摘要
目的探讨3.0T常规磁共振阴性的药物难治性颞叶癫痫(rTLE-N)与药物控制性颞叶癫痫(cTLE-N)脑灰质体积及脑白质结构网络拓扑属性差异。方法选取2017年3月至2019年8月在广西医科大学第一附属医院就诊的20例rTLE-N、15例cTLE-N完成头颅3DT1及DTI扫描,20例健康对照(HC)也完成此项检查。基于体素的形态学分析(VBM)方法比较3组脑灰质体积差异,基于图论的方法比较3组脑白质结构网络拓扑属性差异。结果①VBM结果:与HC组相比,rTLE-N组在双侧海马、丘脑、颞中回、内侧和旁扣带回,左侧直回、眶内额上回,右侧海马旁回灰质体积减少(P<0.001);cTLE-N组右侧颞中回、眶内额上回灰质体积减少(P<0.001)。与cTLE-N组相比,rTLE-N组在双侧岛叶、中央沟盖,左侧海马旁回、眶内额上回、梭状回、小脑6区,右侧丘脑、枕下回灰质体积减少(P<0.001);②脑白质结构网络拓扑属性结果:3组脑白质结构网络均表现出小世界属性。与HC组比较,rTLE-N组最短路径长度(Lp)增加、局部效率(Eloc)及全局效率(Eg)下降(P<0.05),cTLE-N组Lp增加、Eg下降(P<0.05);与cTLE-N组比较,rTLE-N组Lp增加、Eloc及Eg下降(P<0.05)。结论TLE-N是一种脑网络疾病,但rTLE-N与cTLE-N致痫网络不同,cTLE-N脑灰质萎缩较局限但已出现脑结构网络拓扑属性受损,而rTLE-N涉及多个脑区灰质萎缩且脑结构网络拓扑属性损害更严重。
Objective To investigate the difference of the brain gray matter and the topological properties of the structural network of white matter between 3.0T conventional MRI-negative drug-refractory temporal lobe epilepsy(rTLE-N)and 3.0T conventional MRI-negative drug-controlled temporal lobe epilepsy(cTLE-N).Methods 20 cases with rTLE-N,15 cases with cTLE-N and 20 healthy controls(HC)were involved in the study.All subjects completed 3DT1 and DTI scans of the brain.The gray matter volume of the three groups were compared by voxel-based morphological analysis(VBM),and the graph theory were used to compare the topological properties of brain structure networks of the three groups.Results①VBM results:compared with the HC group,the rTLE-N group reduced the gray matter volume in bilateral hippocampus,bilateral thalamus,bilateral middle temporal gyrus,bilateral median cingulate and paracingulate gyri,left gyrus rectus,left medial orbital superior frontal gyrus and right parahippocampa gyrus(P<0.001).Compared with the HC group,the cTLE-N group reduced the gray matter volume in right middle temporal gyrus and right medial orbital superior frontal gyrus(P<0.001).Compared with the cTLE-N group,the rTLE-N group reduced the gray matter volume in the bilateral insular,bilateral rolandic operculum,left parahippocampa gyrus,left medial orbital superior frontal gyrus,left fusiform gyrus,left cerebellum-6,right thalamus and right inferior occipital gyrus.(P<0.001).②The result of Topological properties:the white matter structure networks of the three groups all exhibited small world attributes.Compared with the HC group,the rTLE-N group showed the increase of the shortest path length(Lp)and the decrease of local efficiency(Eloc)and global efficiency(Eg)(P<0.05),and the cTLE-N group showed the increase of Lp and the decrease of Eg(P<0.05).Compared with the cTLE-N group,the rTLE-N group showed the increase of Lp and the decrease of Eloc and Eg(P<0.05).Conclusion TLE-N is a brain network disease,but there are different epileptic networks between cTLE-N and rTLE-N.Although the grey matter atrophy of cTLE-N was limited,the topological properties of the brain structural network are damaged,while rTLE-N involved in the atrophy of gray matter in multiple brain regions and the damage of the topological properties of the brain structural network is more serious.
作者
孙兰凤
黄琪
韦雷
刘朝宁
马美刚
韦兴
廖宇晗
吴原
SUN Lanfeng;HUANG Qi;WEI Lei(Department of Neurology,the First Affiliated Hospital of Guangxi Medical University,Nanning(530021),Guangxi China)
出处
《癫痫与神经电生理学杂志》
2021年第1期10-16,F0003,共8页
Journal of Epileptology and Electroneurophysiology(China)
基金
广西自然科学基金(NO:2017GXNSFAA198047)。
关键词
磁共振阴性颞叶癫痫
药物难治性
脑灰质
脑网络拓扑属性
MRI-negative temporal lobe epilepsy(TLE-N)
drug-refractory
brain gray matter
brain network topological properties
