基于静息态fMRI的难治性癫痫患者丘脑功能连接研究
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摘要
目的利用静息态功能磁共振成像(f MRI)中的功能连接方法,探讨难治性癫痫患者丘脑的功能连接改变及意义。方法难治性癫痫患者19例,多模态神经影像学检查中颅内均未发现明显致痫病灶,发作间期及发作期长程视频脑电图提示双侧大脑半球棘波及棘慢波;同期招募19例健康对照者。采集静息态f MRI数据,分别以左、右丘脑为感兴趣区(ROI)与全脑进行功能连接分析,了解难治性癫痫患者相对于正常对照组功能连接增高和减弱的区域。结果以左侧丘脑为ROI做功能连接分析,难治性癫痫组与双侧梭状回、右侧舌叶、双侧楔叶及双侧楔前叶的功能连接强度增强,而与双侧尾状核、左侧壳核及左侧杏仁核的功能连接强度减弱;以右侧丘脑为ROI做功能连接分析,难治性癫痫组与双侧距状回、双侧楔前叶及左侧直回的功能连接强度增强,而与双侧壳核、双侧尾状核、双侧杏仁核及右侧脑岛的功能连接强度减弱。结论难治性癫痫患者静息状态下丘脑功能连接异常,丘脑可能参与了"癫痫网络"的构成。
Objective To explore the functional connectivity in the pathogenesis of refractory epilepsy using resting-state functional magnetic resonance imaging( f MRI). Methods 19 patients with refractory epilepsy,among which Multi-modal neuroimaging of intracranial lesions without obvious epileptic,seizure exacerbation period and long-term video EEG showed bilateral cerebral hemispheres spine spread spike and wave and 19 healthy persons were recruited as the controls. All f MRI data were preprocessed after resting-state f MRI scanning. Then left and right thalamus were selected as regions of interest( ROI) to calculate the linear correlation between thalamus and whole brain to study the intractable epilepsy group increased and decreased brain areas relative to the control group in functional connectivity. Results Compared with the controls,left thalamus in refractory epilepsy group showed increased functional connectivity with bilateral fusiform gyrus,right lingual,bilateral precuneus,bilateral cuneus and decreased functional connectivity with bilateral AAcaudatas,left putamen,right amygdala. On the contrary right thalamus demonstrated increased functional connectivity with bilateral calcarine gyrus,bilateral precuneus,left rectus and decreased functional connectivity with bilateral putamen,bilateral caudatas,bilateral amygdalas,right insula. Conclusion Altered functional connectivity of thalamus reflects its dysfunction in refractory epilepsy patients,suggesting that thalamus participates in the "epilepsy network".
Objective To explore the functional connectivity in the pathogenesis of refractory epilepsy using resting-state functional magnetic resonance imaging( f MRI). Methods 19 patients with refractory epilepsy,among which Multi-modal neuroimaging of intracranial lesions without obvious epileptic,seizure exacerbation period and long-term video EEG showed bilateral cerebral hemispheres spine spread spike and wave and 19 healthy persons were recruited as the controls. All f MRI data were preprocessed after resting-state f MRI scanning. Then left and right thalamus were selected as regions of interest( ROI) to calculate the linear correlation between thalamus and whole brain to study the intractable epilepsy group increased and decreased brain areas relative to the control group in functional connectivity. Results Compared with the controls,left thalamus in refractory epilepsy group showed increased functional connectivity with bilateral fusiform gyrus,right lingual,bilateral precuneus,bilateral cuneus and decreased functional connectivity with bilateral AAcaudatas,left putamen,right amygdala. On the contrary right thalamus demonstrated increased functional connectivity with bilateral calcarine gyrus,bilateral precuneus,left rectus and decreased functional connectivity with bilateral putamen,bilateral caudatas,bilateral amygdalas,right insula. Conclusion Altered functional connectivity of thalamus reflects its dysfunction in refractory epilepsy patients,suggesting that thalamus participates in the "epilepsy network".
引文
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[2]Bernhardt B C,Bernasconi N,Kim H,et al.Mapping thalamocortical network pathology in temporal lobe epilepsy[J].Neurology,2012,78(2):129-36.
[3]Moeller F,Siebner H R,Wolff S,et al.Changes in activity of striato-thalamo-cortical network precede generalized spike wave discharges[J].Neuroimage,2008,39(4):1839-49.
[4]Blumenfeld H.What is a seizure network?Long-range network consequences of focal seizures[J].Adv Exp Med Biol,2014,813:63-70.
[5]Fisher R S,Scharfman H E,de Curtis M.How can we identify ictal and interictal abnormal activity?[J].Adv Exp Med Biol,2014,813:3-23.
[6]Blumenfeld H,Varghese G I,Purcaro M J,et al.Cortical and subcortical networks in human secondarily generalized tonic-clonic seizures[J].Brain,2009,132(Pt 4):999-1012.
[7]Fridley J,Thomas J G,Navarro J C,et al.Brain stimulation for the treatment of epilepsy[J].Neurosurg Focus,2012,32(3):E13.
[8]魏书航,漆松涛,杨开军.立体定向杏仁核海马毁损术治疗颞叶内侧型癫痫的临床研究[J].中华神经医学杂志,2012,11(6):545-8.
[9]Cash D M,Ridgway G R,Liang Y,et al.The pattern of atrophy in familial Alzheimer disease:volumetric MRI results from the DIAN study[J].Neurology,2013,81(16):1425-33.