發(fā)布時(shí)間：2018-06-19 02:13

  本文選題：原發(fā)性癲癇 + 靜息態(tài)功能磁共振成像　； 參考：《內(nèi)蒙古醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的應(yīng)用靜息態(tài)功能磁共振成像(rfMRI)技術(shù),采用低頻振幅比率分析方法(fALFF)研究首發(fā)原發(fā)性復(fù)雜部分性發(fā)作(CPS)的癲癇患者在治療前后的腦局部自發(fā)活動(dòng)特征,探討首發(fā)原發(fā)性癲癇患者治療前后的腦功能改變情況及其與抗癲癇藥物臨床療效的關(guān)系。方法收集2015年6月-2016年6月內(nèi)蒙古醫(yī)科大學(xué)附屬醫(yī)院神經(jīng)內(nèi)科診斷為原發(fā)性復(fù)雜部分性發(fā)作(CPS)患者14例,對(duì)符合標(biāo)準(zhǔn)的14例CPS患者和14例性別、年齡、利手、受教育程度相匹配的正常對(duì)照分別進(jìn)行MRI檢查,全部被試均采用GE Discovery 750 3.0T超導(dǎo)型磁共振掃描儀采集數(shù)據(jù)。常規(guī)序列包括常規(guī)軸位T2WI、T1WI,以排除顱內(nèi)器質(zhì)性病變,功能序列包括T1-3D BRAVO、靜息態(tài)BOLD,患者組規(guī)律用藥,治療12周后再次檢查。對(duì)病例組治療前后的數(shù)據(jù)及健康對(duì)照組的數(shù)據(jù)進(jìn)行數(shù)據(jù)預(yù)處理,計(jì)算其全腦fALFF值,然后治療前后分別與健康對(duì)照行雙樣本t檢驗(yàn)(two sample t-test),結(jié)果疊加在標(biāo)準(zhǔn)avg152T1像上進(jìn)行顯示,取閾值P=0.001(未校正),經(jīng)過Alphasim校正,去除少于25個(gè)體素的區(qū)域(校正后P0.001),得到兩組被試f ALFF統(tǒng)計(jì)差異腦圖。結(jié)果fALFF值治療前較正常對(duì)照組顯著增高的腦區(qū)為雙側(cè)丘腦、后扣帶回及左側(cè)角回、頂下小葉;顯著降低的腦區(qū)為雙側(cè)內(nèi)側(cè)前額葉、前扣帶回。治療后與對(duì)照組發(fā)現(xiàn)雙側(cè)丘腦異常激活腦區(qū)消失,雙側(cè)后扣帶回、左側(cè)角回異常激活腦區(qū)減小,而左側(cè)頂下小葉激活腦區(qū)范圍變大,另外發(fā)現(xiàn)于雙側(cè)額葉、楔前葉、左側(cè)楔葉有新激活腦區(qū)(P0.001,簇大小≥25個(gè)體素?cái)?shù))。結(jié)論1、fALFF可觀測(cè)原發(fā)性癲癇患者治療前后的腦功能改變情況,為臨床客觀評(píng)價(jià)治療情況及抗癇藥物的療效提供新的見解,也對(duì)其病理生理機(jī)制的進(jìn)一步研究開辟新的思路。2、首發(fā)原發(fā)性癲癇患者靜息狀態(tài)下存在廣泛異常激活及抑制腦區(qū),與以往文獻(xiàn)的觀點(diǎn)一致,被認(rèn)為是癲癇發(fā)病的神經(jīng)基礎(chǔ)。3、經(jīng)12周抗癲癇治療后,CPS患者部分異常腦區(qū)恢復(fù)正常,提示原發(fā)性癲癇的腦功能異常變化可經(jīng)抗癲癇治療逆轉(zhuǎn)。4、治療后發(fā)現(xiàn)小部分未逆轉(zhuǎn)區(qū)及略擴(kuò)大的左側(cè)頂下小葉激活區(qū),其病理生理學(xué)機(jī)制還需我們進(jìn)一步探討。
[Abstract]:Objective to study the characteristics of spontaneous brain activity in epileptic patients with primary complex partial seizure (CPS) before and after treatment with resting functional magnetic resonance imaging (fMRI) technique and the method of low-frequency amplitude ratio analysis (LAPR). To investigate the changes of brain function in patients with primary epilepsy before and after treatment and its relationship with the clinical efficacy of antiepileptic drugs. Methods from June 2015 to June 2016, 14 patients with CPS diagnosed by Department of Neurology, affiliated Hospital of Inner Mongolia Medical University, and 14 patients with CPS who met the criteria were collected. All subjects were examined by MRI using GE Discovery 7503.0T superconducting magnetic resonance scanner. Routine sequences included routine axial T _ 2WI _ T _ 1WI to exclude intracranial organic lesions. Functional sequences included T1-3D Bravo, resting BOLDD, regular medication in the patient group, and re-examination after 12 weeks of treatment. The data of patients before and after treatment and those of healthy control group were pretreated and the whole brain fALFF values were calculated. Two sample t-tests were performed before and after treatment, and the results were displayed on the standard avg152T1 images. The threshold value P0. 001 (uncorrected) was removed by Alphasim correction to remove less than 25 individual elements (P0. 001), and the difference brain map was obtained between the two groups. Results the significantly increased fALFF values were bilateral thalamus, posterior cingulate gyrus and left angular gyrus, inferior parietal lobule, and bilateral medial prefrontal lobe and anterior cingulate gyrus. After treatment and control group, bilateral thalamic abnormal activation brain disappeared, bilateral posterior cingulate gyrus decreased, left angle gyrus decreased, while left inferior parietal lobule became larger, and bilateral frontal lobe and prewedge lobe were also found. In the left cuneate lobe, there was a newly activated brain area (P0.001) with cluster size 鈮，

本文編號(hào)：2037887