不同病程颞叶癫痫患者体素镜像同伦连接分析

Voxel⁃mirrored homotopic connectivity analysis in temporal lobe epilepsy patients with different course

目的 基于体素镜像同伦连接(VMHC)探索不同病程的颞叶癫痫患者的两侧半球间的功能同伦变化。方法 招募20例短病程的颞叶癫痫患者(TLE-SD组)、27例长病程的颞叶癫痫患者(TLE-LD组)及人口学资料相匹配的30名健康受试者(HC组),所有参与者均完成了功能磁共振扫描及神经心理学的评估。基于体素镜像同伦连接分析得到TLE-SD组与HC组、TLE-LD组与HC组显著变化的脑区,然后基于两次比较的不同脑区的VMHC值进行两独立样本t检验,提取患者组异常脑区的VMHC值并与量表分数进行相关分析。结果 相比于HC组,TLE-SD组的壳核及前扣带回的VMHC值降低,而TLE-LD组的壳核、前扣带回、颞上回及额上回的VMHC降低。与TLE-SD组相比,TLE-LD组的颞上回的VMHC值显著降低(t=2.918,P=0.033)。相关分析显示TLE-LD组壳核的VMHC值与蒙特利尔认知评估(MoCA)分数呈正相关(r=0.442,P=0.021)。结论 颞叶癫痫患者两侧半球间功能同伦受到损害,并且这种损害可能在长病程患者中表现更加严重,颞叶癫痫患者认知受损可能与双侧半球间异常的功能同伦相关。

Objective This study aimed to explore the changes of interhemispheric functional homotopy in patients with different course of temporal lobe epilepsy based on voxel-mirrored homotopic connectivity(VMHC).Methods Twenty temporal lobe epilepsy patients with a short disease course(TLE-SD),twenty-seven temporal lobe epilepsy patients with a long disease course(TLE-SD)and thirty healthy controls(HC)matched with demo-graphic data were enrolled.All participants finished functional MRI scans and neuropsychological assessment.Brain regions with significant changes between the TLE-SD/TLE-LD group and the healthy controls group were obtained based on the VMHC analysis,and the two-samples t-test was performed in the different brain regions of VMHC values between the two comparisons.The VMHC values of abnormal brain regions in the patient group were extracted and used for correlation analysis with the scale scores.Results Compared with HC,the VMHC values of the putamen and anterior cingulate gyrus were reduced in the TLE-SD group,while the VMHC values of the putamen,anterior cingulate gyrus,superior temporal gyrus and superior frontal gyrus were reduced in the TLE-LD group.Compared with the TLE-SD group,the VMHC values of the superior temporal gyrus in the TLE-LD group was significantly reduced(t=2.918,P=0.033).Correlation analysis showed that the VMHC values of the putamen was positively correlated with the Montreal Cognitive Assessment(MoCA)scores(r=0.442,P=0.021).Conclusions The interhemispheric functional homotopy was impaired in patients with temporal lobe epilepsy and the impairment may be more severe in patients with a long course of disease.Cognitive impairment in patients with temporal lobe epilepsy may be related to the abnormalities of interhemispheric functional homotopy.