A Study Of The Relationship Between Brain Structure And Cognitive Function In Epileptic Patients Based On VBM

Objective: In this study,voxel-based morphological analysis(VBM),combined with neuropsychological scale and event-related potential(ERP),was used to explore the brain structure changes and their relationship with cognitive function in patients with epilepsy,so as to provide a theoretical basis for the study of cognitive dysfunction in patients with epilepsy.Methods:(1)A total of 32 epileptic patients were included as the case group,including 17 epileptic patients with cognitive dysfunction,15 epileptic patients without cognitive dysfunction,and 17 healthy subjects as the normal group.Routine MRI scans were performed and whole brain sagittal three-dimensional T1-weighted(3D T1WI)brain volume imaging(BRAVO)images were collected.(2)Neuropsychological scale and event-related potential test were performed in both case group and normal group.(3)The VBM method was used to analyze the difference brain regions between the two groups.The difference brain regions were taken as regions of interest(ROI),and the gray matter volume corresponding to the subjects was extracted.Partial correlation analysis was conducted between the gray matter volume of the corresponding ROI and the neuropsychological scale score and the event-related potential index.Results:(1)Compared with the epilepsy group without cognitive impairment,the volume of gray matter in the right cerebellar region 8,the right cerebellar region 6,the right inferior temporal gyrus,and the left orbitofrontal middle gyrus decreased(P<0.001),and the volume of gray matter in the brain region with epilepsy was not increased(P>0.001).The gray matter volume of right infratemporal gyrus and left orbitofrontal gyrus was positively correlated with Mo CA score(P < 0.05),but negatively correlated with P300 latency(P < 0.05).There was no significant correlation between the gray matter volume of right cerebellar region 8 and right cerebellar region 6 and Mo CA score and P300 latency(P>0.05).(2)Compared with the normal group,the gray matter volume of bilateral cerebellar area 9,left cerebellar area 7b,left parahippocampal gyrus,right hippocampus,left hippocampus,left middle temporal gyrus,right cuneus,right superior marginal gyrus,left inferior parietal angular gyrus,and right parietal gyrus decreased(P<0.001),and no gray matter volume increased(P> 0.001).The gray matter volume of right cuneus,left inferior parietal marginal angular gyrus and right parietal gyrus were positively correlated with Mo CA score(P< 0.05),and negatively correlated with P300latency(P< 0.05).The gray matter volume in area 9 of left cerebellum was positively correlated with Mo CA score(P< 0.05),but not with P300 latency(P>0.05).The gray matter volume of left parahippocampal gyrus,right hippocampus and left hippocampus had no significant correlation with Mo CA score(P>0.05),but had negative correlation with P300 latency(P< 0.05).The gray matter volume of right cerebellar area 9,left cerebellar area 7b,left middle temporal gyrus and right superior marginal gyrus had no significant correlation with Mo CA score and P300 latency(P>0.05).(3)Compared with the normal group,the gray matter volume increased in the left lingual gyrus,right insula and right parietal gyrus in the epilepsy group without cognitive impairment(P<0.001),while the gray matter volume decreased in the left middle temporal gyrus(P<0.001).Conclusion:(1)The right inferior temporal gyrus and left orbital medial frontal gyrus may be involved in the mechanism of cognitive dysfunction in epilepsy patients;(2)The gray matter atrophy of epilepsy with cognitive impairment was more extensive than that of epilepsy without cognitive impairment;(3)Changes in brain structure in patients with epilepsy that are not accompanied by cognitive dysfunction may be related to the compensatory mechanism of the body.