基于磁共振的癫痫脑功能和结构异常的研究

发布时间：2018-10-17 13:34

【摘要】：癫痫,即俗称的“羊角风”,是一种常见的危害性极大的神经系统疾病。其中,特发性全面性癫痫(IGE)以全面癫痫发作为特征,在EEG上存在广泛分布的尖峰波和不可检测的局灶性大脑解剖学异常,其发病机制除与遗传因素有密切关系外,暂无其他可识别的原因。全面强直-阵挛发作癫痫(GTCS)作为IGE最常见的亚型,患者发作时呈现剧烈的抽搐,导致癫痫患者出现认知功能损伤,例如注意,记忆和语言功能异常。虽然在过去数十年中作出了巨大努力,但GTCS患者自发神经元功能组织的改变还需要进一步去探索。因此,本研究引入了基于功能连接密度(FCD)的脑功能分析方法和基于纤维束示踪的空间统计(TBSS)的脑结构分析方法来探测癫痫引起的脑功能和脑结构异常变化的特征。研究发现IGE-GTCS患者在小脑前叶和感觉运动区域出现功能连接密度的显著升高,而在颞中回、颞下回、前额叶皮质和顶下小叶等区域的功能连接密度出现了明显的下降,同时也检测到这些异常的功能连接密度与病人的病程具有一定的相关性。结构变化方面,基于体素的统计结果显示IGE-GTCS患者在五个脑区出现各向异性分数(FA)的显著降低,分别为胼胝体膝部、胼胝体体部、左侧前辐射冠、右侧前辐射冠以及右侧后辐射冠。同时,这些异常的结构变化均与病程有显著负相关。此外,观测到的功能连接密度异常已被推测与IGE-GTCS患者长期遭受社会认知功能、神经心理、运动控制等损伤有关,因而本研究为IGE-GTCS的神经病理生理机制提供了新的证据。
[Abstract]:Epilepsy, commonly known as "sheep horn wind", is a common harmful nervous system disease. Among them, idiopathic generalized epilepsy (IGE) is characterized by full-scale epileptic seizures. There are widely distributed spike waves and undetectable focal cerebral anatomical abnormalities on EEG. The pathogenesis of idiopathic generalized epilepsy is closely related to genetic factors. There are no other identifiable causes for the time being. As the most common subtype of IGE, the generalized tonic-clonic seizure (GTCS) presents severe convulsions, resulting in cognitive impairment, such as attention, memory and language dysfunction. Although great efforts have been made in the past decades, the functional changes of spontaneous neurons in patients with GTCS need to be further explored. Therefore, in this study, the brain function analysis method based on functional junction density (FCD) and spatial statistical (TBSS) based on fiber tracer (TBSS) were introduced to detect the characteristics of abnormal changes in brain function and structure caused by epilepsy. The study found that the density of functional junctions increased significantly in the anterior lobe and sensorimotor region of the cerebellum in IGE-GTCS patients, but decreased significantly in the middle temporal gyrus, inferior temporal gyrus, prefrontal cortex and subparietal lobules. At the same time, it was found that the abnormal density of functional connection was correlated with the course of disease. In terms of structural changes, voxel based statistics showed that anisotropy fraction (FA) decreased significantly in five brain regions of IGE-GTCS patients, namely the genu of corpus callosum, left anterior radiating corona. Right anterior radiation crown and right posterior radiation crown. At the same time, the structural changes of these abnormalities were negatively correlated with the course of disease. In addition, the observed abnormal density of functional connections has been speculated to be related to the long-term social cognitive function, neuropsychological, motor control and other injuries in patients with IGE-GTCS, so this study provides new evidence for the neuropathophysiological mechanism of IGE-GTCS.
【学位授予单位】：电子科技大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.2;R742.1

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