右侧颞叶癫痫患者后扣带功能和结构连接与警觉功能的相关性研究

目的利用静息态功能磁共振(functional magnetic resonance imaging,fMRI)及弥散张量成像(diffusiontensor imaging,DTI)技术探讨右侧颞叶癫痫(right temporal lobe epilepsy,rTLE)患者后扣带回功能与结构连接的改变及其与警觉功能关系。方法本实验纳入17例rTLE患者和21例健康对照,对所有被试进行静息态fMRI及DTI扫描、注意网络测试(attention network test,ANT)评估警觉功能。结合静息态f MRI和DTI分析rTLE患者后扣带回功能连接和纤维的微结构改变,并对功能和结构与警觉行相关分析。结果与健康对照相比,rTLE患者固有警觉(intrinsic alertness,IA)与位相性警觉(phasic alertness,PA)的平均反应时间均显著延长(t=-2.771,-2.671;P=0.009,0.011),rTLE患者右后扣带回FA值显著降低(t=-2.136,P=0.040),rTLE患者左后扣带回与右颞极-颞中回、左颞下回、左额上-额中回、右后扣带回的功能连接(functional connectivity,FC)下降(P0.05,Alpha Sim校正,体素值46),右后扣带回与右颞极-颞中回、右海马、右海马旁回、左后扣带回的FC下降(P0.05,Alpha Sim校正,体素值43)。rTLE患者左后扣带回与左额上-额中回间下降的FC与警觉效应行为学成绩呈负相关(r=-0.724,P=0.001),右后扣带回与左后扣带回间下降的FC与固有警觉(r=-0.484,P=0.049)及位相性警觉呈负相关(r=-0.515,P=0.035)。结论 rTLE患者后扣带回警觉功能网络完整性受到破坏,rTLE患者右后扣带回纤维束显著受损,rTLE患者后扣带回间及左后扣带回与左额上-额中回间的功能连接下降可导致警觉功能下降。

Right temporal lobe epilepsy: Abnormal functional and structural connectivity in the posterior cingulate cortex and their relationship with alertness performance

Objective The present study aimed to study the alterations of resting state functional connectivity and structural connectivity in the posterior cingulate cortex and their relationships with alertness performance in patients with right temporal lobe epilepsy (rTLE). Methods A total of 17 right TLE patients and 21 healthy controls were recruited for the current study. All of the participants underwent a resting state functional magnetic resonance imaging (fMRI) and dif-fusion tensor imaging (DTI) scan, and an attention network test (ANT) for the evaluation of their alertness performance. We combined fMRI with DTI to investigate changes in functional and structural connectivity in the posterior cingulate cortex in patients with rTLE. Correlation analysis method was used to analyze the relationship between functional and structural connectivity strength and the alertness performance. Results The reaction times of intrinsic alertness (IA) and phasic alertness (PA) performance were significantly longer in rTLE patients(t=-2.771,-2.671;P=0.009,0.011). The fractional anisotropy (FA) was significantly lower in rTLE patients (t=-2.136, P=0.040). The temporal-pole-mid-dle-right, left inferior temporal gyrus, frontal-superior-medial-left and right posterior cingulate cortex showed deceased functional connectivity with the left posterior cingulate cortex in the rTLE patient group(P<0.05, AlphaSim corrected, clus-ter size>46). The temporal-pole-middle-right, right hippocampus, right parahippocampal gyrus and left posterior cingu-late cortex showed deceased functional connectivity with the right posterior cingulate cortex in the rTLE patient group(P<0.05, AlphaSim corrected,cluster size>43). In the rTLE patient group, the decreased functional connectivity of the left pos-terior cingulate cortex and frontal-superior-medial-left was significantly correlated with the alertness effect performance (r=-0.724, P=0.001);the decreased functional connectivity of the right posterior cingulate cortex and the left posterior cin-gulate cortex was significantly correlated with the intrinsic(r=-0.484, P=0.049) and phasic alertness performance(r=-0.51, P=0.035). Conclusions Our findings suggest that there is the impairment of posterior cingulate cortex alertness functional networks in patients with rTLE. The fasciculus of the right posterior cingulate cortex is damaged in rTLE patients. The de-creased functional connectivity in the posterior cingulate cortex and frontal-superior-medial-left, the right posterior cin-gulate cortex and the left posterior cingulate cortex may cause alertness functional impairment in rTLE patients.