【摘要】 目的应用静息态功能MRI(rs-f MRI)功能连接方法(FC)研究无灶性癫痫(NLE)的脑功能改变,探论FC对NLE的应用价值。加深对NLE病理生理机制的理解,为其诊断及治疗提供可靠的理论依据。材料与方法对43例NLE患者和46例性别、年龄、教育程度及利手相匹配的健康志愿者(对照组),采用3.0 T超导MR扫描仪进行静息态功能序列扫描,然后将病例组与对照组分别进行FC分析,再对ALFF分析结果进行两样本t检验分析,并分析FC统计脑图与病程的相关性。结果与正常对照组相比,病例组右侧海马FC增加的脑区位于右颞上回、左颞下回、双颞中回、双前额内侧回,右额中回;左侧海马FC增加的脑区位于双颞上回、左海马旁回、左额叶、右前额内侧回、左顶下小叶、右中央后回。右侧海马FC降低的脑区位于左内囊膝、左顶下小叶、右扣带回、左额上回、左额叶;左侧海马降低的脑区位于右小脑后叶、左小脑前叶、右颞上回、右丘脑。病例组右侧海马FC病程正相关的脑区位于:左额下回、左颞下回、左颞上回、右额叶、右楔前叶、右顶叶、右顶下小叶、右额中回;左侧海马FC与病程正相关的脑区位于左舌回、双额中回、左顶下小叶、右中央后回。病例组右侧海马FC与病程呈负相关的脑区位于左小脑前叶、左内囊膝;病例组左侧海马FC与病程负相关的脑区位于左小脑扁桃体、左额上回、右颞上回、左楔前叶。结论 ALFF和FC方法可作为一种无创的脑功能研究方法,能检测出NLE静息态脑功能变化,了解与临床变量(病程)的相关性,为癫痫的病理生理机制研究提供可靠的理论依据。更多还原

【Abstract】 Objective: To study the cerebral function change of nonlesional epilepsy(NLE) patients by resting state functional magnetic resonance imaging(rs-f MRI) amplitude of functional connectivity(FC) technique, discussing application value of FC for NLE. To improve the understanding of its pathophysiological mechanisms. Providing the reliable theoretical basis for the diagnosis and treatment of NLE. Materials and Methods: Forty-three patients and 46 sex-, age-, education level- and handedness-matched healthy volunteers were recruited for normal control group. Rsf MRI was performed in all subjects by 3.0 T MR scanner. Then we analyzed FC. Two-sample t-test was used to compare the two groups. And correlation analysis was performed between FC statistical brain mapping and course of disease. Results: Compared with normal control group, in NLE patients, the increased FC of right Hippocampus(RH) was in the right superior temporal gyrus, left inferior temporal gyrus, right middle temporal gyrus, left middle temporal, right medial frontal gyrus, right middle frontal gyrus, left middle temporal gyrus, right middle frontal gyrus and left medial frontal gyrus. The increased FC of the left Hippocampus(LH) was in the right superior temporal gyrus, left superior temporal, left parahippocampa gyrus, left frontal lobe sub-gyral, right medial frontal gyrus, left inferior parietal lobule and right postcentral gyrus. Reduced FC of the RH was in the left genu of internal capsule, left inferior parietal lobule, right cingulate gyrus, left superior frontal gyrus, left frontal Sub-gyral. The reduced FC of the LH was in the right cerebellum posterior lobe, left ecrebellum anterior lobe, right superior temporal gyrus, right thalamus. In NLE patients, positive correlation between RH FC and course of disease was found in the left inferior frontal gyrus, left inferior temporal gyrus, left superior temporal gyrus, right frontal lobe sub-gyral, right precuneus, left parietal lobe sub-gyral, right inferior parietal lobule, left middle frontal gyrus. The positive correlation for LH FC was found in the left lingual gyrus, right middle frontal gyrus, left middle frontal gyrus, left inferior parietal lobule, right postcentral gyrus. The negative correlation of RH FC was found in the left nodule and left genu of internal capsule. The negative correlation of LH FC was found in the left cerebellar tonsi, left superior frontal gyrus, right superior temporal gyrus and left precuneus. Conclusions: ALFF and FC were non-invasive and effective brain functional research motheds, which can detect the resting state cerebral functional changes of NLE patients, and understand correlation with clinical variable(course of disease), provide a theoretical basis for pathophysiological mechanism in epilepsy.更多还原