本文選題：腦網(wǎng)絡(luò)　切入點(diǎn)：側(cè)裂區(qū)　出處：《中國人民解放軍醫(yī)學(xué)院》2017年博士論文

【摘要】：研究背景:語言是人類最重要的高級神經(jīng)功能之一,追求最大程度的保護(hù)神經(jīng)功能是神經(jīng)外科的宗旨;目前左側(cè)大腦半球側(cè)裂區(qū)腦腫瘤對全腦連接性,尤其是對語言網(wǎng)絡(luò)的影響尚不清楚。本研究應(yīng)用經(jīng)典圖論工具,探索由DTI纖維束示蹤構(gòu)建的全腦以及語言纖維連接網(wǎng)絡(luò)全局和局部拓?fù)鋵傩缘淖兓?尋找與語言功能的內(nèi)在聯(lián)系。方法:1.選取33例左側(cè)大腦半球額顳頂葉腦腫瘤患者,根據(jù)術(shù)前語言功能分為2組(語言正常組17例、語言受損組16例),并選取對照組9例,同時(shí)應(yīng)用確定性和概率性纖維追蹤構(gòu)建全腦/語言網(wǎng)絡(luò),采用圖論分析,比較全局和局部參數(shù)差異性,采用NBS分析比較連接差異性;2.選取12例序貫患者,構(gòu)建全腦以及語言纖維連接FA網(wǎng)絡(luò),分析術(shù)前、術(shù)后的拓?fù)鋮?shù)變化及其與語言功能的關(guān)系;同時(shí),選取5種語言相關(guān)傳導(dǎo)束測定其平均FA值,并探索語言傳導(dǎo)束FA值與術(shù)前、術(shù)后語言的聯(lián)系。結(jié)果:1.所有研究對象的全腦/語言網(wǎng)絡(luò)均呈現(xiàn)出小世界性,病例組與對照組的全局效率ELambda具有顯著性差異;確定性全腦網(wǎng)絡(luò)中,排除性別和年齡因素的影響,WAB得分與ELambda具有相關(guān)性,但節(jié)點(diǎn)效率及其側(cè)化指數(shù)均未見明顯差異;NBS分析提示語言受損組存在失聯(lián)子網(wǎng)絡(luò);2. ELambda與術(shù)前及術(shù)后WAB均顯著相關(guān);而語言傳導(dǎo)束分析提示左側(cè)SLF、ILF、IFOF的FA值僅與術(shù)后WAB相關(guān),與術(shù)前語言無相關(guān);此外,SLF側(cè)化指數(shù)與術(shù)后WAB相關(guān)。結(jié)論:左側(cè)大腦半球側(cè)裂區(qū)腫瘤不僅引起局部的腦連接變化,而且導(dǎo)致全腦/語言網(wǎng)絡(luò)的拓?fù)鋵傩宰兓?這種變化與語言功能密切相關(guān)。相對于語言傳導(dǎo)束示蹤,全腦/語言網(wǎng)絡(luò)分析有望成為預(yù)測語言功能變化的有效手段。
[Abstract]:Background: language is one of the most important human advanced neural function, the pursuit of nerve protection function to the maximum extent is the purpose of the Department of Neurosurgery; the left hemisphere lateral fissure area of whole brain connectivity of brain tumors, especially the influence of network language is not clear. This study applied classical graph theory, explore the changes of DTI constructed by fiber beam tracing of whole brain and language fiber connected to the network of local and global topological properties, and find the relation between the language function. Methods: 1. samples from 33 cases of left hemisphere frontotemporal and parietal brain tumor patients, according to the language function before operation were divided into 2 groups (normal language group 17 cases, 16 cases of language impairment group). And selected 9 cases of the control group, while the application of deterministic and probabilistic construction of whole brain fiber tracking / language network, using graph theory analysis, comparison of global and local parameter difference, compared with NBS connection difference; 2. A total of 12 cases of patients with sequential, whole brain construction and language fiber connected to FA network, analysis of preoperative, postoperative changes of topological parameters and its relationship with language function; at the same time, select 5 kinds of language related tracts to determine the average value of FA, and to explore the language bundle FA value and preoperative, postoperative language contact results: 1.. All the research object of the whole brain / language network showed small world ELambda, the overall efficiency of the case group and the control group with significant difference; the uncertainty of whole brain networks, regardless of gender and age factors, associated with the scores of WAB and ELambda, but the node efficiency and laterality index showed no NBS analysis showed obvious differences; language impairment group has lost contact with the sub network; 2. ELambda with preoperative and postoperative WAB were significantly related; and language bundle analysis showed that left SLF, ILF IFOF, the FA value is only related to postoperative WAB and preoperative language phase In addition, SLF; laterality index and postoperative WAB. Conclusion: the left hemisphere lateral fissure area tumor not only cause local brain connectivity changes, but also lead to changes in the network topology language / whole brain, the changes and the language is closely related to the function of language. Compared with the bundle tracer, whole brain / language network analysis is expected to an effective means of predicting language function changes.

【學(xué)位授予單位】：中國人民解放軍醫(yī)學(xué)院
【學(xué)位級別】：博士
【學(xué)位授予年份】：2017
【分類號】：R739.4

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本文編號：1664541