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目的采用静息态功能磁共振成像的低频振幅技术,探讨无灶性癫痫患者低频振幅与注意功能之间可能存在的关系。方法对16例无灶性癫痫患者和16名正常志愿者进行静息态fMRI数据采集及注意功能行为学测试,采用REST软件计算显示无灶性癫痫患者相对于正常人ALFF增高和减弱的区域,对上述的16例无灶性癫痫患者和16例正常对照进行气球叉掉测试,数字符号转换测试及stroop测试检测其注意功能,观察无灶性癫痫患者静息态fMRI与注意功能之间可能存在的联系。结果①无灶性癫痫组和正常对照组相比,ALFF增强的脑区分布在右侧颞叶(15,-90,21)、内侧额叶(0,24,-24)、腹侧前扣带回(-12,30,27)及右侧小脑半球(-51,-57,-4);②无灶性癫痫组和正常对照组相比ALFF减弱的脑区分布在左侧小脑半球及相邻后缘枕叶(-48,-15,39)、后扣带回(60,-21,33)及楔前叶(-6,-54,66);③无灶性癫痫患者的三项注意功能测试反应时间均较正常对照组延长(P<0.01)。Stroop测试结果表明无灶性癫痫组与对照组相比冲突条件下较一致、中性条件下的错误率显著增加。结论无灶性癫痫患者静息状态下表现出异常的脑功能活动方式。长期异常放电对患者的注意功能有明显损害,其中持续注意能力下降,可能与无灶性癫痫患者的颞叶及额叶的病变相关;选择注意能力下降,可能与腹侧前扣带回的损伤密切相关。
Objective To investigate the relationship between low frequency amplitude and attentional function in patients with focal non-focal epilepsy by using low-frequency amplitude technique of resting state functional magnetic resonance imaging. Methods Fetal resting fMRI data acquisition and functional behavioral testing were performed in 16 patients with non-focal epilepsy and 16 normal volunteers. REST software was used to calculate the areas of increased and decreased ALFF in patients with non-focal epilepsy compared with normal subjects. The above 16 cases of non-focal epilepsy and 16 normal control balloon fork off test, digital sign conversion test and stroop test to detect its attention function, observation of patients with non-focal epilepsy resting fMRI and attention may exist between the function Contact. Results ① Compared with the normal control group, the brain regions of ALFF increased in the right temporal lobe (15, -90, 21), medial frontal lobe (0, 24, -24), ventral anterior buckle (-12,30,27) and right cerebellar hemispheres (-51, -57, -4). ② Compared with the normal control group, the decreased brain regions of ALFF were distributed in the left cerebellar hemisphere and Adjacent posterior occipital lobe (-48, -15, 39), posterior cingulate gyrus (60, -21,33) and anterior wedge (-6, -54,66); ③ patients with non-focal epilepsy Note the functional test response time than the normal control group extended (P <0.01). Stroop test results showed that the non-focal epilepsy group compared with the control group under the conditions of conflict is more consistent, the error rate was significantly increased under neutral conditions. CONCLUSIONS: Patients with non-focalized epilepsy exhibit abnormal patterns of brain function activity at rest. Long-term abnormal discharge of patients with obvious damage to the attention function, which continued to pay attention to the ability to decline, may be related to non-patients with temporal lobe and frontal lobe lesions; related to decreased ability to choose attention may be related to ventral anterior cingulate injury closely related.