[1]王后芬,黄书蕾,黄明明,等.左侧颞叶癫痫患者脑白质纤维结构完整性与执行功能研究[J].第三军医大学学报,2020,42(14):1414-1420.
 WANG Houfen,HUANG Shulei,HUANG Mingming,et al.White matter fiber structural integrity in diffusion tensor imaging and executive function of patients with left temporal lobe epilepsy[J].J Third Mil Med Univ,2020,42(14):1414-1420.
点击复制

左侧颞叶癫痫患者脑白质纤维结构完整性与执行功能研究(/HTML )
分享到:

《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
42卷
期数:
2020年第14期
页码:
1414-1420
栏目:
神经科学
出版日期:
2020-07-30

文章信息/Info

Title:
White matter fiber structural integrity in diffusion tensor imaging and executive function of patients with left temporal lobe epilepsy
作者:
王后芬黄书蕾黄明明余晖杨丽铭冯占辉于云莉
贵州医科大学附属医院:神经内科,影像科
Author(s):
WANG Houfen HUANG Shulei HUANG Mingming YU Hui YANG Limin FENG Zhanhui YU Yunli

Department of Neurology, 2Department of Imaging, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou Province, 550004, China

关键词:
颞叶癫痫执行功能纤维连接损害弥散张量成像脑白质纤维结构
Keywords:
temporal lobe epilepsy executive function fibrous connection damage diffusion tensor imaging white matter fiber structure
分类号:
R445.2; R741.02; R742.1
文献标志码:
A
摘要:

目的探讨常规MRI阴性的左侧颞叶癫痫(left temporal lobe epilepsy,L-TLE)患者执行功能损害特点及其与脑白质纤维束微观结构完整性的关系。方法对2018年11月至2019年11月就诊本院的21例L-TLE患者和21例健康对照(healthy control group,HC)进行执行功能评估,包括词语流畅性试验、Stroop色词干扰试验A~C(Stroop color word interference test A~C, Stroop test, A~C)、连线试验、数字广度测试,并对以上患者及对照组进行弥散张量成像(diffusion tensor imaging,DTI)扫描,比较两者纤维束部分各向异性(fractional anisotropy,FA)值、平均弥散率(mean diffusivity,MD)值,将微观结构有变化的纤维束与执行功能评分行相关性分析。结果L-TLE患者在数字广度顺向分数(P=0.028)、词语流畅性分数(P<0.001)较对照组低,StroopC耗时(P=0.008)较对照组高。与对照组相比,L-TLE患者左侧丘脑前辐射、左侧扣带束海马部、胼胝体枕部FA值降低,左侧丘脑前辐射、双侧扣带束、左侧扣带束海马部、胼胝体额部、双侧钩束MD值升高,差异有统计学意义(P<0.05)。相关分析显示:StroopC与左侧丘脑前辐射FA值(r=-0.461,P=0.035)呈负相关,与左侧丘脑前辐射MD值(r=0.634,P=0.002)呈正相关;词语流畅性与左侧扣带束海马部FA值(r=0.486,P=0.026)呈正相关,与左侧钩束MD值(r=-0.513,P=0.017)呈负相关;连线B与左侧丘脑前辐射MD值(r=0.481,P=0.043)呈正相关。结论MRI阴性的L-TLE患者存在执行功能障碍,并出现脑白质纤维束尤其是额颞叶间纤维束完整性的改变;TLE患者执行功障碍与额颞叶纤维束改变有关;额颞叶纤维结构连接异常可能为导致MRI阴性的TLE患者执行功能障碍原因之一。

Abstract:

ObjectiveTo investigate the characteristics of executive dysfunction and its association with microstructural integrity of white matter fiber bundle in patients with left temporal lobe epilepsy (L-TLE) who have negative findings in conventional magnetic resonance imaging (MRI). MethodsExecutive function assessments, including Verbal fluency Test, Stroop Color Word Interference Test A~C (Stroop test, A~C), Trail Marking Test and Digit Span Test, were performed in 21 patients with L-TLE and 21 healthy control subjects. The patients and the control subjects underwent scanning with diffusion tensor imaging (DTI) to compare their fiber bundle fractional anisotropy (FA) and the mean diffusivity (MD) values. The correlation between the fiber bundles with microstructural alterations and the executive function score was analyzed. ResultsCompared with the control subjects, the patients with L-TLE had significantly lower scores for digit span forward (P=0.028) and verbal fluency (P<0.001), and spent more time in Stroop C test (P=0.008). The patients with L-TLE showed significantly decreased FA values in the left anterior thalamic radiation, the left cingulate gyrus near the hippocampus and the forceps major, and increased MD values in the left anterior thalamic radiation, the bilateral cingulate gyrus, the left cingulate gyrus near the hippocampus, the forceps minor and the bilateral uncinate fasciculus compared with the control subjects. Correlation analysis showed that Stroop C test score was negatively correlated with the FA value in the left anterior thalamic radiation (r=-0.461, P=0.035) and positively with the MD value in the left anterior thalamic radiation (r=0.634, P=0.002); Verbal fluency was positively correlated with the FA value in the left-sided cingulate gyrus near the hippocampus (r=0.486, P=0.026) and negatively with the MD value in the left uncinate fasciculus (r=-0.513, P=0.017); Trail Marking Test B score was positively correlated with the MD value in the left anterior thalamus radiation (r=0.481, P=0.043). ConclusionThe MRI-negative patients with L-TLE have executive dysfunction and damage of the white matter fiber bundles, especially the frontotemporal fiber bundle. Executive dysfunction in L-TLE patients is associated with abnormalities in the frontotemporal fiber bundles, and the abnormal connection in the frontotemporal fibrous structures is probably one of the contributing factors to executive dysfunction in MRI-negative patients with L-TLE.

参考文献/References:

[1]BLAIR R D G. Temporal lobe epilepsy semiology[J]. Epilepsy Res Treat, 2012, 2012: 1-10. DOI: 10.1155/2012/751510.

[2]BERTOGLIO D, JONCKERS E, ALI I, et al. In vivo measurement of brain network connectivity reflects progression and intrinsic disease severity in a model of temporal lobe epilepsy[J]. Neurobiol Dis, 2019, 127: 45-52. DOI: 10.1016/j.nbd.2019.02.012.

[3]ROCA M, PARR A, THOMPSON R, et al. Executive function and fluid intelligence after frontal lobe lesions[J]. Brain, 2010, 133(Pt 1): 234-247. DOI: 10.1093/brain/awp269.

[4]KUCUKBOYACI N E, GIRARD H M, HAGLER D J Jr, et al. Role of frontotemporal fiber tract integrity in task-switching performance of healthy controls and patients with temporal lobe epilepsy[J]. J Int Neuropsychol Soc, 2012, 18(1): 57-67. DOI: 10.1017/S1355617711001391.

[5]REYES A, KAESTNER E, BAHRAMI N, et al. Cognitive phenotypes in temporal lobe epilepsy are associated with distinct patterns of white matter network abnormalities[J]. Neurology, 2019, 92(17): e1957-e1968. DOI: 10.1212/WNL.0000000000007370.

[6]ZANO T A, LOPES T M, DE CAMPOS B M, et al. Patterns of default mode network in temporal lobe epilepsy with and without hippocampal sclerosis[J]. Epilepsy Behav, 2019: 106523. DOI: 10.1016/j.yebeh.2019.106523.

[7]FILIPPI M, AGOSTA F. Diffusion tensor imaging and functional MRI[J]. Handb Clin Neurol, 2016, 136: 1065-1087.DOI: 10.1016/B978-0-444-53486-6.00056-9.

[8]ENGEL J Jr, International League Against Epilepsy(ILAE). A proposed diagnostic scheme for people with epileptic seizures and with epilepsy: report of the ILAE task force on classification and terminology[J]. Epilepsia, 2001, 42(6): 796-803. DOI: 10.1046/j.1528-1157.2001.10401.x.

[9]CUI Z X, ZHONG S Y, XU P F, et al. PANDA: a pipeline toolbox for analyzing brain diffusion images[J]. Front Hum Neurosci, 2013, 7: 42. DOI: 10.3389/fnhum.2013.00042.

[10]SMITH S M, JENKINSON M, JOHANSEN-BERG H, et al. Tract-based spatial statistics: voxelwise analysis of multi-subject diffusion data[J]. Neuroimage, 2006, 31(4): 1487-1505. DOI: 10.1016/j.neuroimage.2006.02.024.

[11]SMITH S M, JOHANSEN-BERG H, JENKINSON M, et al. Acquisition and voxelwise analysis of multi-subject diffusion data with tract-based spatial statistics[J]. Nat Protoc, 2007, 2(3): 499-503. DOI: 10.1038/nprot.2007.45.

[12]DIAMOND A. Executive functions[J]. Annu Rev Psychol, 2013, 64: 135-168. DOI: 10.1146/annurev-psych-113011-143750.

[13]EHRLICH T, REYES A, PAUL B M, et al. Beyond depression: The impact of executive functioning on quality of life in patients with temporal lobe epilepsy[J]. Epilepsy Res, 2019, 149: 30-36. DOI: 10.1016/j.eplepsyres.2018.11.004.

[14]SHEA-SHUMSKY N B, SCHOENEBERGER S, GRIGSBY J. Executive functioning as a predictor of stroke rehabilitation outcomes[J]. Clin Neuropsychol, 2019, 33(5): 854-872. DOI: 10.1080/13854046.2018.1546905.

 [15]MARTINO J, DE WITT HAMER P C, VERGANI F, et al. Cortex-sparing fiber dissection: an improved method for the study of white matter anatomy in the human brain[J]. J Anat, 2011, 219(4): 531-541. DOI: 10.1111/j.1469-7580.2011.01414.x.

[16]HUANG W L, HUANG D H, CHEN Z R, et al. Alterations in the functional connectivity of a verbal working memory-related brain network in patients with left temporal lobe epilepsy[J]. Neurosci Lett, 2015, 602: 6-11. DOI: 10.1016/j.neulet.2015.06.031.

[17]ZHANG C, YANG H Y, QIN W, et al. Characteristics of resting-state functional connectivity in intractable unilateral temporal lobe epilepsy patients with impaired executive control function[J]. Front Hum Neurosci, 2017, 11: 609. DOI: 10.3389/fnhum.2017.00609.

[18]KELLER S S, BAKER G, DOWNES J J, et al. Quantitative MRI of the prefrontal cortex and executive function in patients with temporal lobe epilepsy[J]. Epilepsy Behav, 2009, 15(2): 186-195. DOI: 10.1016/j.yebeh.2009.03.005.

[19]GOUBRAN M, HAMMOND R R, DE RIBAUPIERRE S, et al. Magnetic resonance imaging and histology correlation in the neocortex in temporal lobe epilepsy[J]. Ann Neurol, 2015, 77(2): 237-250. DOI: 10.1002/ana.24318.

[20]OSIPOWICZ K, SPERLING M R, SHARAN A D, et al. Functional MRI, resting state fMRI, and DTI for predicting verbal fluency outcome following resective surgery for temporal lobe epilepsy[J]. J Neurosurg, 2016, 124(4): 929-937. DOI: 10.3171/2014.9.JNS131422.

[21]NARENMANDULA B, ZHOU X J, LI Y C, et al. Effects of white matter microstructure lesions on language and memory function in magnetic resonance imaging-negative temporal lobe epilepsy determined by diffusion tensor imaging[J]. Neurol India, 2016, 64(6): 1233-1242. DOI: 10.4103/0028-3886.193839.

[22]VON DER HEIDE R J, SKIPPER L M, KLOBUSICKY E, et al. Dissecting the uncinate fasciculus: disorders, controversies and a hypothesis[J]. Brain, 2013, 136(Pt 6): 1692-1707. DOI: 10.1093/brain/awt094.

[23]BHATIA K, HENDERSON L, YIM M, et al. Diffusion tensor imaging investigation of uncinate fasciculus anatomy in healthy controls: description of a subgenual stem[J]. Neuropsychobiology, 2017, 75(3): 132-140. DOI: 10.1159/000485111.

[24]PAPAGNO C, CASAROTTI A, COMI A, et al. Long-term proper name anomia after removal of the uncinate fasciculus[J]. Brain Struct Funct, 2016, 221(1): 687-694. DOI: 10.1007/s00429-014-0920-8.

[25]BUBB E J, METZLER-BADDELEY C, AGGLETON J P. The cingulum bundle: Anatomy, function, and dysfunction[J]. Neurosci Biobehav Rev, 2018, 92: 104-127. DOI: 10.1016/j.neubiorev.2018.05.008.

[26]FANI N, KING T Z, CLENDINEN C, et al. Attentional control abnormalities in posttraumatic stress disorder: Functional, behavioral, and structural correlates[J]. J Affect Disord, 2019, 253: 343-351. DOI: 10.1016/j.jad.2019.04.098.

[27]JANG S H, KIM S H, LEE H D. Traumatic axonal injury of the cingulum in patients with mild traumatic brain injury: a diffusion tensor tractography study[J]. Neural Regen Res, 2019, 14(9): 1556-1561. DOI: 10.4103/1673-5374.255977.

相似文献/References:

[1]邹志礼,蒙华庆,李静,等.品行障碍青少年执行功能的对照研究[J].第三军医大学学报,2012,34(01):81.
 Zou Zhili,Meng Huaqing,Li Jing,et al.Executive function of adolescents with conduct disorder: a control study[J].J Third Mil Med Univ,2012,34(14):81.

更新日期/Last Update: 2020-07-23