Department of Radiology, The General Hospital of Western Theater Command, Chengdu, China.
Brain Behav. 2021 Feb;11(2):e01979. doi: 10.1002/brb3.1979. Epub 2020 Dec 30.
To evaluate the efficacy of functional magnetic resonance imaging (fMRI) based on Chinese tasks to protect the language function in epileptics.
A total of 34 native Chinese patients with epilepsy were enrolled and examined with BOLD-fMRI scan based on six Chinese tasks. The epileptics were randomly divided into the control group (n = 15) and the experimental group (n = 19). The control group underwent the hollowing and multiple subpial transection operation only based on intraoperative EEG, while the experimental group was under notification of task-state fMRI results in addition. Whereafter, the language ability of patients was evaluated by ABC assessment.
The brain regions related to Chinese function activated by different tasks were remarkably distinct and mainly concentrated in the temporal lobe and frontal lobe. In ontoanalysis, the activation signals of the fusiform gyrus, parahippocampal gyrus, hippocampus, and precentral gyrus were generally low or even could not be detected. Unlike ontoanalysis, group analysis showed that the main effect regions of AN and PN task were in right superior temporal gyrus. The main effect regions of FF and VFC task were in right middle temporal gyrus. The main effect region of SF task was in left superior temporal gyrus. The main effect region of VFL task was in right middle frontal gyrus. The ABC assessment score of the control group 6 months after surgery was significantly lower than that 1 week before surgery (p < .05), while there was no significant difference in the experimental group, and the score of the experimental group was higher than that of the control group.
In the surgical treatment of epilepsy, a personalized surgical plan, based on task-state fMRI and intraoperative EEG, can be developed according to the difference of activation areas to protect the language function and improve the quality of life in postoperative patients.
评估基于中文任务的功能磁共振成像（fMRI）在保护癫痫患者语言功能方面的疗效。
共纳入 34 名母语为中文的癫痫患者，采用基于 6 项中文任务的血氧水平依赖功能磁共振成像（BOLD-fMRI）扫描进行检查。将癫痫患者随机分为对照组（n=15）和实验组（n=19）。对照组仅根据术中脑电图行空洞化和多发性软膜下横切术，实验组则在通知任务态 fMRI 结果的情况下进行手术。随后，采用 ABC 评估对患者的语言能力进行评估。
不同任务激活的与中文功能相关的脑区明显不同，主要集中在颞叶和额叶。在体素分析中，梭状回、海马旁回、海马和中央前回的激活信号普遍较低，甚至无法检测到。与体素分析不同，组分析显示，AN 和 PN 任务的主要效应区位于右侧颞上回；FF 和 VFC 任务的主要效应区位于右侧颞中回；SF 任务的主要效应区位于左侧颞上回；VFL 任务的主要效应区位于右侧额中回。术后 6 个月，对照组 ABC 评估评分明显低于术前 1 周（p<0.05），实验组无明显差异，且实验组评分高于对照组。
在癫痫的手术治疗中，根据激活区的差异，制定基于任务态 fMRI 和术中脑电图的个性化手术方案，可以保护语言功能，提高术后患者的生活质量。
