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目的研究颞叶内侧癫癎患者右侧海马与全脑,尤其是默认网络功能连接的关系,探讨颞叶内侧癫癎患者默认网络异常的机制及其形成的颞叶癫癎网络。方法 23例颞叶内侧癫癎患者,采用静息功能连接的功能磁共振成像,选择右侧海马作为兴趣区,获得正常对照组和颞叶内侧癫癎组受试者的脑功能连接激活图,观察其右侧海马与全脑的功能连接。结果正常对照组受试者默认网络包括海马、后扣带回和(或)楔前叶、前扣带回和(或)前额叶内侧、角回及前颞叶。颞叶内侧癫癎组患者右侧海马与默认网络的正向功能连接明显减弱,与右侧额下回、颞上回及第一运动感觉皮质下部的正向功能连接增强;与前额叶背侧、顶间沟及第一运动感觉皮质上部的负向功能连接减弱。结论在颞叶内侧癫癎患者功能连接网络中,默认网络及部分正向功能连接网络受损,提示患者存在广泛的、与海马相关的生理功能丧失;与右侧额下回、颞上回及第一感觉运动皮质下部的功能连接增强则可能与颞叶癫癎网络有关。
Objective To study the relationship between the right hippocampus and the whole brain in patients with temporal lobe epilepsy, especially the default network function connection. To explore the mechanism of the default network abnormalities in patients with temporal lobe medial epilepsy and its temporal lobe epilepsy network. Methods Twenty-three cases of temporal lobe medial epilepsy were selected by functional magnetic resonance imaging (FMRI) and the right hippocampus was selected as the region of interest to obtain the activation of brain function in subjects with normal control and medial temporal lobe epilepsy. Observe the right hippocampus and whole brain functional connection. Results The normal controls in the normal control subjects included the hippocampus, the posterior cingulate gyrus and / or the anterior wedge anterior cingulate gyrus and / or the medial prefrontal cortex, the angle gyrus and the anterior temporal lobe. In the temporal lobe medial epilepsy group, the positive hippocampus of the right hippocampus was significantly weakened from the default one and positively connected with the right lower frontal gyrus, the superior temporal gyrus and the inferior portion of the first motor sensory cortex. Compared with the dorsal , The ditch and the top of the first movement of the upper cortex of the negative function of the connection weakened. Conclusions In the functional connectivity network of patients with temporal lobe epilepsy, the default network and some of the positive functional connectivity networks are impaired, suggesting that there is a wide range of loss of physiological functions associated with the hippocampus in patients with temporal lobe epilepsy. Compared with the right inferior frontal gyrus, First sensory motor cortex in the lower part of the functional connectivity may be related to the temporal lobe epilepsy network.