内侧颞叶癫痫患者静息态功能磁共振与记忆功能的相关性研究
发布时间：2018-09-17 09:42
【摘要】：【目的】 采用静息态功能磁共振（rs-fMRI）功能连接分析技术,观察不同组内侧颞叶癫痫（MTLE）患者发作间期静息态脑网络的改变，与记忆功能进行相关性分析，探讨MTLE患者记忆功能损害的机制以及内侧颞叶结构在人类记忆保持中的作用，为MTLE病人认知障碍的预防及治疗提供理论基础。 【方法】 1.13例左侧内侧颞叶癫痫（L-MTLE）患者、11例右侧内侧颞叶癫痫（R-MTLE）患者和13例正常对照组分别进行闭眼静息态脑功能成像扫描及临床记忆量表功能测评。 2.分别以左侧海马、右侧海马为种子点，比较不同侧癫痫组与正常组的脑区差异，并将临床记忆量表资料的结果与“患者VS对照”的差异脑区，做基于体素的Pearson相关性分析（p0.05，，AlphaSim校正）。 【结果】 1. MTLE各组指向记忆、联想学习、图形自由回忆、无意义图形再认、人物特点回忆及记忆商均显著低于正常组。指向记忆分值，L-MTLE组明显低于R-MTLE组；但无意义图像再认，L-MTLE组明显高于R-MTLE组，余量表分值在两组MTLE组间差异无统计学意义。 2. L-MTLE组左侧海马功能连接高于正常组的脑区：右额上回、右额中回、右颞上回、右颞下回、右楔前叶；低于正常组的脑区：右嗅皮层、右额中回、左丘脑、左中央前回、左运动前皮质、双侧颞上回。 3.R-MTLE组右侧海马功能连接高于正常组的脑区：右额中回、右额下回、右运动前皮质、左顶下小叶、左额中回、双侧脑干；低于正常组的脑区：右楔前叶、右尾状核、左距状皮层、左壳核、双侧小脑。 4.L-MTLE组左侧海马和左侧中央后回的功能连接与联想学习记忆年龄量表分呈负相关，右侧海马和左侧海马/杏仁核的功能连接与指向记忆年龄量表分、记忆商呈正相关。 5.R-MTLE组左侧海马和右侧枕中回的功能连接与指向记忆年龄量表分、记忆商呈负相关，左侧海马和左侧颞中回的功能连接与指向记忆、联想学习记忆年龄量表分呈正相关，左侧海马和左侧额下回的功能连接与图像自由回忆、无意义图形再认年龄量表分及记忆商呈正相关；右侧海马和右额中回的功能连接与图像自由回忆年龄量表分呈正相关。 【结论】 1. L-MTLE组和R-MTLE组，都存在广泛的记忆损害，但以各自优势侧的损害为主，即L-MTLE组以纯语言记忆损害为主，R-MTLE组以纯视觉记忆损害为主。 2. MTLE患者广泛的脑网络连接异常，形成癫痫网络，其分布模式可能与癫痫活动的传播有关。 3.单侧MTLE患者海马与病灶同侧的功能连接减弱，而与病灶对侧的功能连接增强，这两个显著特点提示增强与病灶对侧脑区的功能连接是其提高记忆功能的重要补偿机制之一。
[Abstract]:[objective] to observe the changes of interictal resting brain network in patients with medial temporal lobe epilepsy (MTLE) using resting functional magnetic resonance (rs-fMRI) functional connection analysis technique, and to analyze the correlation between resting brain network and memory function in patients with medial temporal lobe epilepsy. To explore the mechanism of memory impairment in patients with MTLE and the role of medial temporal lobe structure in human memory preservation. [methods] 1.Thirteen patients with left medial temporal lobe epilepsy (L-MTLE), 11 patients with right medial temporal lobe epilepsy (R-MTLE) and 13 normal controls, respectively. The function of closed eyes resting brain function imaging and clinical memory scale were evaluated. 2. Using the left hippocampus and the right hippocampus as seed points, the differences of brain regions between the different epilepsy groups and the normal group were compared, and the results of the clinical memory scale were compared with the difference of the "patient VS control". Pearson correlation analysis based on voxel (p 0.05 AlphaSim correction). [results] 1. MTLE group was significantly lower than normal group in pointing memory, associative learning, figure free recall, recognition of meaningless figure, character characteristic memory and memory quotient. The point memory score of L-MTLE group was significantly lower than that of R-MTLE group, but that of L-MTLE group was significantly higher than that of R-MTLE group. The left hippocampal functional junction in L-MTLE group was higher than that in normal group: right superior frontal gyrus, right middle frontal gyrus, right superior temporal gyrus, right infratemporal gyrus, right anterior cuneate lobe, and lower than that in normal group: right olfactory cortex, right middle frontal gyrus, left thalamus, left precentral gyrus. Left premotor cortex, bilateral superior temporal gyrus. The right hippocampal functional junction in 3.R-MTLE group was higher than that in normal group: right middle frontal gyrus, right inferior frontal gyrus, right premotor cortex, left inferior parietal lobule, left middle frontal gyrus, bilateral brain stem; The functional connections of left hippocampus and left posterior central gyrus in 4.L-MTLE group were negatively correlated with the age scale scores of associative learning and memory in the right anterior wedge, right caudate nucleus, left talus cortex, left putamen nucleus and bilateral cerebellum. The functional connections of the right hippocampus and the left hippocampus / amygdala were positively correlated with the scores of the directed memory age scale and the memory quotient. In 5.R-MTLE group, the functional connections between the left hippocampus and the right middle occipital gyrus were negatively correlated with the scores of the directed memory age scale and the memory quotient. The functional connections of left hippocampus and left middle temporal gyrus were positively correlated with directed memory, associative learning and memory age scale scores, and the functional connections between left hippocampus and left inferior frontal gyrus were associated with image free recall. The scores of age scale and memory quotient were positively correlated, and the functional connections of right hippocampus and right middle frontal gyrus were positively correlated with the score of age scale of image free recall. [conclusion] 1. There were extensive memory impairment in L-MTLE group and R-MTLE group, but mainly in their dominant side, that is, pure language memory damage in L-MTLE group and pure visual memory impairment in R-MTLE group. 2. MTLE patients have extensive abnormal connections of brain network to form epileptic network, its distribution pattern may be related to the spread of epileptic activity. 3. 3. The functional connections between the hippocampus and the ipsilateral side of the lesion were weakened and the contralateral functional connections were enhanced in patients with unilateral MTLE. These two significant features suggest that the enhancement of the functional connections with the contralateral brain regions is one of the important compensatory mechanisms for improving the memory function of the patients with unilateral MTLE.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R742.1
本文编号：2245476
[Abstract]:[objective] to observe the changes of interictal resting brain network in patients with medial temporal lobe epilepsy (MTLE) using resting functional magnetic resonance (rs-fMRI) functional connection analysis technique, and to analyze the correlation between resting brain network and memory function in patients with medial temporal lobe epilepsy. To explore the mechanism of memory impairment in patients with MTLE and the role of medial temporal lobe structure in human memory preservation. [methods] 1.Thirteen patients with left medial temporal lobe epilepsy (L-MTLE), 11 patients with right medial temporal lobe epilepsy (R-MTLE) and 13 normal controls, respectively. The function of closed eyes resting brain function imaging and clinical memory scale were evaluated. 2. Using the left hippocampus and the right hippocampus as seed points, the differences of brain regions between the different epilepsy groups and the normal group were compared, and the results of the clinical memory scale were compared with the difference of the "patient VS control". Pearson correlation analysis based on voxel (p 0.05 AlphaSim correction). [results] 1. MTLE group was significantly lower than normal group in pointing memory, associative learning, figure free recall, recognition of meaningless figure, character characteristic memory and memory quotient. The point memory score of L-MTLE group was significantly lower than that of R-MTLE group, but that of L-MTLE group was significantly higher than that of R-MTLE group. The left hippocampal functional junction in L-MTLE group was higher than that in normal group: right superior frontal gyrus, right middle frontal gyrus, right superior temporal gyrus, right infratemporal gyrus, right anterior cuneate lobe, and lower than that in normal group: right olfactory cortex, right middle frontal gyrus, left thalamus, left precentral gyrus. Left premotor cortex, bilateral superior temporal gyrus. The right hippocampal functional junction in 3.R-MTLE group was higher than that in normal group: right middle frontal gyrus, right inferior frontal gyrus, right premotor cortex, left inferior parietal lobule, left middle frontal gyrus, bilateral brain stem; The functional connections of left hippocampus and left posterior central gyrus in 4.L-MTLE group were negatively correlated with the age scale scores of associative learning and memory in the right anterior wedge, right caudate nucleus, left talus cortex, left putamen nucleus and bilateral cerebellum. The functional connections of the right hippocampus and the left hippocampus / amygdala were positively correlated with the scores of the directed memory age scale and the memory quotient. In 5.R-MTLE group, the functional connections between the left hippocampus and the right middle occipital gyrus were negatively correlated with the scores of the directed memory age scale and the memory quotient. The functional connections of left hippocampus and left middle temporal gyrus were positively correlated with directed memory, associative learning and memory age scale scores, and the functional connections between left hippocampus and left inferior frontal gyrus were associated with image free recall. The scores of age scale and memory quotient were positively correlated, and the functional connections of right hippocampus and right middle frontal gyrus were positively correlated with the score of age scale of image free recall. [conclusion] 1. There were extensive memory impairment in L-MTLE group and R-MTLE group, but mainly in their dominant side, that is, pure language memory damage in L-MTLE group and pure visual memory impairment in R-MTLE group. 2. MTLE patients have extensive abnormal connections of brain network to form epileptic network, its distribution pattern may be related to the spread of epileptic activity. 3. 3. The functional connections between the hippocampus and the ipsilateral side of the lesion were weakened and the contralateral functional connections were enhanced in patients with unilateral MTLE. These two significant features suggest that the enhancement of the functional connections with the contralateral brain regions is one of the important compensatory mechanisms for improving the memory function of the patients with unilateral MTLE.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R742.1
【参考文献】
相关博士学位论文 前1条
1 彭炳蔚;内侧颞叶癫痫与记忆关系及影响因素的研究[D];中国协和医科大学;2008年
本文编号：2245476
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