颞叶癫痫患者的认知功能与MRI和DTI的关系研究

Relationship of Cognitive Function with MRI and DTI in Patients with Temporal Lobe Epilepsy

目的:研究颞叶癫痫患者认知功能及其与核磁共振(MRI)和弥散张量成像(DTI)的关系。方法:选取我院36例颞叶癫痫患者为癫痫组,36例同期体检健康者为对照组,分别采用简易精神状态量表(MMSE)、韦氏成人智力量表(WAIS)进行认知功能评估及MRI、DTI检查,对比2组大脑感兴趣区的平均扩散率与部分各向异性值,分析其认知功能与影像学表现的关系。结果:癫痫组的MMSE、WAIS评分均较对照组低(P均<0.05);癫痫组的左右丘脑与左右内囊后肢部分各向异性值均低于对照组(P均<0.05);左内囊后肢、左内囊膝部及左丘脑平均扩散率与WAIS评分呈负相关(P均<0.05),左内囊前肢、左枕叶部分各向异性与MMSE评分呈正相关(P均<0.05),左枕叶部分各向异性与操作智商呈正相关(P<0.05),右枕叶部分各向异性与全量表智商、语言智商及操作智商呈正相关(P均<0.05)。结论:颞叶癫痫患者存在一定程度的认知功能障碍,MRI和DTI可有效检出患者脑组织受损处与评估受损程度。

Objective： To study cognitive function and its relationship with magnetic resonance imaging（MRI）and diffusion tensor imaging（DTI） in patients with temporal lobe epilepsy. Methods： Thirty-six patient cases of temporal lobe epilepsy were selected from our hospital as the epilepsy group and 36 healthy cases were selected as the control group. The Mini-Mental State Examination（MMSE） and Wechsler Adult Intelligence Scale（WAIS） were applied to assess cognitive function of the two groups, and MRI and DTI were performed. The values of mean diffusion and fractional anisotropy on different regions of interest were compared between the two groups, and the relationship between cognitive function imaging results was analyzed. Results： The MMSE and WAIS scores of the epilepsy group were lower than those of the control group（all P〈0.05）. The values of fractional anisotropy of the left and right thalamus and the posterior limb of the left and right internal capsule in the study group were lower than those of the control group（all P〈0.05）. Results of correlation analysis showed that the mean diffusion of the left posterior limb of the internal capsule, left genu, and left thalamus showed a significant negative correlation with the WAIS score（all P〈0.05）. The fractional anisotropy of the left anterior limb and the left occipital lobe showed a significant positive correlation with the MMSE score（all P〈0.05）. The fractional anisotropy of the left occipital lobe showed a significant positive correlation with performance IQ（P〈0.05）. The fractional anisotropy of the right occipital lobe showed a significant positive correlation with full IQ,verbal IQ, and performance IQ（all P〈0.05）. Conclusion： Patients with temporal lobe epilepsy possess a certain level of cognitive dysfunction. Examination by MRI and DTI can effectively detect the damaged brain region and evaluate the extent of the damage.