Alterations In Functional Connectivity Of The Cerebellum In Temporal Lobe Epilepsy

ObjectiveApplication of resting state fMRI（rs-fMRI）technology and using voxel-wise functional connectivity methods,we analysed the connectivity characteristics between cerebellum and whole brain function in patients who suffered temporal lobe epilepsy,discussed the cerebellum pathophysiological changes in patients with temporal lobe epilepsy,and observed the relationship between epilepsy durations and functional connecitivy,as well as disease onset time.Method35 temporal lobe epilepsy outpatients and hospitalized patients were collected san-jiu brain hospital of Guangdong province from August to December,2017,which include clinical characteristics,long-range electroencephalo-graph（EEG）and Magnetic Resonance Imaging（MRI）comprehensive evaluation.The temporal lobe epilepsy patients’ average age 26.60± 6.78,22 cases of men,13 cases of women.Temporal lobe epilepsy group lesions are mainly cortical dysplasia and（or）hippocampal sclerosis,which lesions in the left side of the 15 cases（9 cases were male,6 cases were female,mean age 23.80±4.63 years）,the lesion in the right of the 14 cases（8 cases were wen,6 cases were women,mean age 28.93±7.50 years）,6 cases lesions in bilateral（5 cases were male,1 cases were female,mean age 28.17±8.04 years）.The healthy control participants’ average age was 29.29 ±7.88 years,9 were male and 12 were female.All the subjects in the healthy control group were from healthy volunteers.There was no significant difference in age and gender between the temporal lobe epilepsy group and the healthy control group,so did sub-group in the temporal lobe epilepsy group.All of them were right handed,from 16 years old to 50 years old.Two groups of subjects were were acquired by a 1.5T magnetic resonance imaging scanner,which all temporal lobe epilepsy group of former subjects in the group were scaned by epilepsy-related sequences to detect the temporal lobe lesions.After preprocessing,choosing 26 regions of the cerebellum as seed points,the functional connectivities between the cerebellum and the whole brain were built,using SPM to do group-level statistical analysis,finding out the differences of brain regions.Then we choose the epilepsy duration and onset time to do correlation analysis.Results1.Compared to control group,temporal lobe epilepsy group showed increased functional connectivities,but did not show any decreased functional connectivity with cerebellum.2.Compared to control group,temporal lobe epilepsy group showed increased functional connectivities between cerebellum and cerebrum,including right cerebellum 8 area and the right inferior temporal gyrus,right cerebellum 10 area and the left cuneus,vermis 3 and the left inferior temporal gyrus,vermis 3 and the right cortical region of the periphery,vermis 3 and the left praecuneus,vermis 4₅ and the left inner cingulate,vermis 10 and the right putamen,vermis 10 and the right cortical region of the periphery,vermis 10 and the right dorsolateral frontal gyrus,vermis 10 and the left paracentral lobule,vermis 10 and the right superior temporal gyrus,but did not show any decreased functional connectivity with cerebellum.3.Compared to control group,temporal lobe epilepsy group showed increased functional connectivity between cerebellum regions,including vermis 3 and the right cerebellum 8 area,vermis 10 and the left cerebellum 8 area.4.In the analysis of the individual level of temporal lobe epilepsy,there were significant negative correlations between cerebellar-cerebro functional connectivities and epilepsy duration,as well as the onset time.Vermis 10 and the right lateral frontal gyrus,and the epilepsy duration presented a negative correlation（r=-0.484,p=0.003）;Vermis 10 to the left paracentral lobule and epilepsy duration showed a negative correlation（r=-0.343,p=0.044）.There was no significant correlation between the abnormal cerebellar regions functional connectivity and epilepsy duration,as well as onset time.Conclusion1.The temporal lobe epilepsy affects a wide range of brain network connection,which the default network,the dorsal attention network,the language function area,basal ganglia,the visual cortex area,sensorimotor area respectively control attention,language,social stimulation,visual space,motion,cognition.etc are injured.2.Some abnormal cerebellar-cerebro function connection in temporal lobe epilepsy showed negative correlation,suggesting that cerebellar participate in the regulation of temporal lobe epilepsy,which means compensation of function defects caused by the temporal lobe epilepsy.The adjustment is weaker with the extension of the epilepsy duration,so the disease’s early intervention is important.