基于癫痫患者立体定向脑电图皮层电刺激的岛叶功能研究

发布时间：2018-02-11 17:49

本文关键词： 岛叶癫痫立体定向脑电图颅内电极皮层电刺激　出处：《山西医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:岛叶被称为第五脑叶,解剖位置隐蔽,参与的功能和网络复杂,涉及岛叶的癫痫病人症状学表现多样化,国内外至今为止有多种方法研究其结构、功能和网络。本文通过回顾性分析40例癫痫患者SEEG皮层电刺激资料来研究岛叶的功能和解剖,探讨各岛回在癫痫症状产生或相关致痫网络中的作用。方法:回顾性分析2014.4~2016.5在清华大学玉泉医院癫痫中心行了立体定向脑深部电极置入术,筛选出在岛叶置入电极的40例病人皮层电刺激资料。将病人置入电极后的头颅CT与术前MRI图像进行配准融合并三维重建MRI结构像,对每个电极触点进行精确定位。在相邻电极触点进行双相方波刺激,刺激参数为频率50Hz,波宽0.3ms,刺激强度0.2-3mA,时间为5s。进一步对皮层电刺激结果按性质和部位归类。结果:40例病人中,位于岛叶的电极触点数为220个,电刺激有反应数为106个,反应率为48.2%。将电刺激反应的症状(除外发作先兆和后放电)按性质分为躯体感觉、听幻觉、疼痛觉、植物神经症状、味觉、口咽部症状及其它。躯体感觉主要见于岛中央后回,听幻觉常见于后长回和岛中央后回的后缘,疼痛觉分布较分散,植物神经症状主要见于岛极,口咽部症状只见于岛中央前回。结论:通过对置入岛叶的颅内深部电极皮层电刺激产生的症状及分布的特征的分析,有助于对岛叶的解剖及功能的理解,有助于评价各个岛回在癫痫症状产生或相关致痫网络中的作用。同时也说明立体定向脑深部电极置入在怀疑涉及岛叶的癫痫病人评估中的重要作用。
[Abstract]:Objective: the insular lobe is known as the 5th lobes of the brain. Its anatomical location is concealed, its function and network are complex, the symptomatic manifestations of epileptic patients involved in the insular lobe are diversified, and there are many methods to study its structure at home and abroad. Function and network. The function and anatomy of the insular lobe were studied by retrospectively analyzing the data of SEEG electrical stimulation in 40 patients with epilepsy. Objective: to explore the role of the gyrus of each island in the epileptic symptom generation or associated epileptic network. Methods: stereotactic deep brain electrode implantation was performed in the epileptic center of Yuquan Hospital, Tsinghua University, on June 6, 2014. Cortical electrical stimulation data were selected from 40 patients who were implanted with electrodes in the insular lobe. The CT images were registered with preoperative MRI images, and 3D MRI images were reconstructed. Accurate location of each electrode contact. Biphasic square wave stimulation at adjacent electrode contact, The stimulation parameters were frequency 50 Hz, wave width 0.3 Ms, stimulation intensity 0.2-3 Ma, time 5 s. Further, the results of cortical electrical stimulation were classified according to their properties and locations. Results in 40 patients, the number of electrode contacts located in the insular lobe was 220, and the number of responsive electrical stimuli was 106. The response rate was 48.2%. The symptoms of electrical stimulation (excluding onset precursor and post-discharge) were divided into somatosensory, auditory hallucination, pain sensation, autonomic nerve symptom, taste sensation, oropharyngeal symptom and others according to their properties. Somatosensory symptoms were mainly found in the posterior central gyrus of the island. Auditory hallucinations were common in the posterior margin of the posterior long gyrus and the posterior central gyrus of the island. Conclusion: it is helpful to understand the anatomy and function of the island by analyzing the characteristics of the symptoms and distribution of the electrical stimulation of the deep intracranial electrode in the precentral part of the island. It is helpful to evaluate the role of each island gyrus in the generation of epilepsy symptoms or associated epileptic network. It also shows the important role of stereotactic deep brain electrode placement in the evaluation of epileptic patients suspected to be involved in the insular lobe.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R651.1

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