伴有认知障碍的内侧颞叶癫痫静息态脑网络的功能MRI研究

Functional MRI study of resting state network in mesial temporal lobe epilepsy with cognitive impairment

目的应用静息态功能磁共振成像技术(resting state functional MRI,rs-fMRI)探究伴有认知障碍的内侧颞叶癫痫(mesial temporal lobe epilepsy,mTLE)患者的静息态脑网络(resting-state network,RSNs)的改变及意义。方法纳入24例伴有认知障碍的mTLE患者(蒙特利尔评分<26分)和18例健康志愿者,采集所有被试的rs-fMRI数据并提取RSNs后,比较患者组与正常对照组的RSNs间功能连接(functional connectivity,FC)强度的差异以及分析有组间差异的RSNs与MoCA量表评分的相关性。结果与正常对照组比较,执行控制网络(executive control network,ECN)与内侧视觉网络(medial visual network,m VN)间的FC减低;ECN与感觉运动网络(sensorimotor network,SMN),ECN与左额顶网络(left frontoparietal network,l FPN)间的FC均增加,且增加FC的与MoCA总分及语言、抽象、注意力分数呈负相关。结论本研究发现伴有认知障碍的mTLE患者出现以ECN为主的多个RSNs的异常改变,这有助于我们进一步揭示mTLE患者认知障碍的潜在机制。

Objective We used the resting state functional MRI（rs-fMRI） to explore the alterations and significance of resting state networks（RSNs） in mesial temporal lobe epilepsy（mTLE） patients with cognitive impairment. Methods 24 mTLE patients with cognitive impairment（Montreal cognitive assessment,MoCA 26） and 18 healthy controls（HC） were recruited in our study. Functional connectivity（FC） between RSNs was compared between patients and HC after rs-fMRI data were acquired and RSNs were abstracted. The correlation between RSNs with inter group differences and MoCA results were analysed. Results When compared with HC group,the patients group showed decreased FC between executive control network（ECN） and medial visual network（m VN）,and also showed increased FC between ECN and sensorimotor network（SMN） as well as ECN and left frontoparietal network（l FPN）,and the increased FC was negatively correlated with scores of MoCA as well as scores of multiple domains in MoCA. Conclusion This study finds the abnormal alterations of ECN and other RSNs in mTLE patients with cognitive impairment,which help us further reveal the mechanisms of cognitive impairment in mTLE patients.