中文摘要：

目的应用静息态功能磁共振成像（rs-f MRI）探讨难治性癫痫患者楔前叶与全脑功能连接的改变及其意义。方法对23例难治性癫痫患者（癫痫组）及23名健康人（对照组）进行rs-f MRI检查,采集数据后采用功能连接的方法,分别计算以左侧楔前叶和右侧楔前叶为感兴趣区与全脑的功能连接,运用双样本t检验的统计学方法发现两组的显著性差异并进行分析。结果癫痫组左侧楔前叶与双侧顶下小叶、双侧岛叶、右侧缘上回、右侧额中回和双侧额下回的功能连接较对照组减弱（均P〈0.05）;癫痫组左侧楔前叶与双侧海马旁回、双侧额上回、左侧后扣带回的功能连接较对照组增强（均P〈0.05）。癫痫组右侧楔前叶与左侧顶下小叶、右侧缘上回、右侧额中回、右侧额下回的功能连接较对照组减弱（均P〈0.05）;癫痫组右侧楔前叶与双侧楔叶、左侧后扣带回的功能连接较对照组增强（均P〈0.05）。结论难治性癫痫患者静息状态下楔前叶与全脑的功能连接存在异常,＂默认网络＂功能的抑制可能是癫痫患者意识及认知等功能损害的重要原因。

英文摘要：

Objective To explore the changes and significance of functional connectivity between precuneus and the whole brain in refractory epilepsy patients using resting-state functional magnetic resonance imaging（ rsf MRI） technology. Methods Twenty-three patients with refractory epilepsy（ epilepsy group） and 23 healthy controls（ control group） were recruited to take a rs-f MRI scan. After which functional connectivity methods were used to calculate and analyze in both side of precuneus for the region of interest with the whole brain. Using the statistical method of two samples t test,it attempted to seek and discuss the significant difference of functional connectivity in two groups. Results Compared with the control group,epilepsy group showed decreased functional connectivity in left precuneus with bilateral inferior parietal lobe,insular lobe,right supramarginal and right middle frontal gyrus,as well as inferior frontal gyrus（ all P〈0. 05）; while epilepsy group showed increased functional connectivity in left precuneus with bilateral parahippocampal,frontal lobe and left posterior cingutate（ all P〈0. 05）. Compared with the control group,epilepsy group showed decreased functional connectivity in right precuneus with left inferior parietal lobule and right frontal lobes（ all P〈0. 05）; while epilepsy group showed increased functional connectivity in right precuneus with bilateral precuneus and left posterior cingulate（ all P〈0. 05）. Conclusion Functional connectivity of precuneus with the whole brain in patients with refractory epilepsy generally altered,and the inhibition of＂default mode network＂is likely to be an important reason for consciousness and cognitive impairment.