摘要
目的：探讨原发性全面强直阵挛癫痫（GTCS）发作间期静息态下全脑功能活动特点。方法：选取原发性GTCS患者21例（GTCS组），以及21名与GTCS组在性别、年龄、受教育程度、利手等相匹配的健康志愿者（正常对照组），采用3.0T MR扫描仪进行梯度回波-平面回波成像（GRE-EPI），获取被试者全脑静息态数据，利用DPARSF软件进行静息态数据预处理，计算并对比GTCS组与正常对照组全脑比率低频振幅（fALFF）改变的脑区，观察fALFF改变的脑区与患者国立医院癫痫发作严重程度量表（NHS3）评分的相关性。结果：与正常对照组相比，GTCS组较正常对照组fALFF减低的脑区为扣带回、额内侧回、右侧岛盖、左侧缘上回（t值为-4.63～-3.88，P值均<0.01），GTCS组较正常对照组fALFF升高的脑区为小脑后叶/小脑扁桃体、右侧梭状回、颞下回（t值为5.21～6.04，P值均<0.01）。GTCS患者的NHS3评分与左侧顶叶、顶下小叶、右侧枕颞内侧回、颞下回的fAIFF呈正相关（P＜0.01），与额内侧回、额上回、左侧岛叶、颞上回的fALFF呈负相关（P＜0.01）。结论：GTCS发作间期扣带回、额内侧回、颞下回、小脑后叶、小脑扁桃体等脑区功能活动异常，这些功能区的异常可能与GTCS患者的发病机理及临床表现有关，提示借助fALFF可以帮助我们更深入解释GTCS的临床表现及病理生理机制。
Abstract
Objective: To explore the whole brain activity features during the interictal time of generalized tonic-clonic seizure(GTCS) using resting state MRI. Methods: Twenty-one GTCS individuals and 21 healthy control subjects, well matched in gender, age, education and handedness, were enrolled as the GTCS group and control group, respectively． A Siemens 3.0T MR scanner was used to acquire all the subjects’ resting state data with GRE-EPI sequence, DPARSF software was used to process resting functional MRI data. fALFF of the two groups were calculated and compared. The correlation between fALFF and NHS3 scores of GTCS was observed. Results: In comparison with the control group, the GTCS group showed reduced fALFF in cingulate gyrus, medial frontal gyrus, right opercula insulae, left supramarginal gyrus(t＝-4.63～-3.88, P<0.01). fALFF was increased in the cerebellum posterior lobe/cerebellar tonsil, right fusiform gyrus, inferior temporal gyrus(t＝5.21～6.04, P<0.01). In addition, fALFF in the left parietal lobe, inferior parietal lobule, right fusiform gyrus, inferior temporal gyrus positively correlated with the NHS3 scores of the patients(P＜0.01), while in the medial frontal gyrus, superior frontal gyrus, left insular lobe superiortemporal gyrus correlated negatively with the NHS3 scores of the patients(P＜0.01). Conclusion: GTCS patients had abnormal activity at the cingulate gyrus, medial frontal gyrus, inferior temporal gyrus, cerebellum posterior lobe, cerebellar tonsil et al, during the interictal time; and these abnormal activities might be related with clinical manifestation and pathophysiology, which may help for explanation of the clinical manifestations and pathophysiological mechanisms in GTCS.
关键词
癫痫 /
强直阵挛性 /
磁共振成像
Key words
Epilepsy /
tonic-clonic /
Magnetic resonance imaging
刘光耀;杨晓萍;张 喆;蒋 健;韩月东;马强华;柯 铭.
原发性全面强直阵挛癫痫全脑比率低频振幅的静息态fMRI研究[J]. 中国临床医学影像杂志. 2013, 24(9): 609-612
LIU Guang-yao;YANG Xiao-ping;ZHANG Zhe;JIANG Jian;HAN Yue-dong;MA Qiang-hua;KE Ming.
Fractional amplitude analysis of low frequency fluctuation in generalized tonic-clonic seizure:a resting state functional MRI study[J]. Journal of China Clinic Medical Imaging. 2013, 24(9): 609-612
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