原发全面强直阵挛癫痫功能连接密度图研究

Study of functional connectivity density in interictal epilepsy with generalized tonic-clonic seizures based on fMRI

目的采用静息态fMRI(rs-fMRI)功能连接密度图(functional connectivity density,FCD)方法观察全面强直阵挛癫痫(GTCS)发作间期脑网络水平的改变。方法对40例GTCS患者(GTCS组)与40名性别、年龄相匹配的健康人(正常对照组)。采用3.0T超导MR仪采集rs-fMRI数据,计算并对比GTCS组相比正常对照组FCD改变的脑区,观察FCD改变的脑区与患者发作频率的相关性。结果与正常对照组相比,GTCS患者发作间期FCD增加区域呈对称性分布,以双侧丘脑、双侧舌回、距状回及双侧楔叶为主(P<0.05);FCD减低的区域主要包括双侧颞叶、双侧海马旁回区域及双侧内侧前额叶。GTCS患者的发病频率与双侧丘脑FCD呈负相关(右侧为r=-0.315,P=0.048;左侧为r=-0.349,P=0.027)。结论本研究发现IGE-GTCS患者丘脑及DMN区域功能连接的异常,有助于进一步揭示GTCS的发病机制。

Objective To observe the interictal alteration of the brain activity level in patients with generalized tonic-clonic seizure （GTCS） using the method of functional connectivity density. Methods We studied a group of forty patients with untreated GTCS and forty matched controls using resting-state fMRI. We measured functional connectivity between every pair of voxels and generated images of ＂whole-brain＂ functional connectivity by counting the number of functional connections of each voxel. Results There were marked differences between GTCS patients and controls in whole brain functional connectivky. The patients had increased connectivity in the thalamus, lingual gyrus, calcarine gyrus and cuneus lobe, decreased connectivity in the bilateral temporal lobe, parahippocampal gyrus and bilateral medial prefrontal region （ P〈0.05）. In addition, FCD in the bilateral thalamus was correlated negatively with the epilepsy frequency of the patients （right r=-0. 315, P =0. 048; left r=-0. 349, P =0. 027）. Conclusion These findings suggest enduring changes in function of the thalamus and the cortex in GTCS patients. These human functional connectivity data may contribute to further reveal the GTCS pathogenesis.