目的：应用基于体素的形态学测量方法结合李代数微分同胚配准算法（Voxel-based morphometry-diffeomorphic anatomical registration through exponential lie algebra，VBM-DARTEL）测定颞叶癫痫（Temporal lobe epilepsy，TLE）患者大脑灰质和白质的体积改变并研究其与执行功能的关系。方法：收集经确诊的左侧颞叶癫痫（Left-sided temporal lobe epilepsy，lTLE）患者16例、右侧颞叶癫痫（Right-sided temporal lobe epilepsy，rTLE）患者26例及健康对照者（Healthy control，HC）38例，行常规MRI扫描并采集3D快速梯度回波T1加权像；应用VBM-DARTEL方法计算分割后的脑灰质和白质体积值，并获得有统计学差异的脑区（P<0.001，uncorrected，K≥50）；应用注意网络测试评价执行功能；研究全脑灰、白质体积值与执行功能的关系。结果：TLE患者有全脑广泛的脑灰、白质体积的减少，灰质体积减少以颞叶、额叶为著，白质体积的减少则主要在颞叶和海马；rTLE组的右侧楔前叶灰质较lTLE组明显减少；未发现灰、白质体积增加的脑区；lTLE组和rTLE组执行网络效率值均较HC组显著增大（P<0.05），lTLE组的执行网络效率值较rTLE组显著增大（P<0.05）；rTLE组执行网络效率值与灰质体积值呈负相关。结论：TLE患者存在大脑灰质和白质结构的改变，不同致痫侧的TLE患者结构和功能改变存在差异，rTLE患者全脑灰质体积的减少导致执行功能下降。
Abstract
Objective: To measure the volumetric changes of grey and white matters in patients with temporal lobe epilepsy(TLE) using voxel-based morphometry-diffeomorphic anatomical registration through exponential lie algebra(VBM-DARTEL) and to study its relationship with the executive function. Methods: Sixteen left-sided temporal lobe epilepsy(lTLE) patients, 26 right-sided temporal lobe epilepsy(rTLE) patients and 38 healthy controls(HC) underwent routine MRI scanning and acquisition 3D fast gradient echo T1 weighted imaging. The VBM-DARTEL method was used to calculate grey matter and white matter volume values after segmentation, and the brain regions with statistical difference were obtained(P<0.001, uncorrected, K≥50), the attention network test was used to evaluate the executive function, and the relationship between the volume value of grey matter and white matter and executive function was studied. Results: TLE patients had diffuse cerebral atrophy, grey matter atrophy of brain regions was mainly in temporal lobe and frontal lobe. The white matter was mainly in temporal lobe and hippocampus, the right anterior lobe of grey matter in rTLE patients was less than that in lTLE patients, no grey and white matter volume increased, compared to HC, the TLE patients’ executive network efficiency values were significantly increased(P<0.05), and executive network efficiency values of the lTLE patients were significantly higher than that of the rTLE patients(P<0.05), and executive network efficiency values were negatively correlated with grey matter volumes in rTLE patients. Conclusion: There are changes in brain structure of the TLE patients. There were differences in the structure and function of patients with different origin lesions. In rTLE patients, the decrease in the volume of grey matters have led to a decline in executive function.
关键词
癫痫 /
颞叶；磁共振成像
Key words
Epilepsy, temporal lobe /
Magnetic resonance imaging
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基金
国家自然科学基金资助项目（编号81360202）；国家自然科学基金资助项目（编号81560223）。
