目的 利用静息态功能磁共振成像中的功能连接方法,探讨难治性癫痫患者杏仁核的功能连接改变及意义.方法 安徽医科大学附属省立医院癫痫门诊2013年8月至2014年6月接诊的难治性癫痫患者19例,多模态神经影像学检查中颅内未发现明显致痫病灶,发作间期及发作期长程视频脑电图提示双侧大脑半球棘波及棘慢波;同期招募19名健康对照者.采集静息态功能磁共振数据后进行预处理,分别以左、右杏仁核为感兴趣区与全脑进行功能连接分析,了解难治性癫痫患者相对于正常对照组功能连接增强和减弱的区域.结果 以左侧杏仁核为感兴趣区做功能连接分析,难治性癫痫组与双侧梭状回、双侧距状回和右侧舌叶功能连接增强,与双侧楔叶、双侧楔前叶、双侧尾状核及左侧丘脑呈现减弱状态;以右侧杏仁核为感兴趣区,其与双侧距状回、双侧舌叶连接增强,与双侧尾状核、左侧壳核的功能连接强度减弱(P<0.05).结论 难治性癫痫患者静息状态下杏仁核功能连接异常,杏仁核作为“癫痫网络”的重要组成部分可能参与了癫痫的发生和发展.
Objective To explore the functions of amygdala functional connectivity in the pathogenesis of refractory epilepsy with resting-state functional magnetic resonance imaging (RS-fMRI).Methods A total of 19 patients with refractory epilepsy were recruited from August 2013 to June 2014.And 19 healthy persons were selected as the controls.No obvious epileptogenic lesions of intracranial structures were found on multi-modal neuroimaging.Ictal and interictal epileptic activities on long-term video electroencephalogram (EEG) showed spine spread spike and wave in bilateral cerebral hemispheres.All fMRI data were preprocessed after RS-fMRI scanning.Then left and right amygdalas were selected as regions of interest (ROIs) for calculating the linear correlation between amygdala and whole brain.As relative to the control group,the changes of brain areas in functional connectivity were examined for the intractable epilepsy group.Results Compared with the controls,left amygdala in refractory epilepsy group showed increased functional connectivity with bilateral fusiform gyrus,bilateral calcarine gyrus and right lingual,on the contrary decreased functional connectivity with bilateral cuneus,bilateral precuneus,bilateral caudatas and left thalamus.However,right amygdala demonstrated increased functional connectivity with bilateral calcarine gyrus and bilateral linguals,but decreased functional connectivity with bilateral caudatas and left putamen (P < 0.05).Conclusion Altered functional connectivity of amygdala reflects its dysfunction in refractory epilepsy patients.It suggested that amygdala is an important component of "epileptic network" participating in the occurrence and development of refractory epilepsy.