颞叶癫痫患者前额叶背外侧的定量质子磁共振波谱研究

发布时间：2018-01-02 04:07

本文关键词：颞叶癫痫患者前额叶背外侧的定量质子磁共振波谱研究　出处：《放射学实践》2016年03期 　论文类型：期刊论文

【摘要】：目的:利用氢质子磁共振波谱(1 H-MRS)研究颞叶癫痫(TLE)患者前额叶背外侧区(DLPFC)的生化改变,探讨额叶在TLE发病代谢机制中的作用。方法:纳入TLE患者(TLE组)及健康志愿者(健康对照组)各20例。根据24h视频脑电图(VEEG)所提示致痫灶所在部位将TLE组分为左侧TLE亚组及右侧TLE亚组。利用单体素1 H-MRS点分辨波谱序列(PRESS)进行扫描,并采用LCModel软件进行后处理,获取所有被试者双侧DLPFC区氮乙酰天门冬氨酸(NAA)、肌酸(Cr)、胆碱(Cho)、肌醇(Ins)及谷氨酸/谷氨酰胺复合物(Glx)的绝对浓度。然后分别对比健康对照组及TLE患者左侧DLPFC区与右侧DLPFC区、健康对照组与TLE患者同侧DLPFC区之间各代谢物浓度的差异。结果:健康对照组左右侧DLPFC区NAA浓度分别为(7.24±0.57)mmol/L、(6.76±0.87)mmol/L,左侧NAA浓度显著高于右侧(P=0.024);而TLE患者上述NAA不对称性消失,左右侧NAA浓度分别为(6.58±0.56)mmol/L、(6.31±0.62)mmol/L(P=0.092)。与健康对照相比,TLE患者左侧DLPFC区NAA、Cr及Ins浓度显著降低(P=0.000、0.014、0.025),右侧DLPFC区仅Ins浓度显著降低(P=0.013),而Cho、Glx浓度在左右侧DLPFC区均无显著改变。分层分析进一步揭示左侧TLE亚组的左侧DLPFC区NAA、Cr及Ins浓度较对照组显著降低(P=0.001、0.047、0.007),右侧DLPFC区Ins浓度较对照组显著降低(P=0.002);而右侧TLE组仅有左侧DLPFC区NAA浓度显著降低(P=0.037)。结论:颞叶癫痫患者的额叶也存在生化代谢异常,且以左侧额叶改变为主,说明额叶在TLE发病的代谢机制中可能起着重要作用。
[Abstract]:Objective: to study the biochemical changes of DLPFC in the dorsolateral prefrontal area of patients with temporal lobe epilepsy (TLEs) by 1H-MRS. To explore the role of frontal lobe in the pathogenesis and metabolism of TLE. Methods: twenty patients with TLE and 20 healthy volunteers (healthy control group) were included in the study. The results suggested that the TLE group was divided into the left TLE subgroup and the right TLE subgroup where the epileptogenic foci were located. The monosome 1H-MRS point-resolved spectral sequence was used for scanning. After processing with LCModel software, all the subjects were obtained from the bilateral DLPFC region, including NAA, creatine, choline and aspartate. The absolute concentrations of inositol (Ins) and glutamate / glutamine complex (Glx) were compared between the left DLPFC region and the right DLPFC area in the healthy control group and the TLE patients. Results: the concentration of NAA in the left and right DLPFC region of the healthy control group was 7.24 卤0.57, respectively. Mmol/L. The concentration of NAA in the left side was significantly higher than that in the right side (6.76 卤0.87 mmol / L). The asymmetry of NAA disappeared in the patients with TLE, and the NAA concentration on the left and right side was 6.58 卤0.56 mmol / L, respectively. The left DLPFC area NAA of TLE patients was 6.31 卤0.62mmol / L, 0.092mmol / L, compared with that of healthy controls. The concentrations of Cr and Ins decreased significantly (P < 0.05), while the concentration of Ins in the right DLPFC region decreased significantly (P < 0.05), while that in the right DLPFC region decreased significantly (P < 0.05). There was no significant change in the concentration of Glx in the left and right DLPFC regions. The delamination analysis further revealed the NAA in the left DLPFC region of the left TLE subgroup. Compared with the control group, the concentrations of Cr and Ins were significantly lower than those of the control group. The concentration of Ins in the right DLPFC region was significantly lower than that in the control group, and the Ins concentration in the right DLPFC region was significantly lower than that in the control group. In the right TLE group, the concentration of NAA in the left DLPFC area was significantly decreased by 0.0370.Conclusion: the frontal lobe of the patients with temporal lobe epilepsy also has abnormal biochemical metabolism, and the left frontal lobe is the main change. It suggests that frontal lobe may play an important role in the metabolic mechanism of TLE.
【作者单位】：四川大学华西医院放射科磁共振研究中心;四川大学华西医院神经内科;
【基金】：国家自然科学基金面上项目(81371528)
【分类号】：R445.2;R742.1
【正文快照】： 【推荐理由】该文用磁共振波谱(MRS)研究了颞叶癫痫患者双侧前额叶背外侧区(DLPFC)的神经生化改变,并对各代谢物的生理意义及其在颞叶癫痫发病机制中的可能作用进行了初步的探讨,得到了很有价值的结论。文章具有以下特点:1研究具有创新性。既往已有不少研究表明颞叶癫痫患者在

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