【摘要】 目的观察癫痫患者海马与全脑功能连接(FC)的变化,比较不同类型癫痫的脑网络改变差异,探讨其可能的神经病理机制。资料与方法收集2014年8月—2016年12月于天津市第一中心医院就诊的17例颞叶内侧癫痫(m TLE)、12例伴中央颞区棘波良性儿童癫痫(BECT)以及社区招募的19名健康志愿者(对照组),均行结构和功能MRI扫描。以海马头部为感兴趣区,采用REST 1.8软件对3组研究对象分别进行组内和组间海马与全脑功能连接分析。结果对照组的海马头部功能连接脑区存在正、负2种相关性表现,正相关连接脑区主要位于杏仁核、海马旁回、颞叶外侧皮层、岛叶、丘脑、基底节区等;负相关连接脑区主要位于双侧额叶、顶叶、枕叶等皮层。海马功能连接强度(FCS)比较显示,m TLE组较对照组及BECT组均表现为多个脑区FC减低,主要位于海马和海马旁回、颞叶、楔前叶等脑区(P<0.05);而BECT组则表现为FC强度增加,运动区较为明显(P<0.05)。结论不同类型的癫痫脑网络改变模式可完全不同,可能与其所表现的不同临床症状、病程及预后的病理机制相关。更多还原

【Abstract】 Purpose To observe the change of hippocampus and whole brain functional connectivity(FC) in epilepsy patients to compare variance of brain network with different types of epilepsy and explore possible neuropathological mechanisms. Materials and Methods Seventeen mesial temporal lobe epilepsy(mTLE), 12 benign epilepsy with centrotemporal spikes(BECT) patients who received treatment in Tianjin First Central Hospital from August 2014 to December 2016 and 19 healthy volunteers recruited from community were collected, all of whom were offered structural and functional MRI scanning. With hippocampus head as region of interest, REST 1.8 software was taken to analyze functional connectivity of hippocampus with the whole brain within the group and among groups for research objects in these three groups. Results Two positive and negative correlation representations were seen in functional connectivity brain regions of hippocampus head. Positive correlation connectivity brain region mainly located in amygdala, parahippocampal gyrus, extratemporal cortex, insula, thalamus, basal ganglia and other, and negative correlation connectivity brain region were mainly in bilateral frontal lobe, parietal lobe, occipital lobe and other cortical regions. Comparison of functional connectivity strength(FCS) of the hippocampus showed that multiple brain regions in mTLE group was decreased compared to normal group and BECT group, which were mainly seen in the hippocampus and parahippocampal gyrus, temporal, precuneus lobe and other brain regions(P<0.05). Whereas FS in BECT group was increased, which was more obvious in motor area(P<0.05). Conclusion Network changes of different epilepsy could be totally varied, which may be related to the pathological mechanisms of various clinical symptoms, duration and prognosis.更多还原