颞叶癫痫认知功能的血氧水平依赖功能MRI研究

Blood-oxygen level-dependent functional MRI study of cognitive function in temporal lobe epilepsy

目的分析血氧水平依赖功能MRI与颞叶癫痫(TLE)患者的认知功能(包括语言功能、执行功能和记忆功能)的联系,探索患者脑组织功能机制原理。方法选取25例TLE患者为试验组及25名正常人为对照组,均给与神经心理学测试以及记忆功能评估,比较两组在言语智商(VIQ)、操作智商(PIQ)、总智商(FIQ)以及记忆智商(MQ)的差异,同时比较两组功能MRI的数据。结果对照组的神经心理学测试、记忆功能评估以及VIQ、PIQ、FIQ和MQ的评分均明显高于试验组,差异有统计学意义(均P<0.01)。试验组和对照组在脑部组织的正性激活均存在明显差异(均P<0.05)。在进行语言测试时,试验组和对照组间的正性激活部位不同表现在右侧额前叶、颞外侧回和左侧小脑、角回边缘侧、楔前叶及中央后回,而负性激活区域为左侧额前叶皮质和右侧小脑、角回边缘侧及扣带前回;在进行执行功能测试时,正性激活部位不同表现在右侧额前叶、颞叶、小脑前叶及左侧颞上回,脑组织负性激活区没有明显差别;在进行记忆功能测试时,正性差异位于双侧扣带前回及楔前叶,而负性激活差异位于左侧额下回及中央后回。结论认知功能与皮质下的连接功能相关,TLE和非TLE人群在进行不同的任务测试时,被激活的脑组织区域也存在明显的差异。

Objective To analyze the association between blood-oxygen level-dependent functional MRI(fMRI)and cognitive function(including language,executive and memory function)in temporal lobe epilepsy(TLE)patients,which will help to explore the mechanism of brain function in patients.Methods Twenty-five patients with TLE(experimental group)and 25 normal subjects(control group)were recruited.All subjects underwent neuropsychological testing and memory functional evaluation.Changes in verbal intelligence quotient(VIQ),performance intelligence quotient(PIQ),full intelligence quotient(FIQ)and memory quotient(MQ)were compared between two groups.fMRI data were also collected from two groups to evaluate these changes.Results Each individual score of neuropsychological testing and memory functional evaluation were higher in control group,which were statistically different while the VIQ,PIQ,FIQ and MQ showed the same trend(all P<0.01).The data showed the positive activation differences in brain regions between experimental and control group(all P<0.05).During the language task,the activated brain regions of the TLE patients were the right prefrontal lobe,lateral temporal gyri,and left cerebellum,angular gyrus edge,precuneus and postcentral gyrus;whereas the negatively activated brain areas were the left prefrontal cortex,the right cerebellum,angular gyrus edge and anterior cingulate gyrus.During the executive task,epilepsy patients showed activation difference in the right prefrontal and temporal lobe,cerebellum anterior lobe and left superior temporal gyrus compared with the control group;no negatively activated differences in brain areas.During the memory task,the differences were located in bilateral anterior cingulate gyrus and precuneus while the negatively activated brain areas were the left inferior frontal gyrus and postcentral gyrus.Conclusions The cognitive functioning is related to the functional connectivity within the cortex.There are significant differences in the activation of brain areas during different tasks between the TLE patients and the non-TLE people.