示了MTLE-HS的异常变化,为理解MTLE-HS的内在病理机制提供了重要信息。
[Abstract]:Aim: mesial temporal lobe epilepsysyn (MTL) is a common intractable epilepsy, among which Hippocampal sclerosisHSs is considered to be the most common cause of MTLE. The long-term seizure of mesial temporal lobe epilepsy with hippocampal hippocampal LE-HS) in the medial temporal lobe with hippocampal sclerosis may cause changes in the related brain structure of the patients, which will have a serious effect on the development of the patients' brain, and even lead to functional defects such as spatial resolution of memory in the patients. Therefore, it is important to study the changes of brain structure in patients with MTLE-HS in order to understand the underlying pathological mechanism of MTLE-HS. Methods: thirteen cases of left mesial temporal lobe with hippocampal hippocampal LLE-HSN with left hippocampal sclerosis were collected from 13 children with right mesial temporal lobe with hippocampal sclerosism RMTLE-HSM, and 20 cases with sex ratio. There was no significant age difference in T 1 weighted 3 D magnetization pregradient echo sequence MRI in healthy children. The volume of gray matter, the thickness of cortex and the structure network of LMTLE-HS/RMTLE-HS were statistically analyzed using voxel-based morphology-based morphology-based morphology-based morpholog@@ Then the morphological parameters above were compared among groups to analyze the morphological abnormalities of children compared with normal children. Results in the VBM study, LMTLE-HS showed increased gray matter volume in the left parahippocampal gyrus, amygdaloid nucleus, middle temporal gyrus, superior temporal gyrus, middle frontal gyrus and bilateral cerebellum. In the ipsilateral posterior central gyrus, the volume of gray matter atrophied. RMTLE-HS was found in the ipsilateral parahippocampal gyrus, and the middle frontal gyrus and inferior parietal gyrus showed increased gray matter volume, and in the contralateral frontal lobe. The volume atrophy of gray matter in precentral gyrus and superior parietal lobule. SBM study showed that the cortex thickness of left middle frontal gyrus was thinned in LMTLE-HS group, and the thickness of right inferior temporal gyrus was thicker. RMTLE-HS group was in left parietal lobe ventral side, middle frontal gyrus, superior frontal gyrus, moment cortex. Right superior parietal gyrus, ventral occipital lobe, posterior central gyrus and paracentral gyrus, posterior parietal gyrus, posterior central gyrus cortical thickness thinning. The analysis of brain structure network found that the small world attribute, network attribute and network stability of LMTLE-HSR / RMTLE-HS group were destroyed, showing lower clustering attribute, longer shortest path length, lower global efficiency and local efficiency. In the face of external random and destination side, node attack shows low network stability. Conclusion the morphological structure of the patients with brain network is abnormal, and the topological structure of brain network is damaged. LMTLE-HS and RMTLE-HS show different morphological structure and brain topological network. This study revealed the abnormal changes of MTLE-HS in brain morphology and brain junction network and provided important information for understanding the underlying pathological mechanism of MTLE-HS.
【学位授予单位】：深圳大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R742.1

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