Abnormal Seed-based Functional Connection And Behavioral Association In Patients With Temporal Lobe Epilepsy

Objective Temporal lobe epilepsy is a type of adult epilepsy,which is commonest focal type.Large number of behavioral tests have shown that patients with temporal lobe epilepsy have early abnormal vigilance and severe executive dysfunction.However,the neurobiological mechanism underlying these cognitive impairment has been still unclear.Based on the neuroimaging studies,it was found that the anterior cingulate gyrus participated in the processing of vigilance function,and the middle frontal gyrus participated in the processing of executive function.Here,Therefore,in this study,we used the seed point functional connection method of behavioral test fusion with resting f MRI to select the anterior cingulate gyrus and the middle frontal gyrus on the lesion side as the seed points,respectively,to explore the whole brain functional connection status of all subjects,and to reveal the abnormal functional connection strength of brain area in patients with temporal lobe epilepsy,the clinical characteristics of subjects and the results of clinical behavioral test To clarify the functional mechanism and compensatory rule of brain area in patients with temporal lobe epilepsy.Methods Traditional attention network testing and precise interference task design were used to record and calculate the alertness function and executive function of subjects.By analyzing the clinical characteristics and ANT scores of all subjects,we divided the patients with temporal lobe epilepsy into two groups:temporal lobe epilepsy with decreased alertness and temporal lobe epilepsy with decreased executive function.There were 82 people in the first group with TLE accompanied by decreased alertness function,including 42 rTLE and 40 lTLE.There were 43 subjects in the second group of TLE with decreased executive function(all were patients with rTLE).In addition,all subjects were scanned with rs-f MRI and T1,T2 structure MRI.After preprocessing.In the first group,In the first group,the anterior cingulate gyrus of the focus side was extracted as the seed point for the whole brain functional connection mode.Compared with the age and gender matched normal subjects,the characteristics of the abnormal functional connection of the anterior cingulate gyrus in the temporal lobe epilepsy patients with decreased alertness were revealed.Finally,correlation analysis was used to reveal the relationship between the two groups of subjects as seed points and the functional connection value of different brain regions,and the behavior and course of disease;in the second group,we extracted the middle frontal gyrus on the focus side as seed points to conduct the whole brain functional connection mode,and revealed the middle frontal gyrus function of the subjects in the group of temporal lobe epilepsy with decreased executive function compared with the age and gender matched normal subjects It can connect the abnormal brain area and connect the characteristics of abnormal brain area..Results In the first group: compared with HC group,our study found that rTLE group with decreased alerting function and the right anterior cingulate gyrus were mainly distributed in the right superior temporal gyrus and left middle frontal gyrus,while the right anterior cingulate gyrus as seed point was mainly distributed in bilateral inferior parietal lobules,right posterior cerebellar lobe and left anterior central gyrus.In the analysis of the correlation between the functional connection at the brain level and the ant score and the clinical observation index,it was found that the intensity coefficient of the functional connection between the right anterior cingulate gyrus and the left middle frontal gyrus was negatively correlated with the alerting function efficiency.In addition,we also found that compared with HC group,the brain areas with increased connection strength with left anterior cingulate gyrus were mainly distributed in four brain areas(right inferior frontal gyrus,left superior frontal gyrus,right inferior parietal lobule,left middle frontal gyrus).The correlation analysis showed that the functional connection coefficient between left anterior cingulate gyrus and right inferior frontal gyrus was negatively correlated with the course of disease in the lTLE group.At the same time,we found for the first time that the functional connection strength between left anterior cingulate gyrus and left superior frontal gyrus was negatively correlated with the course of disease in the TLE group.In the two group: by comparing the whole brain functional connection strength with the right middle frontal gyrus between the rTLE group and the normal control group,we found that the functional connection value increased significantly in brain area of the right superior temporal gyrus,the left middle temporal gyrus and the right middle temporal gyrus in the unilateral rTLE group.In addition,there was no Pearson linear correlation between the value of functional connection in the right middle frontal gyrus and the value of ANT score(P>0.05).Conclusion 1)In patients with unilateral temporal lobe epilepsy accompanied by decreased alertness,the connection between anterior cingulate gyrus and whole brain function was changed,mainly involving motor,cognitive and emotional brain areas.2)It was found that the left middle frontal gyrus was involved in the alerting function.3)RTLE needs a long time to resolve the conflict,executive function is damaged,and it is found that the connection between right middle frontal gyrus and the whole brain function is changed,involving memory and emotional brain area.