基于脑表面形态学分析对特发性全面性癫痫的初步研究

发布时间：2018-04-10 05:12

本文选题：癫痫　切入点：特发性　出处：《遵义医学院》2014年硕士论文

【摘要】：目的：应用FreeSurfer软件基于脑表面形态学的分析方法，初步研究特发性全面性癫痫患者脑皮层形态学（全脑皮层厚度、表面面积、体积）的微观结构改变，探讨这种新技术对特发性全面性癫痫的应用价值，并分析异常脑区与临床变量（病程、发病起始年龄）的相关性。方法：收集2011年3月至2013年9月遵义医学院附属医院门诊及住院特发性全面性癫痫患者16例（经高年资神经内科及儿科医师按照2005年国际抗癫痫联盟诊断癫痫和癫痫综合征的标准进行筛选），男6例，，女10例，同时招募16例健康志愿者作为对照组，两组性别、年龄、教育程度及利手相匹配。所有受试对象采用西门子公司3.0T Trio A Tim超导MR扫描仪进行常规序列和高分辨率3D-T1WI结构像。皮层厚度、表面面积及体积的分析采用FreeSurer软件，采用一般线性模型进行分析；年龄及性别作为协变量，设P0.05为两组差异脑区有统计学意义。采用SPSS17.0软件分析异常脑区与临床变量（病程及发病起始年龄）的相关性。本实验得到遵义医学院伦理委员会的批准，受试者均被告知相应的权利和义务，并征得本人及家属同意并签署参与研究的知情同意书。结果：患者组与对照组性别、年龄、受教育程度均无统计学差异（P值分别为1.000、0.960、0.084）。与正常对照组相比，患者组脑形态学改变为：右颞中回皮层变薄（P=0.0109），左脑未见异常脑区。左颞中回表面积减小（P=0.0003）；左额下回中部（P=0.0002）、左外侧枕叶（P=0.0436）、右岛叶（P=0.0007）表面积增大；左颞上回（P=0.0119）体积减小，右大脑体积未见异常脑区。上述异常脑区与患者病程、发病起始年龄无相关性（P0.05）。其中，皮层厚度异常脑区（右颞中回）与病程的相关分析P值（P=0.06）接近于0.05。结论：本研究发现IGE皮层厚度、表面面积及体积多个脑区异常，反映了IGE的微观结构形态学的变化，为IGE潜在的神经病理、解剖学的变化以及病理生理机制的理解提供影像学依据。
[Abstract]:Objective: to study the microstructural changes of cerebral cortex morphology (whole cerebral cortex thickness, surface area, volume) in patients with idiopathic comprehensive epilepsy using FreeSurfer software.To explore the application value of this new technique in idiopathic comprehensive epilepsy, and to analyze the correlation between abnormal brain area and clinical variables (course of disease, onset age of onset).Methods: from March 2011 to September 2013, 16 patients with idiopathic comprehensive epilepsy were collected from the affiliated Hospital of Zunyi Medical College.The criteria for epilepsy syndrome were selected, 6 cases of male, 6 cases of epileptic syndrome,Ten women and 16 healthy volunteers were recruited as control group. The sex, age, education level and handy hand of the two groups were matched.All subjects were examined by Siemens 3.0T Trio A Tim superconducting Mr scanner for conventional sequences and high-resolution 3D-T1WI structure images.The cortical thickness, surface area and volume were analyzed by FreeSurer software and general linear model. Age and sex were covariables.The correlation between abnormal brain area and clinical variables (course of disease and onset age) was analyzed by SPSS17.0 software.This experiment was approved by the Ethics Committee of Zunyi Medical College. The subjects were informed of their rights and obligations and signed the informed consent to participate in the study with the consent of themselves and their families.Results: there was no significant difference in sex, age and education level between the patients group and the control group (P = 1.0000.960,0.084).Compared with the normal control group, the morphologic changes of the brain in the patients group were as follows: the cortex of the right middle temporal gyrus was thinning and the left brain was not abnormal.The surface area of left middle temporal gyrus decreased (P = 0.0003), while that of left inferior frontal gyrus was 0.0002, and that of left lateral occipital lobe was increased (P = 0.0436, P = 0.0007), and the volume of left superior temporal gyrus (P = 0.0119) was decreased, and no abnormal brain area was found in right cerebrum.There was no correlation between the above abnormal brain area and the course of disease and onset age (P 0.05).The correlation between abnormal cortical thickness (right middle temporal gyrus) and course of disease (P = 0.06) was close to 0.05.Conclusion: in this study, the cortical thickness, surface area and volume of IGE were found to be abnormal, which reflected the microstructural and morphological changes of IGE and was a potential neuropathology of IGE.Anatomical changes and understanding of pathophysiological mechanisms provide imaging evidence.
【学位授予单位】：遵义医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R742.1

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