颞叶癫痫：丘脑静息态功能连接性降低及其与警觉性表现的关系。

Temporal lobe epilepsy: decreased thalamic resting-state functional connectivity and their relationships with alertness performance.

作者信息

Chen Xue-Mei, Huang Dong-Hong, Chen Zi-Rong, Ye Wei, Lv Zong-Xia, Zheng Jin-Ou

机构信息

Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.

Department of Radiology, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.

出版信息

Epilepsy Behav. 2015 Mar;44:47-54. doi: 10.1016/j.yebeh.2014.12.013. Epub 2015 Jan 23.

DOI:10.1016/j.yebeh.2014.12.013

PMID:25622022

Abstract

OBJECTIVES

Studies have provided evidence regarding the pathology of the thalamus in patients with temporal lobe epilepsy (TLE). The thalamus, particularly the right thalamus, is one of the subcortical structures that are most uniformly accepted as being significantly involved in alertness. Moreover, alertness impairment in epilepsy has been reported. This study aimed to investigate alterations in thalamic resting-state functional connectivity (FC) and their relationships with alertness performance in patients with TLE; an issue that has not yet been addressed.

METHODS

A total of 15 patients with right TLE (rTLE) and 16 healthy controls were recruited for the present study. All of the participants underwent a resting-state functional magnetic resonance imaging (fMRI) scan and the attention network test (ANT). Whole-brain voxel-wise FC analyses were applied to extract the thalamic resting-state functional networks in the patients with rTLE and healthy controls, and the differences between the two groups were evaluated. Correlation analyses were employed to examine the relationships between alterations in thalamic FC and alertness performance in patients with rTLE.

RESULTS

Compared to the healthy controls, the FC within and between the bilateral thalamus was decreased in the patients with rTLE. Moreover, in the patient group, the bilateral anterior cingulate cortex (ACC) and subcortical regions, including the bilateral brainstem, cerebellum, putamen, right caudate nucleus, and amygdala, exhibited decreased FC with the ipsilateral thalamus (p<0.05, AlphaSim corrected, cluster size>44) but not with the contralateral thalamus (p<0.05, AlphaSim corrected, cluster size>43). The intrinsic and phasic alertness performances of the patients were impaired (p=0.001 and p<0.001, respectively) but not correlated with decreased thalamic FC. Meanwhile, the alertness performance was not altered in right TLE but was negatively correlated with decreased thalamic FC with ACC (p<0.05).

CONCLUSIONS

Our findings highlight the functional importance of the thalamus in TLE pathology and suggest that damage to the thalamic resting-state functional networks, particularly ipsilateral to the epileptogenic focus, is present in patients with TLE.

摘要

目的

研究已提供了有关颞叶癫痫（TLE）患者丘脑病理学的证据。丘脑，尤其是右侧丘脑，是被最一致认为与警觉性密切相关的皮质下结构之一。此外，已有报道癫痫患者存在警觉性损害。本研究旨在调查TLE患者丘脑静息态功能连接（FC）的改变及其与警觉性表现的关系；这一问题尚未得到解决。

方法

本研究共招募了15例右侧TLE（rTLE）患者和16名健康对照者。所有参与者均接受了静息态功能磁共振成像（fMRI）扫描和注意力网络测试（ANT）。应用全脑体素水平的FC分析来提取rTLE患者和健康对照者的丘脑静息态功能网络，并评估两组之间的差异。采用相关性分析来检查rTLE患者丘脑FC改变与警觉性表现之间的关系。

结果

与健康对照者相比，rTLE患者双侧丘脑内部及之间的FC降低。此外，在患者组中，双侧前扣带回皮质（ACC）和包括双侧脑干、小脑、壳核、右侧尾状核和杏仁核在内的皮质下区域，与同侧丘脑的FC降低（p<0.05，经AlphaSim校正，簇大小>44），但与对侧丘脑的FC未降低（p<0.05，经AlphaSim校正，簇大小>43）。患者的内在和相位警觉性表现受损（分别为p=0.001和p<0.001），但与丘脑FC降低无关。同时，右侧TLE患者的警觉性表现未改变，但与丘脑与ACC的FC降低呈负相关（p<0.05）。