Department of Neurology, the People's Hospital of Guangxi Zhuang Autonomous Region.
Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Neuroreport. 2021 Aug 11;32(12):1009-1016. doi: 10.1097/WNR.0000000000001681.
Numerous neuroimaging studies have demonstrated that functional brain aberrations are associated with cognitive impairments in temporal lobe epilepsy (TLE). Here, we aimed to investigate the neural substrates of attention deficits by combining assessment of regional intrinsic brain activities with large-scale functional connectivity in patients with right TLE (rTLE).
Thirty-five patients with rTLE and 33 matched healthy controls were recruited. All participants completed the Attention Network Test (ANT) and resting-sate functional MRI (rs-fMRI) scans. The z-standardized fractional amplitude of the low-frequency fluctuation (zfALFF) approach was applied to evaluate the brain's intrinsic activity. The cerebral regions with significant zfALFF values were selected as seeds for subsequent functional connectivity analyses. A correlation analysis was performed between functional activity and clinical variables.
Compared with the healthy control group, the patients showed decreased zfALFF in the right inferior temporal gyrus and bilateral superior parietal gyrus, and the right inferior temporal gyrus exhibited increased functional connectivity with the bilateral cerebellum-6/vermis-6 and decreased functional connectivity with right superior frontal gyrus. The ANT indicated that the rTLE group exhibited attention deficits. Furthermore, a positive correlation was found between the zfALFF value of the left superior parietal gyrus and alerting performance, while a negative correlation between the zfALFF value of the right superior parietal gyrus and disease duration.
This study demonstrated aberrant intrinsic cerebral activity and functional connectivity in the whole brain network, which may act as responsible and compensatory factors in attention deficits, especially further profoundly illuminated the compensatory role of cerebellum in patients with rTLE.
大量神经影像学研究表明，功能脑异常与颞叶癫痫（TLE）患者的认知障碍有关。在这里，我们旨在通过结合评估局部内在脑活动与右侧 TLE（rTLE）患者的大规模功能连接来研究注意力缺陷的神经基础。
招募了 35 名 rTLE 患者和 33 名匹配的健康对照者。所有参与者都完成了注意力网络测试（ANT）和静息状态功能磁共振成像（rs-fMRI）扫描。应用 z 标准化低频波动分数（zfALFF）方法评估大脑的内在活动。选择具有显着 zfALFF 值的脑区作为后续功能连接分析的种子。对功能活动与临床变量之间进行相关性分析。
与健康对照组相比，患者的右侧颞下回和双侧顶上回的 zfALFF 值降低，右侧颞下回与双侧小脑-6/蚓部-6 的功能连接增加，与右侧额上回的功能连接减少。ANT 表明 rTLE 组存在注意力缺陷。此外，左侧顶上回的 zfALFF 值与警觉表现呈正相关，而右侧顶上回的 zfALFF 值与疾病持续时间呈负相关。
本研究表明整个大脑网络中存在异常的内在脑活动和功能连接，这可能是注意力缺陷的责任和代偿因素，特别是进一步深入阐明了小脑在 rTLE 患者中的代偿作用。
