Yang Fan, Jia Wenxiao, Kukun Hanjiaerbieke, Ding Shuang, Zhang Haotian, Wang Yunling
Department of Radiology, The First Affiliated Hospital of Xinjiang Medical University, Ürümqi, Xinjiang, People's Republic of China.
Neuropsychiatr Dis Treat. 2022 Jun 2;18:1107-1116. doi: 10.2147/NDT.S366189. eCollection 2022.
Patients with magnetic resonance imaging (MRI)-negative temporal lobe epilepsy (TLE-N) represent an important subgroup of temporal lobe epilepsy (TLE). Here, we aimed to combine three voxel-based local brain area analysis methods of resting-state functional MRI (rs-fMRI), to examine the TLE-N patients' resting brain function based on neural synchronization and intensity of local brain areas.
The study included 47 patients with TLE, including 28 cases of drug-controlled TLE (cTLE-N) and 19 cases of drug-resistant TLE-N (rTLE-N), as well as 30 participants in the healthy control (HC) group. To comprehensively assess the altered brain function associated with TLE-N patients, we analyzed three data-driven rs-fMRI algorithms for amplitude of low-frequency fluctuations (ALFF), fractional ALFF (fALFF) and regional homogeneity (ReHo).
Compared to the HC group, the distribution of abnormal functional brain areas in cTLE-N patients was dominated by occipital lobe activation, as measured by increased fALFF values in the superior occipital gyrus (SOG) and increased ReHo values in the lingual gyrus (Lin), fusiform gyrus, and middle occipital gyrus. Patients with rTLE-N exhibited a diffuse distribution of abnormal functional brain areas, showing increased fALFF values in the SOG, Lin, superior temporal gyrus, and postcentral gyrus, and decreased fALFF values in the inferior frontal gyrus orbital, parahippocampal gyrus, and superior frontal gyrus orbital. The ReHo values were reduced in the orbital region of the middle frontal gyrus, the precuneus, and the parietal inferior angular gyrus; while ReHo values were elevated values in several frontal, temporal, occipital, and subcortical brain areas.
Patients with rTLE-N have local brain activity changes in the prefrontal limbic system and default model network dysfunction, while cTLE-N patients have local brain activity changes in the visual functional areas. Different epilepsy networks exist between cTLE-N and rTLE-N.
磁共振成像（MRI）阴性的颞叶癫痫（TLE-N）患者是颞叶癫痫（TLE）的一个重要亚组。在此，我们旨在结合基于体素的静息态功能磁共振成像（rs-fMRI）的三种局部脑区分析方法，基于神经同步性和局部脑区强度来检查TLE-N患者的静息脑功能。
该研究纳入了47例TLE患者，包括28例药物控制的TLE（cTLE-N）和19例药物难治性TLE-N（rTLE-N），以及30名健康对照（HC）组参与者。为了全面评估与TLE-N患者相关的脑功能改变，我们分析了三种数据驱动的rs-fMRI算法，即低频波动幅度（ALFF）、分数ALFF（fALFF）和局部一致性（ReHo）。
与HC组相比，cTLE-N患者脑功能异常区域的分布以枕叶激活为主，表现为枕上回（SOG）的fALFF值增加，舌回、梭状回和枕中回的ReHo值增加。rTLE-N患者表现出脑功能异常区域的弥漫性分布，SOG、舌回、颞上回和中央后回的fALFF值增加，眶额下回、海马旁回和眶额上回的fALFF值降低。额中回眶部、楔前叶和顶下颞角回的ReHo值降低；而在几个额叶、颞叶、枕叶和皮质下脑区ReHo值升高。
rTLE-N患者在前额叶边缘系统存在局部脑活动变化和默认模式网络功能障碍，而cTLE-N患者在视觉功能区存在局部脑活动变化。cTLE-N和rTLE-N之间存在不同的癫痫网络。
