| Part1:Study on default network homogeneity and attentional network test in patients with unilateral temporal lobe epilepsyObjective To explore the differences of default mode network homogeneity(NH)between patients with temporal lobe epilepsy(TLE)and healthy control group by resting-state functional magnetic resonance(rs-f MRI),combining with network homogeneity(NH)analysis and independent component analysis(ICA)analysis and study attentional function by attentional network test(ANT).Methods 107 patients with TLE from the Epilepsy Clinic of the First Affiliated Hospital of Guangxi Medical University were selected,including 55 patients with right temporal lobe epilepsy(rTLE),52 patients with left-side temporal lobe epilepsy(l TLE)and 53 healthy controls matched in gender,age and education years.The whole brain rs-f MRI scan and ANT,using ICA and NH method,can be based on the clinical application of remote network hypothesis-driven research.The NH values of abnormal brain areas were correlated with the course of disease and behavioral data.Results 1.ICA analysis showed that DMN was mainly distributed in anterior ventral cingulate gyrus,dorsolateral prefrontal lobe,central anterior gyrus,cuneiform lobe,lateral temporal lobe,middle occipital gyrus,inferior parietal lobule,inferior cerebellar foot and superior cerebellar foot.2.Compared with the control group,NH values in bilateral middle temporal gyrus and bilateral medial superior frontal gyrus were significantly decreased(P<0.05),and NH values in right anterior cuneiform lobe were significantly increased(P < 0.05).Behavioral tests showed that the response time(RT)of phasic alerting RT and intrinsic alert RT of patients were longer than that of the control group(P<0.05),but there was no significant difference in alert RT and executive RT between the two groups(P>0.05).The NH value of the middle temporal gyrus was positively correlated with the course of the disease(p<0.05).3.Compared with the control group,the NH value of l TLE patients decreased in bilateral middle temporal gyrus(TMG)and increased in left precuneus(PCu).There was no significant correlation between NH values in these abnormal brain areas and course of disease,alert response time and executive response time.Conclusion(1)In patients with unilateral TLE,there was a decrease in the NH value of bilateral sacral gyrus and an increase in the NH value of the anterior anterior wedge.The brain region with reduced consistency in rTLE patients also had bilateral medial frontal gyrus,presumably presenting unilateral TLE patients.The default network consistency is abnormal,the epilepsy damage is unequal;(2)Patients with TLE have inherent vigilance and phase alertness impairment.The abnormal default network consistency may be the pathophysiological basis of unilateral TLE,which may impair the cognitive function of unilateral TLE patients;(3)Compensation occurs in the course of the disease.Part 2: Altered Functional Connectivity of DMN and attentional network test patients with unilateral temporal lobe epilepsyObjective Resting-state functional magnetic resonance imaging(rs-fMRI)and attentional network test(ANT)were used to study temporal lobe epilepsy patients by combining seed-based functional connectivity(CBFC)and independent component analysis(ICA)methods.The FC value and attention function of default mode network(DMN)were studied to explore the activation mode and significance of brain regions in patients with temporal lobe epilepsy.Methods 107 patients with temporal lobe epilepsy(TLE)from the Epilepsy Clinic of the First Affiliated Hospital of Guangxi Medical University were selected,including 55 patients with right temporal lobe epilepsy(rTLE),52 patients with left-side temporal lobe epilepsy(l TLE)and 53 healthy controls matched in sex,age and education years.The brain regions with abnormal default network consistency were studied by using ICA combined with seed-based functional connectivity analysis,and the correlation between FC value of abnormal brain regions and course of disease and behavioral data was analyzed.Results 1.ICA analysis showed that DMN was mainly distributed in anterior ventral cingulate gyrus,dorsolateral prefrontal lobe,central anterior gyrus,cuneiform lobe,lateral temporal lobe,middle occipital gyrus,inferior parietal lobule,inferior cerebellar foot and superior cerebellar foot.2.In rTLE group,the brain area connecting the medial and posterior cingulate gyrus was distributed in bilateral middle temporal gyrus,middle frontal gyrus,dorsolateral superior frontal gyrus,inferior temporal gyrus,anterior cuneiform lobe and medial superior frontal gyrus and superior temporal gyrus and superior cerebellar foot;in l TLE group,the area of the brain connecting the middle and posterior cingulate gyrus was distributed in bilateral middle temporal gyrus,middle frontal gyrus,dorsolateral superior frontal gyrus,anterior cuneate lobe,inferior temporal gyrus,posterior central gyrus,superior temporal gyrus,medial superior frontal gyrus,anterior central gyrus,middle occipital gyrus and fusiform gyrus;in normal control group,the area of the brain connecting the middle and posterior cingulate gyrus was The functional connections of the right superior marginal gyrus and the left inferior parietal angular gyrus in the rTLE group were enhanced compared with those in the normal control group.4.Compared with the normal control group,the functional connections of the right superior marginal gyrus and the left inferior parietal angular gyrus in the l TLE group were not found to be decreased.The functional connection of anterior wedge and left wedge decreased,while the functional connection of left inferior parietal angular gyrus increased.Conclusion(1)Patients with unilateral TLE have increased or decreased functional connectivity in the lateral hemisphere,partial functional connectivity in some brain regions,and functional synchrony and coordination in some brain regions between cerebral hemispheres,indicating a default network for unilateral TLE patients.An abnormality has occurred and the functional connection damage has inequality;(2)The decrease of FC value in left CUN and right PCu brain areas may be the pathophysiological basis of cognitive impairment of l TLE;(3)Functional compensation exists in unilateral TLE brain network.Part 3: Structural deficits and attentional network test patients with unilateral temporal lobe epilepsyObjective Previous studies have shown that patients with temporal lobe epilepsy(TLE)are often accompanied by abnormal attention function.However,the damage of white matter fibers in the brain areas related to attention has rarely been reported.In this study,resting-state functional magnetic resonance imaging(rs-f MRI),diffusion tensor imaging(DTI)and attentional network test(ANT)were used to study the white matter fibers structure and positive distribution of default network in patients with temporal lobe epilepsy(TLE).To understand the possible damage of white matter fibers in TLE patients by default mode network,and to explore its significance.Methods 107 patients with temporal lobe epilepsy(TLE)from the Epilepsy Clinic of the First Affiliated Hospital of Guangxi Medical University were selected,including 55 patients with right temporal lobe epilepsy(rTLE),52 patients with left-side temporal lobe epilepsy(l TLE)and 53 healthy controls matched in sex,age and education years.The whole brain rs-f MRI scans,diffusion tensor imaging(DTI)and ANT are performed.The PANDA virtual machine is activated under the Linux system and runs matlab R2013 b.The image preprocessing is performed using the toolkit PANDA [25](https://www.nitrc.org/projects/panda/).Firstly,image preprocessing was performed,and then deterministic white matter fiber tracking method was used to study the changes of white matter microstructures in default network brain areas.The correlation between the fractional anisotropy(FA),the number of fibers(FN),the length of fibers(FL)and ANT results,course of disease and other clinical data was analyzed.Results 1.In l TLE patients,FA decreased mainly in the right dorsolateral superior frontal gyrus and central anterior gyrus,left superior orbital frontal gyrus and temporal pole superior gyrus,right rectus gyri and orbital superior frontal gyrus,left anterior cingulate gyrus and bilateral medial cingulate gyrus,left medial cingulate gyrus and posterior cingulate gyrus;FN decreased in bilateral anterior central gyrus and dorsolateral superior frontal gyrus and bilateral cingulate gyrus.2.The damaged white matter fibers were mainly distributed in the right anterior central gyrus and dorsolateral superior frontal gyrus,the right superior orbital frontal gyrus and the superior temporal gyrus,and the brain areas with decreased FN values were in the right superior frontal gyrus and rectus gyrus,the right superior orbital frontal gyrus and the superior temporal gyrus,the right central anterior gyrus and dorsolateral superior frontal gyrus,the superior orbital frontal gyrus and rectus gyrus.The brain areas with decreased values were in the right dorsolateral superior frontal gyrus and cingulate gyrus,the orbital superior frontal gyrus and rectus gyri.3.There were no brain areas with increased FA,FN and FL values in statistics.4.There was no linear correlation between FA,FN and FL values in abnormal brain areas and clinical data such as ANT results and course of disease.Conclusion(1)The default network white matter microstructure of patients with unilateral TLE is obviously impaired,and there is a decrease in the anisotropy fraction of white matter fibers,the length of fibers and the number of fibers,Obviously,it suggests the basis of white matter microstructural lesions with impaired default network;(2)The degree and direction of damage of white matter fibers in the left and right side lesions are different,and the laterality is different.(3)No correlation between FA,FL,FN and clinical data such as disease duration and frequency of onset is found,which may have certain compensatory function and network with damaged white matter fiber structure. The robustness is related. |
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