特发性全身性癫痫分数低频振幅及局部一致性的静息态f MR I研究

目的：观察特发性全身性癫痫(IGE)患者静息状态下全脑功能改变情况。方法采用3.0T MR扫描仪对23例 IGE患者(IGE组)及23例健康志愿者(对照组)行全脑3D 结构相及静息态功能磁共振成像(RS-fMRI)扫描,进行全脑分数低频振幅(fALFF)及局部一致性(ReHo)功能分析,并对比 IGE组相比对照组 fALFF及 ReHo 改变的脑区,分析 IGE 组差异脑区与患者病程的相关性。结果与正常对照组相比,IGE组 fALFF升高的脑区位于双侧中央前回、左侧辅助运动区、左侧扣带回、左侧中央旁小叶、左侧距状裂周围皮层、左侧枕上回、左侧枕中回及右侧楔前叶；fALFF降低的脑区位于双侧颞下回、右侧海马旁回、右侧岛叶、右侧楔前叶及左侧顶下小叶(P<0.005)。ReHo 升高的脑区位于左侧距状裂周围皮层、左顶上小叶、左中央后回及右中央前回；ReHo降低的脑区位于右侧梭状回、左侧豆状核、右侧额下回、右内侧额上回、左侧枕中回、右侧岛叶及双侧顶下小叶(P<0.005)。IGE组 fALFF及 ReHo的差异脑区与患者病程均无相关性。结论 IGE患者脑内广泛的脑区功能异常改变可能是 IGE复杂临床表现的神经病理基础。联合应用 RS-fMRI的2种分析方法能较全面地评价静息状态下脑功能状态的改变情况,为 IGE 神经病理生理机制的研究提供可靠的功能神经解剖学依据。

Study of fractional amplitude of low frequency fluctuation and regional homogeneity in idiopathic generalized epilepsy based on resting-state functional MRI

Objective To observe the changes of whole brain function in idiopathic generalized epilepsy(IGE).Methods Three-dimensional structure scan and resting-state functional scan were performed in 23 cases of IGE patients and 23 health controls at 3.0T super-conducting MRI scanner.Brain functional analysis by fALFF and ReHo methods were obtained and the changes of brain areas were compared.Correlation analysis between different brain regions of IGE patients with the course of disease were performed.Results Compared with normal controls,IGE group showed increasd fALFF in the bilateral precentral gyrus,left supplementary motor area, left cingulate gyrus,left paracentral lobule,left superior occipital gyrus,left calcarine cortex,left middle occipital gyrus and right precuneus;decreased fALFF in the bilateral inferior temporal gyrus,right parahippocampa gyrus,right insula,right precuneus and left inferior parietal lobule(P<0.005).IGE group showed increasd ReHo in the left calcarine cortex,left superior parietal lobule, left postcentral gyrus,right precentral gyrus;decreased ReHo in the right fusiform gyrus,left lentiform nucleus,right inferior frontal gyrus,right superior medial frontal gyrus,left middle occiptal gyrus,right insula and bilateral inferior parietal lobule(P<0.005). These different brain regions in fALFF and ReHo results for IGE patients were no correlated with the course of disease.Conclusion IGE patients having wide range of brain areas with abnormal changes in function is the basis of the IGE complex clinical manifestations of the nerve.Combined application of two analysis methods of RS-fMRI can evaluate the change of brain function more comprehensively, and provide functional neuroanatomical evidence for the researches on neuro pathogenesis mechanism of IGE.