应用功能磁共振成像研究单侧颞叶癫痫患者警觉功能的影响因素

发布时间：2018-04-04 06:41

本文选题：颞叶癫痫　切入点：静息态功能磁共振　出处：《临床放射学杂志》2017年05期

【摘要】：目的应用静息态功能磁共振成像(f MRI)和神经心理学方法探讨颞叶癫痫(TLE)患者警觉网络损害及其相关影响因素。方法分析44例单侧TLE患者和32名健康对照者的静息态f MRI数据、注意网络测试结果,搜集患者的临床资料,并对左侧颞叶癫痫(LTLE)患者、右侧颞叶癫痫(RTLE)患者与健康对照组的警觉相关网络进行组内分析及组间比较,提取TLE患者背外侧前额叶脑区功能连接Z值作为因变量,以相关影响因素作为自变量,进行多因素线性回归分析。结果 TLE组警觉网络相关脑区连接强度较对照组降低,LTLE与RTLE比较左侧海马功能连接减低。TLE组与对照组相比,固有警觉反应时间增加(t=3.198,P=0.002),位相性警觉反应时间增加(t=3.995,P=0.000),警觉反应时间减少(t=-2.983,P=0.004),差异均有统计学意义(P0.05)。多因素线性回归分析显示,不同的发作类型和脑电图痫性放电为影响TLE患者警觉功能的原因。结论 TLE患者存在警觉网络损害,固有警觉和位相性警觉均存在损害,发作类型和痫性放电与警觉功能损害有关。
[Abstract]:Objective to investigate the impairment of alertness network in patients with temporal lobe epilepsy (TLEs) by resting functional magnetic resonance imaging (MRI) and neuropsychology.Methods the rest f MRI data of 44 patients with unilateral TLE and 32 healthy controls were analyzed. The results of network test were observed, the clinical data were collected, and the patients with left temporal lobe epilepsy were studied.Intra-group analysis and inter-group comparison were performed between patients with right temporal lobe epilepsy and healthy controls. Z values of functional connections in dorsolateral prefrontal cortex were extracted from patients with TLE as dependent variables, and correlation factors were used as independent variables.Multivariate linear regression analysis was performed.Results in TLE group, the connection intensity of alerting network related brain area was lower than that of control group. The left hippocampal functional junction was lower in TLE group than in RTLE group.The inherent alertness reaction time increased, the positional alertness reaction time increased, and the alert reaction time decreased. The difference was statistically significant (P 0.05).Multivariate linear regression analysis showed that different seizure types and EEG epileptic discharges were the reasons for the alertness of TLE patients.Conclusion there is network damage in patients with TLE, both inherent alertness and positional alertness are related to the impairment of alertness function. The type of seizure and epileptic discharge are related to the impairment of alertness function.
【作者单位】：广西医科大学第一附属医院神经内科;广西医科大学第一附属医院放射科;
【基金】：国家自然科学基金资助项目(编号:81360202) 广西自然科学基金项目(编号2015jj AA40009)
【分类号】：R445.2;R742.1

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