颞叶癫痫患者磁共振弥散张量成像及记忆损害的研究.pdf

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1、风与神经疾病杂志2012年旦·13文章编号：1003—2754(2012)01-0013-04颞叶癫痫患者磁共振弥散张量成像及记忆损害的研究李丽萍，郑金瓯，余璐，黄东红，陈子蓉摘要：目的利用磁共振弥散张量成像技术(DTI)研究颞叶癫痫(TLE)患者脑内微观改变及记忆损害的相关脑区。方法对颞叶癫痫患者15例和健康对照者15例，进行DTI检查，利用韦氏记忆量表检测记忆功能。结果TLE患者部分各向异性弥散(FA)值降低激活区域有颞叶、边缘叶、扣带回和岛叶，升高区有：额叶、顶叶、枕叶，表观系数(ADC)值升高激活区域在颞叶、额叶、枕叶、顶叶；无ADC值降低区域。与健康者相比，颞叶癫痫患者

2、的记忆商数(MQ)(90．73±19．72)显著下降，P<0．01。对照组FA值在左岛叶、颞叶与MQ值正相关；患者组FA值在右额、顶、枕叶、左顶叶与MQ值正相关，在左颞叶与MQ值负相关。对照组ADC与MQ正相关区域在左边缘叶，与MQ成负相关区域在左顶叶、患者组正相关区域在左、右颞叶。结论初步证实TLE患者的脑内结构变化不局限于颞叶，还包括颞叶外网络结构；TLE患者全脑DTI与MQ存在着相关激活脑区，表明记忆功能损害与脑内相关结构改变有关。关键词：颞叶癫痫；弥散张量成像；记忆功能中图分类号：R742．1文献标识码：ADifusiontensorimagingandmemoryimp

3、airmentinpatientswithtemporallobeepilepsyL／Li-ping，ZHENGfin—ou，YULu，eta1．(DepartmentofNeurology，TheFirstAfiliatedHospital，GuangxiMedicalUniversity，Nanning530021，Chi—aa)Abstract：ObjectiveUsingdiffusiontensorimaging(DTI)toexplorethepathologicalchangesinbrainandthere—latedtomemoryimpairmentoftem

4、porallobeepilepsy(TLE)，andtodiscussthepossiblemechanism．Methods15TLEcasesand15healthyindividualswererandomlyselectedandincludedintotheDTIstudy．TheWechslermemoryscale(WMS)wereadoptedtoassessthememoryofallthesubjects．ResultsComparedwithcontrolinvoxel—basedanalysis(VBA)，thepatientshadlessactivat

5、ionoffrontallobe，apicallobe、occipital，withincreaseddiffusivityfoundinthosere—gions．Adecreaseddiffusivitywasfoundinthetemporallobe，limbiclobeandinsularlobe．AsignificantincreaseinADCwasfoundinthetemporallobe，frontallobe，apicallobeandoccipitallobe．TheMQofpatients(90．73±19．72)wassignifi—cantlydro

6、ppedcomparedwithcontrolgroup(P<0．01)．FAactivationresuhregressedagainstMQ，inthecontrolgroup，leftinsularlobeandlefttemporelobewerepositivelycorrelatedwithMQ．Rightfrontallobe，apicallobe，occipitallobeandleftapicallobewerepositivelycorrelatedwithMQintheTLEpatients．Lefttemporelobeshowednegativecore

7、lationintheTLEgroup．Inthecontrolgroup，therewereADCactivationresultpositivecorrelationwithMQinleftlimbiclobe．Leftapi—callobe，parahippocampalgymsandrighttemporelobewerenegativelycorrelatedwithMQ．IntheTLEgroup，therewereADCactivationresultpositiv