本文選題：顳葉癲癇 + 警覺功能��； 參考：《廣西醫(yī)科大學》2017年碩士論文

【摘要】：目的結合行為學測試,運用聯(lián)合任務態(tài)功能磁共振(f MRI)和基于體素的形態(tài)學研究(VBM)的方法,探討顳葉癲癇患者警覺功能及腦結構的損害特點及其關系。方法顳葉癲癇患者(癲癇組)21例,正常人(健康對照組)19例,均予行為學練習和測試,并進行警覺功能的任務態(tài)f MRI和3D結構像的掃描。行為學數(shù)據(jù)采用數(shù)據(jù)采用SPSS16.0軟件統(tǒng)計分析,磁共振數(shù)據(jù)采用SPM8、Rest1.8軟件統(tǒng)計分析。結果1、注意網(wǎng)絡測試中TLE組雙重暗示平均反應時間(638.03±78.81ms)顯著長于健康對照組(584.26±88.33 ms),差異有統(tǒng)計學意義(t=2.035,P0.05),而警覺網(wǎng)絡效應反應時間(RT)兩組并無差異(t=0.011,P0.05)。2、任務態(tài)f MRI中警覺網(wǎng)絡組內及組間分析:(1)健康對照組警覺效應激活腦區(qū)主要為右頂葉、右額葉、雙側顳葉,雙側枕葉、小腦等腦區(qū)激活(P0.05)。(2)TLE患者組其主要激活腦區(qū)為雙側的顳葉、右額葉、左枕葉,但總體激活的強度和范圍較對照組小,且小腦、頂葉未見明顯激活(P0.05)(3)組間分析兩樣本t檢驗:TLE患者組較健康對照組在右頂葉(頂下小葉)、右枕葉、小腦、左顳葉的激活明顯下降(P0.05,Alphasim校正,體素152)3、VBM組間分析結果顯示TLE患者組較健康對照組在右島葉、右顳葉、右側嗅皮層以及左顳葉、左側楔前葉、距狀回等腦區(qū)灰質體積明顯減少。(P0.05,Alphasim校正,體素228)4、右側頂下小葉與警覺網(wǎng)絡效應RT呈中等程度負相關關系(r=-0.449,p0.05),其余腦區(qū)相關分析未見有統(tǒng)計學意義。結論1、顳葉癲癇患者警覺網(wǎng)絡腦區(qū)的激活明顯下降,具有右側偏性,可能是TLE患者警覺功能下降的基礎。2、右頂葉(頂下小葉)是警覺腦功能網(wǎng)絡中的一個重要節(jié)點。3、TLE患者灰質減少的腦區(qū)主要集中在內側顳葉的海馬旁回,以及顳葉以外的右額葉嗅皮層、左枕葉的距狀回、左楔葉等。4、警覺激活下降的區(qū)域主要為內側顳葉以遠端的頂枕葉為主,而VBM下降的區(qū)域以顳葉及其鄰近的額葉為主。二者大部分不重疊。
[Abstract]:Objective to investigate the characteristics and relationship between alertness and brain structure in patients with temporal lobe epilepsy by means of combined task state functional magnetic resonance imaging (fMRI) and voxel based morphologic study (VBM). Methods Twenty one patients with temporal lobe epilepsy (epileptic group) and 19 normal subjects (healthy control group) were examined with behavioral exercises and tests, and the task-based fMRI and 3D structural images of alertness were performed. The behavioral data were analyzed by SPSS 16.0 software, and the magnetic resonance data by SPM8 / Rest1.8 software. Results 1. The average response time (638.03 鹵78.81ms) of the TLE group was significantly longer than that of the healthy control group (584.26 鹵88.33 ms), while the alert network response time (RT) was not different between the two groups (t 0.011 P 0.05). Intra-group and inter-group analysis: (1) the right parietal lobe was the main brain area activated by alerting effect in healthy control group. In the right frontal lobe, bilateral temporal lobe, bilateral occipital lobe, and cerebellar area activation (P0.05). (2), the main activation areas were bilateral temporal lobe, right frontal lobe, left occipital lobe, but the overall activation intensity and range were smaller than those in the control group. There was no significant activation in the parietal lobe (P0.05) (3) the activation of the right parietal lobe, the right occipital lobe, the cerebellum and the left temporal lobe was significantly decreased (P0.05 Alphasim correction) in the TLE group compared with the healthy control group. The volume of gray matter in the right insular lobe, the right temporal lobe, the right olfactory cortex and the left temporal lobe, the left anterior cuneate lobe and the talar gyrus were significantly decreased in the TLE group than in the healthy control group. The correlation between right inferior parietal lobule and alert network effect RT was negatively correlated (r = -0.449, p 0.05). No significant correlation was found in other brain regions. Conclusion 1. The activation of the alert network area in patients with temporal lobe epilepsy was significantly decreased, and the right side of the brain was deviated. The right parietal lobe (inferior parietal lobule) is an important node in the alerting brain function network. The decreased gray matter of TLE patients is mainly concentrated in the parahippocampal gyrus of the medial temporal lobe. Besides, the olfactory cortex of the right frontal lobe, the talus gyrus of the left occipital lobe, the left cuneiform lobe, etc. 4. The medial temporal lobe with the distal parietal occipital lobe, the medial temporal lobe with the medial temporal lobe, and the region with VBM decreased mainly in the temporal lobe and its adjacent frontal lobe. Most of the two do not overlap.
【學位授予單位】：廣西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R445.2;R742.1

【參考文獻】

相關期刊論文 前7條

1 宋無名;陳南圭;;功能MRI:最先進方法的簡要回顧和展望(英文)[J];磁共振成像;2013年05期

2 尹清;樹海峰;劉宏亮;楊輝;顏如冰;;難治性顳葉癲癇腦組織IL-6、IL-6受體及sIL-6R、sgp130的表達及意義[J];中華神經(jīng)醫(yī)學雜志;2012年06期

3 劉菲;欒國明;;影響顳葉癲癇手術療效的相關因素研究進展[J];立體定向和功能性神經(jīng)外科雜志;2012年01期

4 曾高;焦風;劉波;劉獻增;張慶俊;梁冶矢;;難治性癲癇的外科治療(附30例報告)[J];山東醫(yī)藥;2012年08期

5 周健;鮑民;翟鋒;欒國明;;MRI陰性的顳葉癲癇的外科治療[J];中華神經(jīng)外科雜志;2011年12期

6 覃百靈;鄭金甌;黨超;葉偉;陳子蓉;余璐;;顳葉癲癇患者警覺功能的腦功能磁共振研究[J];中風與神經(jīng)疾病雜志;2011年10期

7 鄭金甌;黨超;梁志堅;余璐;李麗萍;陳子蓉;葉偉;;顳葉癲癇患者執(zhí)行功能的功能磁共振研究[J];中國神經(jīng)精神疾病雜志;2011年03期

，

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