论文部分内容阅读
目的应用静息态功能磁共振成像(f MRI)和神经心理学方法探讨颞叶癫痫(TLE)患者警觉网络损害及其相关影响因素。方法分析44例单侧TLE患者和32名健康对照者的静息态f MRI数据、注意网络测试结果,搜集患者的临床资料,并对左侧颞叶癫痫(LTLE)患者、右侧颞叶癫痫(RTLE)患者与健康对照组的警觉相关网络进行组内分析及组间比较,提取TLE患者背外侧前额叶脑区功能连接Z值作为因变量,以相关影响因素作为自变量,进行多因素线性回归分析。结果 TLE组警觉网络相关脑区连接强度较对照组降低,LTLE与RTLE比较左侧海马功能连接减低。TLE组与对照组相比,固有警觉反应时间增加(t=3.198,P=0.002),位相性警觉反应时间增加(t=3.995,P=0.000),警觉反应时间减少(t=-2.983,P=0.004),差异均有统计学意义(P<0.05)。多因素线性回归分析显示,不同的发作类型和脑电图痫性放电为影响TLE患者警觉功能的原因。结论 TLE患者存在警觉网络损害,固有警觉和位相性警觉均存在损害,发作类型和痫性放电与警觉功能损害有关。
Objective To investigate the alertness network damage and its related factors in patients with temporal lobe epilepsy (TLE) by resting magnetic resonance imaging (f MRI) and neuropsychological methods. Methods Forty-four patients with unilateral TLE and 32 healthy controls were studied for resting fMRI data. The results of the network test were collected and the clinical data of patients were collected. The left temporal lobe epilepsy (LTLE), right temporal lobe epilepsy (RTLE) patients and healthy control group, the intracorporeal analysis and comparison between groups were carried out. The functional connectivity Z value of dorsolateral prefrontal lobe of TLE was extracted as the dependent variable and the relevant influencing factors were taken as independent variables to make multi-factor linear regression analysis. Results Compared with the control group, the connection intensity of the alertness-related brain regions in the TLE group was decreased, and the left hippocampal function connection was decreased in the LTLE and RTLE groups. Compared with the control group, the alertness reaction time increased (t = 3.198, P = 0.002) and the alertness reaction time increased (t = 3.995, P = 0.000) = 0.004), the differences were statistically significant (P <0.05). Multivariate linear regression analysis showed that different types of seizures and electroencephalogram epileptiform discharges are the reasons that affect the alert function in patients with TLE. Conclusion There is alertness network impairment in TLE patients. Both intrinsic and phase alertness are impaired. Types of seizures and epileptic discharge are associated with impaired alertness.