颞叶癫痫共病抑郁的静息态磁共振研究

摘要/Abstract

摘要： 目的研究颞叶癫痫（TLE）患者的脑功能异常对抑郁的影响,找到TLE共病抑郁相关的功能特异的脑区,从而进一步辅助临床诊疗工作。方法收集TLE患者共30例,根据汉密尔顿抑郁量表评分,将其分成抑郁组及非抑郁组,每组15例。30例患者均完善多导视频脑电图（VEEG）检查、3.0T磁共振头颅平扫和静息态功能磁共振扫描,然后进行影像数据的预处理及统计分析。结果 2组患者的基本信息,如性别、年龄对比,差异无统计学意义（P>0.05）,而病程对比差异有统计学意义（P<0.05）。抑郁组优势侧放电多见。对静息态分析方法（ALFF、fALFF、ReHo）的样本独立t检验显示,和非抑郁组相比,抑郁组激活增强的脑区有脑默认网络的楔前叶、前扣带回、顶上回,以及颞上回、额下回等脑区。结论 TLE共病抑郁患者病程普遍较长、优势半球受累多见,脑默认网络激活、脑区结构异常与抑郁的产生有关。临床可应用此项技术来指导诊疗及外科手术干预。

关键词: 癫痫, 颞叶癫痫, 抑郁, 静息态功能磁共振, 视频脑电图, 脑功能

Abstract: Objective To study the effect of TLE brain dysfunction on depression by analysing the brain electrical activity, and find out the functional specific brain regions related to TLE complicated with depression, so as to further assist clinical diagnosis and treatment. Methods According to Hamilton depression scale score, a total of 30 patients with temporal lobe epilepsy were collected and divided into 15 patients with temporal lobe epilepsy comorbidities depression group and 15 patients with non-depression group. All the 30 patients underwent VEEG examination, 3.0T MRI and RS-fMRI examination, and then the image data were preprocessed and statistically analyzed. Results There were no significant differences in age, sex between the two groups (P>0.05). The difference in duration of epilepsy was statistically significant(P<0.05). Dominant side discharge was more common in depression group. The independent t-test of two samples which based on three kinds of RS-fMRI analysis methods(amplitude of low frequency fluctuations, fractional alff and regional homogeneity) showed that stronger activate brain regions were included the cingulum, the precuneus, the parietal which belonged to default-mode network. Conclusion Depression patients with temporal lobe epilepsy comorbidities generally have a longer course of disease, and more dominant hemispheres are involved. The activation of the brain default network and the abnormal structure of brain regions are related to the generation of depression. The technique can be applied to guide diagnosis, treatment and surgical intervention.

Key words: epilepsy, temporal lobe epilepsy, depression, resting-state functional magnetic resonance imaging, video electroencephalogram, brain function

中图分类号:

R742.1

胡天羽, 崔书奎, 张丽芳. 颞叶癫痫共病抑郁的静息态磁共振研究[J]. 承德医学院学报, 2023, 40(2): 116-120.

HU Tian-yu, CUI Shu-kui, ZHANG Li-fang. Resting-state Functional Magnetic Resonance Study of Temporal Epilepsy Comorbidity Depression[J]. Journal of Chengde Medical University, 2023, 40(2): 116-120.

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