中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2008年
23期
1594-1598
,共5页
张志强%卢光明%钟元%谭启富%朱建国%姜黎%陈志立%王中秋%史继新%臧玉峰%刘一军
張誌彊%盧光明%鐘元%譚啟富%硃建國%薑黎%陳誌立%王中鞦%史繼新%臧玉峰%劉一軍
장지강%로광명%종원%담계부%주건국%강려%진지립%왕중추%사계신%장옥봉%류일군
磁共振成像%癫痫,颞叶%海马%硬化
磁共振成像%癲癇,顳葉%海馬%硬化
자공진성상%전간,섭협%해마%경화
Magnetic resonance imaging%Epilepsy,temporal lobe%Hippocampus%Sclerosis
目的 采用静息功能磁共振成像低频振幅(ALFF)技术,探讨颞叶癫痫脑活动的神经机制.方法 采用功能磁共振成像技术,观察伴有双侧海马硬化(HS)的内侧颞叶癫痫(mTLE)患者脑血氧水平依赖信号活动的改变.对南京军区南京总医院20例伴有HS的mTLE患者及20名正常志愿者进行静息态数据采集,并计算出各受试者ALFF值;采用两样本t检验,以P＜0.01水平观察TLE患者相对正常人,ALFF增高及降低的区域.结果 相比正常人,TLE患者BOLD信号ALFF改变的区域呈双侧对称分布.ALFF升高区域以边缘叶为中心进行分布:包括双侧海马旁回、杏仁核、脑干网状结构区、下丘脑、部分扣带回等边缘系统;双侧感觉运动区、枕叶、颞下回及眶额回等新皮层区;以及中脑腹侧及小脑内侧等皮层下结构,以右中央前回(15,-12,51)为最大ALFF增高区(T=6.02).ALFF幅度降低的区域包括:扣带回前部、内侧前额叶及楔前叶等经典缺省模式区域,双背外侧前额叶及颞上回,双豆状核头部、中脑背侧结构及小脑后叶等结构,以小脑(3,-78,-21)为最大ALFF降低区(T=-4.42).结论 ALFF功能磁共振成像技术可以对癫痫引起的脑活动改变情况进行观察.ALFF增高的脑区反映了大脑对癫痫活动的产生、传播等易化作用,边缘叶在TLE中起着重要作用;ALFF降低区域反映了大脑对癫痫活动的抑制,尤其是缺省模式功能的受抑制.
目的 採用靜息功能磁共振成像低頻振幅(ALFF)技術,探討顳葉癲癇腦活動的神經機製.方法 採用功能磁共振成像技術,觀察伴有雙側海馬硬化(HS)的內側顳葉癲癇(mTLE)患者腦血氧水平依賴信號活動的改變.對南京軍區南京總醫院20例伴有HS的mTLE患者及20名正常誌願者進行靜息態數據採集,併計算齣各受試者ALFF值;採用兩樣本t檢驗,以P＜0.01水平觀察TLE患者相對正常人,ALFF增高及降低的區域.結果 相比正常人,TLE患者BOLD信號ALFF改變的區域呈雙側對稱分佈.ALFF升高區域以邊緣葉為中心進行分佈:包括雙側海馬徬迴、杏仁覈、腦榦網狀結構區、下丘腦、部分釦帶迴等邊緣繫統;雙側感覺運動區、枕葉、顳下迴及眶額迴等新皮層區;以及中腦腹側及小腦內側等皮層下結構,以右中央前迴(15,-12,51)為最大ALFF增高區(T=6.02).ALFF幅度降低的區域包括:釦帶迴前部、內側前額葉及楔前葉等經典缺省模式區域,雙揹外側前額葉及顳上迴,雙豆狀覈頭部、中腦揹側結構及小腦後葉等結構,以小腦(3,-78,-21)為最大ALFF降低區(T=-4.42).結論 ALFF功能磁共振成像技術可以對癲癇引起的腦活動改變情況進行觀察.ALFF增高的腦區反映瞭大腦對癲癇活動的產生、傳播等易化作用,邊緣葉在TLE中起著重要作用;ALFF降低區域反映瞭大腦對癲癇活動的抑製,尤其是缺省模式功能的受抑製.
목적 채용정식공능자공진성상저빈진폭(ALFF)기술,탐토섭협전간뇌활동적신경궤제.방법 채용공능자공진성상기술,관찰반유쌍측해마경화(HS)적내측섭협전간(mTLE)환자뇌혈양수평의뢰신호활동적개변.대남경군구남경총의원20례반유HS적mTLE환자급20명정상지원자진행정식태수거채집,병계산출각수시자ALFF치;채용량양본t검험,이P＜0.01수평관찰TLE환자상대정상인,ALFF증고급강저적구역.결과 상비정상인,TLE환자BOLD신호ALFF개변적구역정쌍측대칭분포.ALFF승고구역이변연협위중심진행분포:포괄쌍측해마방회、행인핵、뇌간망상결구구、하구뇌、부분구대회등변연계통;쌍측감각운동구、침협、섭하회급광액회등신피층구;이급중뇌복측급소뇌내측등피층하결구,이우중앙전회(15,-12,51)위최대ALFF증고구(T=6.02).ALFF폭도강저적구역포괄:구대회전부、내측전액협급설전협등경전결성모식구역,쌍배외측전액협급섭상회,쌍두상핵두부、중뇌배측결구급소뇌후협등결구,이소뇌(3,-78,-21)위최대ALFF강저구(T=-4.42).결론 ALFF공능자공진성상기술가이대전간인기적뇌활동개변정황진행관찰.ALFF증고적뇌구반영료대뇌대전간활동적산생、전파등역화작용,변연협재TLE중기착중요작용;ALFF강저구역반영료대뇌대전간활동적억제,우기시결성모식공능적수억제.
Objective To study the changes of amplitude of low-frequency fluctuation (ALFF) of the resting-fMRI in the mesial temporal lobe epilepsy (mTLE) with bilateral hippocampal sclerosis ( HS) , and discussed its underlying neuro-pathophysiological mechanism. Methods The resting-fMRI data of 20 TLE patients with HS and 20 normal volunteers were performed ALFF analysis. 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 TLE patients were demonstrated by comparing to normal subjects with 2-sample t-test with threshold of P <0. 01. Results By comparison with that of normal subjects, the regions showing increased and decreased ALFF in TLE patients were distributed in the brain symmetrically and bilaterally. The regions showing increased ALFF were distributed with center of limbic system, such as parahippocampal gyri, araygdale, hypothalamus, dorsal anterior cingulate gyrus and part of posterior insular lobe, as well as the neocortices such as primary sensorimotor cortices, occipital cortices, inferior temporal gyri, orbital gyri, and the subcortical structures of verbal brainstem and mesial cerebellum. The point with maximal increased ALFF(T = 6. 02) located in the right precentral gyru (15, -12,51). While the regions showing decreased ALFF covered the areas of default mode, such as posterior cingulate cortex/ precuneus and medial prefrontal cortex /ventral anterior cingulate cortex, as well as other structures such as dorsal lateral prefrontal corties, superior temporal gyri, caudate heads, dorsal brain stem and the posterior cerebellum (3, -78, -21) with the maximal decreased ALFF(T= -4.42). Conclusion The method of ALFF allows the direct observation to the epileptic activation in TIE. The increased ALFF is considered the facilitation such as the epileptic activity generation and propagation; while the ALFF decrease is considered the function inhibition in these regions, especially implies the suspension in the default mode activity.
