应用度中心度方法研究不同病程颞叶癫痫患者脑网络与执行功能的关系

Degree centrality in different duration of patients with temporal lobe epilepsy

目的应用度中心度(degree centrality,DC)方法研究不同病程颞叶癫痫(temporal lobe epilepsy,TLE)患者全脑水平功能连接的改变,及其与执行功能的关系。材料与方法利用注意网络测试(attention network test,ANT)对21例病程≤5年、19例病程>5年的TLE患者和30例健康对照组的执行功能进行研究;计算所有被试静息态功能磁共振(resting-state functional magnetic resonance imaging,rsf MRI)下的DC值图,提取差异脑区的DC值与执行控制反应效率进行相关性分析。结果患者组执行控制网络效率较对照组明显下降(P<0.05)。与对照组相比,病程≤5年患者组DC降低的脑区位于右侧海马旁回,病程>5年患者组DC降低的脑区位于右侧尾状核、左侧额叶,DC升高的脑区位于左侧中央前回、中央后回;病程>5年患者组较病程≤5年患者组DC升高的脑区位于左侧岛叶(P<0.01,Alphasim校正)。其中,病程>5年患者组右侧尾状核DC值与执行控制网络效率成负相关(P<0.05)。结论 TLE患者执行功能受损;不同病程患者脑区连接强度(点)有差异,不同病程患者执行功能与不同脑区连接有关,仅仅发现在病程较长患者部分脑区存在代偿作用,且尾状核的功能连接强度与执行功能有关。

Objective:To study the changes of the level of brain function in patients with temporal lobe epilepsy(TLE),and to explore the relationship between them and the executive function using degree centrality(DC).Materials and Methods:The executive function of21patients with disease duration^5years,19cases of disease>5years of TLE patients and30healthy controls were studied by using attention network test(ANT).At the same time,the DC values of resting-state functional magnetic resonance imaging(rs-fMRI)were calculated,and the correlation between the DC values of the extracted brain regions and the efficiency of the control reaction was analyzed.Results:The efficiency of the control group was significantly lower than that of the control group(P<0.05).Compared with the control group,the brain area of the patients with less than5-year-old group was located in the right hippocampus,and the brain area in the5-yearold group was located in the right caudate nucleus,the left frontal lobe and the DCincreased brain area was located on the left side of the central anterior,central posterior;course of disease>5years of patients than the course of^5years of patients with DC increased brain area in the left island leaves.(cluster threshold at/<0.01,Alphasim corrected).The DC value of the right caudate nucleus in the5-year group was negatively correlated with the efficiency of the control network(P<0.05).Conclusions:TLE patients with impaired function,different course of patients with brain area connection intensity(node)are different,different course of patients with executive function and different brain connection,only found in patients with longer course of the brain part of the existence of compensatory effect,and thefunctional connection intensity of the caudate nucleus is related to the execution function.