联合脑电功能MRI观察颞叶癫痫脑活动局域的一致性改变

Combined electroencephalogram and functional MRI study of altered regional homogeneity in mesial temporal lobe epilepsy

目的探讨颞叶癫痫患者功能MRI(fMRI)局域一致性(ReHo)改变的癫痫电活动基础。方法对6例单侧颞叶癫痫患者行同步脑电图(EEG)-fMRI。另选取正常对照21名,采集fMRI数据。所有fMRI数据经处理后被分为42小段,分析每小段数据的ReHo值与该段数据时间内间期痫样发放次数的相关性。结果与正常对照相比,mTLE患者右侧海马区域、右侧颞叶及双侧顶叶ReHo值明显增高。体素依赖分析结果显示,癫痫侧的内侧颞叶、丘脑及脑干等部位ReHo值与间期痫样发放次数呈正相关,其中内侧颞叶处相关性较高(r=0.36,P<0.02)。结论癫痫电活动发放是ReHo值升高的主要生理基础,为基于ReHo分析的fMRI在癫痫活动检测方面的应用提供了生物学证据。

Objective To investigate the electro-physiological substrates of the alteration of regional homogeneity（ReHo）in mesial temporal lobe epilepsy（mTLE）.Methods Six patients with unilateral mTLE underwent simultaneous electroencephalogram（EEG）-functional MRI（fMRI）.Twenty-one normal controls underwent fMRI only.For facilitating the performance of statistical analysis,all the fMRI data were segmented to 42 sections.Then,a correlation analysis was conducted between the ReHo value and the number of the interictal epileptic discharges during each section.Results Compared with normal controls,ReHo increased obviously in right hippocampus,right temporal lobe and bilateral lobi parietalis.Significant positive correlation was found between the ReHo value of ipsilateral mesial temporal lobe,thalamus,pons and the number of the interictal epileptic discharges.Conclusion The increased ReHo value in mTLE is related to the occurrence of interictal epileptic discharges,suggesting that the epileptic activity is the physiological substrates of the alteration of ReHo in epilepsy,therefore supplying the biological evidence for the application of the ReHo analysis in the epileptic activity detection by using fMRI.