Wang Xiang-qing, Iang Sen-yang, Lu Hong, Ma Lin, Mao Yan-ling, Yang Fei
Department of Neurology, General Hospital of the Chinese People's Liberation Army, Beijing, China.
Zhonghua Yi Xue Za Zhi. 2007 Dec 4;87(45):3183-7.
To explore the cognitive changes and the relation with the parameters of DTI in the brain areas in patients with temporal lobe epilepsy by neuropsychological test and DTI study.
Thirty-two patients with temporal lobe epilepsy, 11 males and 8 females, aged 32 +/- 12, with the education year of 8.6 +/- 1.2, and 42 sex, age, and education level-matched healthy controls underwent and a comprehensive test battery test including verbal fluency (VI), digit span (DSp), digit symbol (DSy), Stroop color-word test, trail making test, and so as to evaluate the intelligence level. Nineteen patients and twenty-one control subjects underwent diffusion tensor imaging (DTI) of the head. The correlation between the results of DTI and cognitive function tests of the patients was analyzed.
VI test showed that the number of word spoken in 1 min by the healthy control group was (16 +/- 4), significantly more than that of the patient group [(11 +/- 4), P = 0.00]. The DSp score of the control group was (14.6 +/- 3.1) points, significantly more than that of the patient group [(11.1 +/- 2.8), P = 0.00]. The number of DSy filled by the patient group was (47 +/- 17), significantly less than that of the control group [(60 +/- 16), P = 0.00]. The time needed to make trail of the patients was (56 +/- 20) s, significantly longer than that of the control group [(37 +/- 11) s, P = 0.01]. The Stroop reaction time of the patient group was (6.1 +/- 4.5) s, significantly longer than that of the control group [(30 +/- 5) s, P = 0.00]. The Stroop error number of the patient group was (6.1 +/- 4.5), significantly more than that of the control group [(1.4 +/- 1.2), P = 0.00]. The fractional anisotropy (FA) values of the posterior limb of left internal capsule and of the bilateral thalami of the patient group were significantly lower than those of the control group (P = 0.01 or P = 0.00). VI was negatively correlated with the mean diffusivity (MD) in left caudamen (r = -0.56, P = 0.04), right putamen (r = -0.58, P = 0.04), left putamen (r = -0.58, P = 0.04), and right thalamus (r = -0.64, P = 0.02), and was positively correlated with the FA in white matter of left frontal lobe (r = 0.43, P = 0.04)and left occipital lobe (r = 0.47, P = 0.02). DSp was negatively correlated with the MD in splenium of corpus callosum (r = 0.58, P = 0.04) and left putamen (r = -0.59, P = 0.04). TMT was positively correlated with the MD in the posterior limb of right internal capsule (r = 0.65, P = 0.02) and posterior limb of left internal capsule (r = 0.59, P = 0.03).
The prefrontal cortex is a vital component of the circuitry subserving executive function. But the corresponding damaged area in patients with impaired executive function was not limited to frontal lobe,more areas beyond frontal lobe may be involved in executive function.
通过神经心理学测试和弥散张量成像（DTI）研究，探讨颞叶癫痫患者脑区的认知变化及其与DTI参数的关系。
选取32例颞叶癫痫患者，其中男性11例，女性8例，年龄32±12岁，受教育年限8.6±1.2年；42名性别、年龄和教育水平相匹配的健康对照者接受包括言语流畅性（VI）、数字广度（DSp）、数字符号（DSy）、Stroop颜色-文字测试、连线测试等在内的综合测试组测试，以评估智力水平。19例患者和21名对照者接受头部弥散张量成像（DTI）检查。分析患者DTI结果与认知功能测试结果之间的相关性。
VI测试显示，健康对照组1分钟说出的单词数为（16±4）个，显著多于患者组[（11±4）个，P = 0.00]。对照组的DSp得分是（14.6±3.1）分，显著高于患者组[（11.1±2.8）分，P = 0.00]。患者组填写的DSy数量为（47±17）个，显著少于对照组[（60±16）个，P = 0.00]。患者完成连线测试所需时间为（56±20）秒，显著长于对照组[（37±11）秒，P = 0.01]。患者组的Stroop反应时间为（6.1±4.5）秒，显著长于对照组[（3.0±0.5）秒，P = 0.00]。患者组的Stroop错误数为（6.1±4.5）个，显著多于对照组[（1.4±1.2）个，P = 0.00]。患者组左侧内囊后肢和双侧丘脑的各向异性分数（FA）值显著低于对照组（P = 0.01或P = 0.00）。VI与左侧尾状核（r = -0.56，P = 0.04）、右侧壳核（r = -0.58，P = 0.04）、左侧壳核（r = -0.58，P = 0.04）和右侧丘脑（r = -0.64，P = 0.02）的平均扩散率（MD）呈负相关，与左侧额叶白质（r = 0.43，P = 0.04）和左侧枕叶白质（r = 0.47，P = 0.02）的FA呈正相关。DSp与胼胝体压部（r = 0.58，P = 0.04）和左侧壳核（r = -0.59，P = 0.04）的MD呈负相关。连线测试与右侧内囊后肢（r = 0.65，P = 0.02）和左侧内囊后肢（r = 0.59，P = 0.03）的MD呈正相关。
前额叶皮质是执行功能神经回路的重要组成部分。但执行功能受损患者的相应受损区域并不局限于额叶，额叶以外的更多区域可能参与执行功能。
