颞叶癫痫患者rs-fMRI功能连接及其与记忆功能关系的研究

Correlation between Brain Functional Connection with Resting State fMRI and Memory Function in Patients with Temporal Lobe Epilepsy

目的:分析颞叶癫痫患者静息态磁共振(rest-f MRI)功能连接及其与记忆功能之间的关系,探讨其脑功能连接的异常及其对记忆障碍诊治的应用价值。方法:对16例颞叶癫痫患者(癫痫组)和与之相匹配的16例健康对照者(对照组)进行静息态脑功能成像和记忆功能测评,比较2组间的脑区差异,分析与记忆功能相关的脑区。结果:癫痫组与对照组比较,海马与全脑功能连接增高的脑区有:左侧旁中央小叶、左侧中央前回、左侧中央后回、左侧前运动皮质和辅助运动区、左侧内侧额叶等;减低的脑区有:右侧小脑、左侧颞上回等。癫痫组海马与全脑功能连接与记忆商呈正相关的脑区有:双侧前扣带回、双侧楔前叶/后扣带回等;呈负相关的脑区有:左侧额下回、左侧中央后回等。结论:左侧旁中央小叶、左侧中央前回、左侧中央后回、左侧前运动皮质和辅助运动区、左侧内侧额叶等脑区可能构成颞叶癫痫患者的癫痫网络,在癫痫发生和发展过程中起重要作用;右侧小脑、左侧颞上回等脑区的功能异常可能与颞叶癫痫患者认知功能损伤有关。双侧前扣带回、双侧楔前叶/后扣带回、左侧额下回、左侧中央后回等脑区与海马之间的功能连接与记忆相关,其对记忆功能具有潜在临床预测价值。

Objective：To analyze the relationship between brain functional connection using resting state fMRI and memory function in patients with temporal lobe epilepsy; To explore the characteristics of connectivity of rest-fM-RI in patients with temporal lobe epilepsy and its value in evaluating the memory impairment. Methods： Rest-fMRI scanning and neuropsychological-scale memory function test were performed in 16 patients with temporal lobe epilepsy and 16 gender, age and educational levels matched normal controls. The difference of brain connectivity was compared between the two groups and the areas related with memory were to explored. Results： Compared with normal control group, patients with temporal lobe epilepsy showed higher connectivity in regions of bilateral hippocampus and whole brain including left paracentral lobule, left precentral gyrus, left postcentral gyrus, left pre-motor cortex and supplementary motor area, left medial frontal brain regions. The following areas in patients pre-sented lower connectivity than the normal controls including right cerebellum, left superior temporal gyrus The pos-itive correlation between the brain connection and memory funciton was found in bilateral anterior cingulate gyrus, bilateral precuneus / posterior cingulate; The negative correlation between brain connection and memory function existed in left inferior frontal gyrus, left postcentral gyrus. Conclusion： The left paracentral lobule, left precentral gyrus, left postcentral gyrus, left premotor cortex and supplementary motor area, left medial frontal brain areas may constitute epilepsy network in patients with temporal lobe epilepsy, which may play an important role in the patho-logical process of epilepsy. The function abnormalities of right cerebellum, left superior temporal gyrus may be re-lated to cognitive impairment in patients with temporal lobe epilepsy. The connectivity in Bilateral anterior cingu-late gyrus, bilateral precuneus / posterior cingulate, left inferior frontal gyrus, left postcentral gyrus is relevant to memory function.