难治性癫痫患者脑默认网络结构连接的DTI研究

DTI study of default mode network structural connection in patients with refractory epilepsy

目的利用DTI探究难治性癫痫患者脑默认网络(DMN)神经纤维结构连接的变化情况及其意义。方法对2017年12月至2018年4月安徽医科大学附属省立医院癫痫外科收治的13例难治性癫痫患者(癫痫组)及同时期招募的14名健康人(健康对照组)进行DTI和T_1像磁共振数据采集。利用概率性纤维追踪技术获得DMN脑区间纤维束连接的分数各向异性(FA)值、横向扩散系数(RD)值,并构成DMN结构网络。比较癫痫组与健康对照组DMN结构连接的差异。结果与健康对照组相比,癫痫组患者DMN纤维束连接FA值普遍下降,RD值升高,差异有统计学意义(均P<0.05)。结论难治性癫痫患者的DMN结构网络的神经纤维整合性和连通性明显下降,髓鞘受到破坏。这可能是导致患者DMN功能连接异常,并出现环境监控、记忆提取、社会认知、自我控制等能力障碍的重要原因。

Objective To explore the changes of the structure connection of the default mode network(DMN)in brains of patients with refractory epilepsy using DTI,and discuss their significance.Methods DTI and T1 data of 13 patients with refractory epilepsy admitted from outpatient department of Affiliated Provincial Hospital of Anhui Medical University from December 2017 to April 2018(epilepsy group)and 14 healthy people recruited at the same time(healthy control group)were obtained.Probabilistic fiber tracing technique was used to obtain the fractional anisotropy(FA)values and radial diffusivity(RD)values of the DMN brain-fiber bundles,and the DMN structure network was constructed.The structural connection differences of DMN were compared between epilepsy group and healthy control group.Results Compared with healthy control group,FA values of DMN fiber bundles were significantly decreased,and RD values were significantly increased in epilepsy group(all P<0.05).Conclusions The DMN structural network of patients with refractory epilepsy has a marked decline in nerve fiber integration and connectivity,and their myelin is damaged.This may be an important cause of dysfunction in DMN function in patients,and ultimately in environmental monitoring,memory extraction,social cognition,self-control and other ability obstacles.