颞叶癫痫患者小脑结构与功能改变的磁共振成像研究进展

Progresses on the study of structural and functional MRI changes of cerebellum in patients with temporal lobe epilepsy

癫痫的发病机制非常复杂,至今仍未完全明确,目前熟知的机制是中枢神经系统兴奋与抑制失衡。随着MRI技术的发展,越来越多的研究利用先进的影像学技术,从小脑结构与功能改变的角度对癫痫发生机制进行探索,目前的研究发现不同类型癫痫患者的小脑结构与功能发生改变,本文针对颞叶癫痫(temporal lobe epilepsy,TLE)患者影像学中小脑结构及功能的异常改变。对既往研究进行总结,发现TLE患者小脑体积萎缩、小脑与大脑之间白质通路和小脑-海马相关联系的改变、小脑与大脑部分脑区功能连接障碍以及小脑在警觉网络、默认模式网络等网络中的作用。小脑还与TLE患者认知能力、执行控制能力、语言能力及记忆力的减退有关。同时小脑的灌注和代谢也存在异常。利用先进的磁共振成像技术有望进一步阐明小脑在TLE中发挥的作用,揭示TLE的病理生理机制,使小脑在未来成为TLE的潜在治疗靶点成为可能。

The pathogenesis of epilepsy is very complex and still not fully understood.The well-known mechanism is the imbalance of excitation and inhibition in the central nervous system.With the development of MRI technology,more and more studies use advanced imaging technology to explore the mechanism of epilepsy from the perspective of cerebellar structural and functional changes.Current studies have found changes in the structure and function of the cerebellum in patients with different types of epilepsy.This paper summarizes the previous studies on the abnormal changes in the structure and function of the cerebellum in patients with temporal lobe epilepsy(TLE).Changes in white matter pathways and cerebellum-hippocampal connections between the brains,functional connectivity impairments between the cerebellum and some cerebral regions,and the role of the cerebellum in networks such as the alertness network and the default mode network.The cerebellum is also associated with cognitive,executive control,language,and memory impairments in patients with TLE.There are also abnormalities in cerebellar perfusion and metabolism.The use of advanced MRI technology is expected to further clarify the role of the cerebellum in TLE,reveal the pathophysiological mechanism of TLE,and make the cerebellum a potential therapeutic target for TLE in the future.