单侧颞叶癫痫患者双侧大脑半球间的功能协同性研究

Interhemispheric functional alterations in unilateral temporal lobe epilepsy

目的研究单侧颞叶癫痫患者双侧大脑半球间同伦功能连接的变化。方法纳入左侧颞叶癫痫(left temporal lobe epilepsy,LTLE)21例、右侧颞叶癫痫患者(right temporal lobe epilepsy,RTLE)22例以及正常对照(normal control,NC)20例。采用体素-镜像同伦功能连接(voxel-mirrored homotopic connectivity,VMHC)方法分析数据,计算出各组VMHC改变的脑区。结果与NC组相比较,LTLE组双侧辅助运动区(t=-3.35)、颞中回(t=-3.50)、内侧额上回(t=-3.20)、顶下小叶(t=-3.66)VMHC值降低;双侧角回(t=3.03)、枕下回(t=4.25)、顶上回(t=3.62)VMHC值升高(P<0.05,alphasim校正)。与NC组相比较,RTLE组双侧颞中回(t=-4.26)、中央前回(t=-3.29)VMHC值减低;双侧枕下回(t=3.22)、海马旁脑回(t=3.32)和小脑(t=3.50)VMHC值升高(P<0.05,alphasim校正)。结论单侧颞叶癫痫患者两侧半球间部分脑区的功能协同性发生了变化。

Objectives To investigate the alterations of homotopic connectivity in unilateral temporal lobe epilepsy （TLE）. Methods Resting-state functional MR imaging data were acquired from patients with unilateral temporal lobe epilepsy （n=43） [21 left temporal lobe epilepsy（LTLE） and 22 right temporal lobe epilepsy（RTLE）] and normal controls （NC） （n=20）. The functional connectivity between any pair of symmetric interhemispheric voxels （i.e., functional homotopy） was measured by voxel-milxored homotopic connectivity （VMHC）. Results Compared with NC group, the LTLE patients showed decreased functional connectivity in the bilateral supplementary motor areas （t=-3.35 ）, middle temporal gyri （t= -3.50）, medial frontal gyri （t= -3.20）and inferior parietal lobules （t= -3.66）, and increased interhemispherie functional connectivity in the bilateral angular gyri （t= 3.03）, occipital gyri （t= 4.25） and superior parietal gyri （t= 3.62）. Compared with control subjects, RTLE patients exhibited decreased functional connectivity in the bilateral middle temporal gyri （t= -4.26）, precentral gyri （t= -3.29）, as well as increased interhemispheric functional connectivity between bilateral inferior occipital gyri （t= 3.22）, parahippocampa gyri （t= 3.32）, cerebellum （t= 3.50）. Conclusions There are alterations of the functional synchronization and coordination in the two hemispheres in unilateral TLE patients.