右侧颞叶癫痫的静息态大脑熵改变及与警觉的关系

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目的应用静息态功能磁共振成像研究右侧颞叶癫痫(right temploal lobe epilepsy,r TLE)患者大脑熵的改变及其与警觉功能的关系。方法利用注意网络测试(attention network test,ANT)对20名r TLE患者和22名健康对照者的警觉功能进行研究;同时计算两组被试静息态功能磁共振(resting-state functional magnetic resonance,rs-f MRI)下的大脑熵(Brain Entropy,BEN),并选取两组的差异脑区(P<0.01)作为感兴趣区(region of interesting,ROI),提取熵值和各区的部分各向异性指数(fractional anisotropy,FA)值;分别对大脑熵值、FA值和警觉功能之间关系进行研究。结果与正常人相比,r TLE患者的固有警觉和位相性警觉反应时间显著增加;大脑熵在右颞下回、左额上回眶部显著增加,在右侧楔前叶、左侧顶上小叶等脑区显著降低;左额上回眶部的FA值较正常对照显著减小;固有警觉反应时间与左额上回眶部熵值呈正相关,与右侧楔前叶、左中央后回熵值呈负相关;位相性警觉反应时间与左额上回眶部的FA值、右侧楔前叶熵值及左中央后回熵值呈负相关。结论 r TLE患者警觉功能的下降与某些脑区其静息态大脑熵的改变和局部细微结构的损害有关,BEN作为一个新的指标可以用来研究癫痫患者脑功能。 Objective To study the changes of cerebral entropy and its relationship with alertness in patients with right temporal lobe epilepsy (r TLE) by resting state functional magnetic resonance imaging. Methods The attention network test (ANT) was used to study the alert function of 20 r TLE patients and 22 healthy controls. The resting-state functional magnetic resonance (P <0.01) as region of interest (ROI). The entropy and the partial entropy of each region were extracted Fractional anisotropy (FA) values ​​were calculated. The relationship between entropy, FA value and alertness function were studied. Results Compared with normal subjects, the alertness and phase response alertness of r TLE patients were significantly increased. The entropy of brain was significantly increased in the right inferior temporal gyrus and the upper orbital part of the left frontal gyrus. Lobes and other brain regions were significantly reduced; the left frontal gyrus orbital FA value was significantly reduced compared with the normal control; intrinsic alertness reaction time and the left frontal gyrus orbital entropy was positively correlated with the right wedge anterior lobe, left central back There was a negative correlation between the entropy and the phase reaction alert response time. The phase reaction alert time was negatively correlated with the FA of the upper left orbit, the anterior wedge anterior entropy and the left central retrospective entropy. Conclusions The decline of alertness function in patients with r TLE is related to the change of entropy of resting brain in some brain regions and the damage of local fine structure. BEN as a new index can be used to study brain function in epileptic patients.
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