CAJ | 학술논문

目的采用基于低频振幅算法的血氧水平依赖功能磁共振成像技术,探讨无灶性癫痫脑活动的神经机制及其意义. 方法运用功能性磁共振成像技术观察安徽医科大学附属省立医院自2010年9月至2011年3月收治的16例无灶性癫痫患者和同期招募的15名健康对照者脑血氧水平依赖信号的改变；收集其静息态数据,然后运用低频振幅算法对数据进行分析,得到每个受试者的低频振幅统计图,观察无灶性癫痫患者相对于健康对照者低频振荡幅度(ALFF)增高和减弱的区域. 结果无灶性癫痫组和健康对照组相比ALFF增强的脑区分布在右侧颞叶(MNI坐标分别为15,-90,-21)、内侧额叶(0,24,-24)、腹侧前扣带回(-12,30,27)及右侧小脑半球(-51,-57,-4)；而ALFF减弱的脑区分布在左侧小脑半球及相邻后缘枕叶(-48,-15,39)、后扣带回(60,-21,33)及楔前叶(-6,-54,66). 结论无灶性癫痫患者静息状态下表现出异常的脑功能活动方式,ALFF升高的脑区反映了大脑对癫痫活动的产生、传播等易化作用,表明了癫痫的高活动:而ALFF减低的脑区则反映了大脑对癫痫活动的抑制.
목적 채용기우저빈진폭산법적혈양수평의뢰공능자공진성상기술,탐토무조성전간뇌활동적신경궤제급기의의. 방법 운용공능성자공진성상기술관찰안휘의과대학부속성립의원자2010년9월지2011년3월수치적16례무조성전간환자화동기초모적15명건강대조자뇌혈양수평의뢰신호적개변；수집기정식태수거,연후운용저빈진폭산법대수거진행분석,득도매개수시자적저빈진폭통계도,관찰무조성전간환자상대우건강대조자저빈진탕폭도(ALFF)증고화감약적구역. 결과 무조성전간조화건강대조조상비ALFF증강적뇌구분포재우측섭협(MNI좌표분별위15,-90,-21)、내측액협(0,24,-24)、복측전구대회(-12,30,27)급우측소뇌반구(-51,-57,-4)；이ALFF감약적뇌구분포재좌측소뇌반구급상린후연침협(-48,-15,39)、후구대회(60,-21,33)급설전협(-6,-54,66). 결론 무조성전간환자정식상태하표현출이상적뇌공능활동방식,ALFF승고적뇌구반영료대뇌대전간활동적산생、전파등역화작용,표명료전간적고활동:이ALFF감저적뇌구칙반영료대뇌대전간활동적억제.
Objective To study the changes of amplitude of low-frequency fluctuation (ALFF) in blood oxygenation level dependent functional MRI (BOLD-fMPI) in non-lesional epilepsy (NLE),and discuss its underlying neurophysiological mechanism. Methods The BOLD-fMRI data of 16 patients with NLE and 15 normal volunteers were analyzed by ALFF. The amplitude of the blood oxygenation level dependent activation of the resting state brain was investigated. The brain structures showing increased and decreased ALFF in NLE patients were demonstrated by comparing to normal subjects with 2-sample t-test with threshold of P＜0.05. Results As compared with those in normal subjects,the regions showing increased ALFF in NLE patients were distributed in the right temporal lobe (Montreal Neurological Institute [MNI] coordinates:x=15,y=90,z=21),medial frontal lobe (MNI coordinates:0,24,-24),ventral anterior cingulated (MNI coordinates:-12,30,27) and right cerebellar hemisphere (MNI coordinates:-51,-57,-4); while the regions showing decreased ALFF covered the areas of the left cerebellar hemisphere (MNI coordinates:-48,-15,39),posterior cingulum gyrus (MNI coordinates:60,-21,33) and precuneus (MNI coordinates:-6,-54,66). Conclusion NLE patients show abnormal brain functional organization in resting state; the increased ALFF is considered to be the facilitation such as epileptic activity generation and propagation,while the decreased ALFF might be considered as the functional inhibition in these regions.