Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Epilepsy Behav. 2019 Jul;96:80-86. doi: 10.1016/j.yebeh.2019.03.020. Epub 2019 May 15.
Numerous studies have highlighted important roles for the cerebellum in cognition and movement, based on numerous fiber connections between the cerebrum and cerebellum. Abnormal cerebellar activity caused by epileptic discharges has been reported in previous studies, but researchers have not clearly determined whether aberrant cerebellar activity contributes to the disruption of the cerebellar-cerebral networks in right temporal lobe epilepsy (rTLE). Here, thirty patients with rTLE and 30 age- and sex-matched healthy controls (HCs) were recruited. All participants underwent the Attention Network Test (ANT) and resting-state functional magnetic resonance imaging (rs-fMRI) scanning. Cerebellar functional networks were extracted and analyzed by defining seeds in the cerebellum. A correlation analysis was performed between attentional performance and voxels that showed differences in functional connectivity (FC) in patients compared with HCs. Relative to HCs, patients exhibited significantly decreased FC in the dentate nucleus (DN) network (right DN with the left postcentral gyrus, left precentral gyrus, left cuneus, and left calcarine gyrus) and motor network (right cerebellar lobule V with the right putamen) and increased FC in the executive control network (right cerebellar crus I with the right inferior parietal lobule). Alerting, orienting, and executive control performances were impaired in patients with rTLE. Furthermore, the executive control effect was significantly correlated with aberrant FC strength between the right DN and the left precentral/postcentral gyrus. Our findings highlight that the disrupted cerebellar-cerebral functional network ipsilateral to the epileptogenic focus causes both impairments in and compensatory effects on attentional deficits in patients with rTLE. These findings contribute to our understanding of the cerebellar damage caused by epileptic discharges and the corresponding effect on attentional performance.
大量研究基于大脑和小脑之间众多的纤维连接，强调了小脑在认知和运动中的重要作用。以前的研究报道了由癫痫放电引起的异常小脑活动，但研究人员尚未明确确定异常小脑活动是否会导致右侧颞叶癫痫(rTLE)中小脑-大脑网络的中断。在这里，招募了 30 名 rTLE 患者和 30 名年龄和性别匹配的健康对照者(HCs)。所有参与者均接受注意力网络测试(ANT)和静息态功能磁共振成像(rs-fMRI)扫描。通过在小脑中定义种子来提取和分析小脑功能网络。对注意力表现与患者与 HCs 相比功能连接(FC)差异较大的体素之间进行相关性分析。与 HCs 相比，患者在齿状核(DN)网络(右侧 DN 与左侧中央后回、左侧中央前回、左侧楔叶和左侧距状回)和运动网络(右侧小脑小叶 V 与右侧壳核)中表现出明显降低的 FC，而在执行控制网络(右侧小脑 Crus I 与右侧顶下小叶)中表现出增加的 FC。rTLE 患者的警觉、定向和执行控制表现受损。此外，执行控制效果与右侧 DN 与左侧中央后回/中央前回之间异常 FC 强度显著相关。我们的研究结果强调了致痫灶对侧小脑-大脑功能网络的破坏导致 rTLE 患者注意力缺陷的既有损伤和代偿作用。这些发现有助于我们理解癫痫放电引起的小脑损伤以及对注意力表现的相应影响。
