部分性发作癫痫患者静息状态功能磁共振默认模式网络的功能连接改变

Changes in default mode network functional connectivity of resting-state functional magnetic resonance imaging in partial epilepsy

目的应用静息状态功能磁共振成像（fMRI）探讨部分性发作癫痫患者静息状态下的脑功能改变。方法对60例部分性发作癫痫患者（患者组）和60名性别、年龄和教育程度匹配的健康对照者（对照组），使用3．0T磁共振采集两组的静息状态下fMRI数据，采用功能连接方法分析计算脑区的默认模式网络的功能连接，利用SPM5软件分析比较患者组和对照组脑功能的差异。结果患者组的默认模式网络的功能连接主要包括左侧楔前叶／后扣带回和角回、扣带回；对照组的功能连接主要包括左侧楔前叶／后扣带回和右侧角回，双侧内侧额叶和颞叶；患者组的左侧顶下小叶[坐标值（x，y，z）：-57，-39，48；t=4．90，P〈0．01]、左侧缘上回[坐标值（x，y，z）：-63，-48，33；t=4．25，P〈0．01]、左侧海马旁回[坐标值（x，y，z）：-30，-6，-21；t=4．05，P〈0．01]、左侧颞上回[坐标值（x，y，z）：-48，-39，6；t=3．72，P〈0．01]，左侧钩回[坐标值（x，y，z）：-24，6，-36；t=4．56，P〈0．01]及右侧钩回[坐标值（x，y，z）：33，-15，-36；t=4．00，P〈0．01]的默认模式网络功能连接较对照组降低；未发现功能连接升高的脑区。结论部分性发作癫痫患者静息状态下脑区的功能连接改变，可能是部分性发作癫痫潜在的病理生理机制。静息状态fMRI能发现常规MRI正常的癫痫患者的广泛脑功能异常，是一种无创的研究癫痫患者脑功能的有效方法。

Objective To explore changes of brain function among patients with partial epilepsy in resting state by using the blood oxygenation level dependent functional magnetic resonance imaging （fMRI） techniques. Methods fMRI scanning was performed in resting state among 60 patients with partial epilepsy and 60 gender, age and educational levels matched normal controls. The functional connectivity analysis was applied to calculate the default mode network （DMN） functional connectivity in resting-state fMRI. SPM5 was used to analyze differences in functional connectivity between the two groups （P 〈 0. 001, cluster 〉 50）. Results Left precuneus and adjacent posterior cingulate cortex （Pcu/PCC）, angular gyrus, and cingulate gyrus were involved in the DMN of epileptic patients. By contrast, the DMN of controls included left Peu/ PCC, right angular gyrus, bilateral medial frontal lobe and temporal lobe. Compared with normal controls, patients with partial epilepsy showed a significantly decrease in functional connectivity of DMN region such as left inferior parietal lobule, supramarginal gyrus, parahippoeampa gyrus and superior temporal gyrus, and bilateral uncus, while no regions were found increased functional connectivity in patients group. Conclusions Patients with partial epilepsy show abnormal changes in functional connectivity of DMN in resting state by fMRI, which may associate with the potential pathophysiological mechanisms of epilepsy. The findings demonstrate that the resting-state fMRI might detect the extensive changes of brain function in partial epilepsy with negative results of conventional MRI, suggestive of fMRI as an effective and non-invasive method to explore brain function in epilepsy.