Grassia Fabio, Poliakov Andrew V, Poliachik Sandra L, Casimo Kaitlyn, Friedman Seth D, Shurtleff Hillary, Giussani Carlo, Novotny Edward J, Ojemann Jeffrey G, Hauptman Jason S
1Department of Neurological Surgery, University of Milano-Bicocca, San Gerardo Hospital, Monza, Italy.
Departments of2Radiology and.
J Neurosurg Pediatr. 2018 Sep;22(3):270-275. doi: 10.3171/2018.3.PEDS17701. Epub 2018 Jun 22.
OBJECTIVE Functional connectivity magnetic resonance imaging (fcMRI) is a form of fMRI that allows for analysis of blood oxygen level-dependent signal changes within a task-free, resting paradigm. This technique has been shown to have efficacy in evaluating network connectivity changes with epilepsy. Presurgical data from patients with unilateral temporal lobe epilepsy were evaluated using the fcMRI technique to define connectivity changes within and between the diseased and healthy temporal lobes using a within-subjects design. METHODS Using presurgical fcMRI data from pediatric patients with unilateral temporal lobe epilepsy, the authors performed seed-based analyses within the diseased and healthy temporal lobes. Connectivity within and between temporal lobe seeds was measured and compared. RESULTS In the cohort studied, local ipsilateral temporal lobe connectivity was significantly increased on the diseased side compared to the healthy temporal lobe. Connectivity of the diseased side to the healthy side, on the other hand, was significantly reduced when compared to connectivity of the healthy side to the diseased temporal lobe. A statistically significant regression was observed when comparing the changes in local ipsilateral temporal lobe connectivity to the changes in inter-temporal lobe connectivity. A statistically significant difference was also noted in ipsilateral connectivity changes between patients with and those without mesial temporal sclerosis. CONCLUSIONS Using fcMRI, significant changes in ipsilateral temporal lobe and inter-temporal lobe connectivity can be appreciated in unilateral temporal lobe epilepsy. Furthermore, fcMRI may have a role in the presurgical evaluation of patients with intractable temporal lobe epilepsy.
目的 功能连接磁共振成像（fcMRI）是功能磁共振成像的一种形式，可在无任务的静息模式下分析血氧水平依赖信号变化。该技术已被证明在评估癫痫患者的网络连接变化方面具有有效性。采用受试者内设计，利用fcMRI技术对单侧颞叶癫痫患者的术前数据进行评估，以确定患病和健康颞叶内部及之间的连接变化。方法 作者使用单侧颞叶癫痫患儿的术前fcMRI数据，在患病和健康颞叶内进行基于种子点的分析。测量并比较颞叶种子点内部及之间的连接性。结果 在研究队列中，与健康颞叶相比，患病侧局部同侧颞叶连接性显著增加。另一方面，与健康侧到患病颞叶的连接性相比，患病侧到健康侧的连接性显著降低。比较局部同侧颞叶连接性变化与颞叶间连接性变化时，观察到具有统计学意义的回归关系。在有和没有内侧颞叶硬化的患者之间，同侧连接性变化也存在统计学显著差异。结论 利用fcMRI，可以观察到单侧颞叶癫痫患者同侧颞叶和颞叶间连接性的显著变化。此外，fcMRI可能在难治性颞叶癫痫患者的术前评估中发挥作用。
