无灶性癫痫患者静息态fMRI与注意功能的相关性研究

Study on NLE patients the resting state fMRI correlation with attention

目的采用静息态功能磁共振成像的低频振幅技术,探讨无灶性癫痫患者低频振幅与注意功能之间可能存在的关系。方法对16例无灶性癫痫患者和16名正常志愿者进行静息态fMRI数据采集及注意功能行为学测试,采用REST软件计算显示无灶性癫痫患者相对于正常人ALFF增高和减弱的区域,对上述的16例无灶性癫痫患者和16例正常对照进行气球叉掉测试,数字符号转换测试及stroop测试检测其注意功能,观察无灶性癫痫患者静息态fMRI与注意功能之间可能存在的联系。结果①无灶性癫痫组和正常对照组相比,ALFF增强的脑区分布在右侧颞叶(15,-90,21)、内侧额叶(0,24,-24)、腹侧前扣带回(-12,30,27)及右侧小脑半球(-51,-57,-4);②无灶性癫痫组和正常对照组相比ALFF减弱的脑区分布在左侧小脑半球及相邻后缘枕叶(-48,-15,39)、后扣带回(60,-21,33)及楔前叶(-6,-54,66);③无灶性癫痫患者的三项注意功能测试反应时间均较正常对照组延长(P<0.01)。Stroop测试结果表明无灶性癫痫组与对照组相比冲突条件下较一致、中性条件下的错误率显著增加。结论无灶性癫痫患者静息状态下表现出异常的脑功能活动方式。长期异常放电对患者的注意功能有明显损害,其中持续注意能力下降,可能与无灶性癫痫患者的颞叶及额叶的病变相关;选择注意能力下降,可能与腹侧前扣带回的损伤密切相关。

Objective To study the changes of amplitude of low-frequency fluctuation（ALFF）of the resting state fMRI in non-lesional Epilepsy（NLE）,and discussed relationship between the low-frequency amplitude and attention functions.Methods The resting state fMRI data of 16 NLE patients and 16 normal volunteers analyzed by ALFF.With REST software calculations showing increased and decreased ALFF in NLE patients.And then test attention functional tests with balloons tests,symbol digital modalities test and stroop test were demonstrated by comparing to normal subjects.Results ①Compared with normal subjects,the regions showing increased ALFF in NLE patients were distributed in right temporal lobe（15,-90,21）、medial frontal lobe（0,24,-24）、ventral anterior cingulate（-12,30,27）and the right cerebellar hemispher（-51,-57,-4）.② while the regions showing decreased ALFF covered the areas of the left cerebellar hemispher（-48,-15,39）、posterior cingulum gyrus（60,-21,33）and precunens（-6,-54,66）.③NLE patients with three attention functional tests of reaction time get low score compared with the normal group;the Stroop test showed that NLE patients compared with control group,in congruous /neutral conditions.error rate under incongruous conditions.The selected attention damaged with NLE patients.Conclusion NLE patients shows abnormal brain functional organization in resting state.Decline in the ability of the sustained attention may be related to epilepsy patients with temporal lobe and frontal lobe regions;a decline ability of selected attention,may be closely related to the ventri anterior cingulated cortex damage.