Resting Functional Magnetic Resonance Imaging Plus Diffusion Tensor Imaging For Investigating The Cognitive Impairment In Patients With Temporal Lobe Epilepsy

[Objective]:Temporal lobe epilepsy is the most common type of refractory epilepsy, and the patients usually had neurologic damages because the temporal lobes are connected with many encephalic regions. Based on this, this study combined resting functional magnetic resonance imaging(rfMRI) and diffusion tensor imaging(DTI) to investigate the condition of damages of patients' cognitive function and cerebral microstructures. At the same time, the revised Wechsler memory scale(WMS R) examination was used to assess memory function of them.[Methods]:21 patients and 21 healthy volunteers were included in this study. All the subjects were given Wechsler memory scale(WMS R) examination,resting functional magnetic resonance imaging(rfMRI) and diffusion tensor imaging(DTI) scan. The radiological results were analysed by amplitude of low frequency fluctuation(ALFF),regional homogeneity(ReHo),apparent diffusion coefficient(ADC) and fractional anisotropy(FA). By the SPSS13.0 and SPM5, we made the statistical analysis of the datas and research into the correlations of them.[Results]:(1),Compared with the controls, on rfMRI, patients's ALFF was increased in left cerebellum, left limbic lobe,posterior cingutate(BA30), left occipital lobe, left cerebral ganglion, right limbic lobe,posterior cingutate, right prefrontal lobe, right occipital lobe(BA18), right posterior lobe of cerebellum; in left supramarginal gyrus(BA40), left limbic lobe,posterior cingutate, left inferior frontal gyrus, right apical lobe, right midfrontal lobe, right inferior frontal gyrus(BA46), ALFF was reduced.(2),In TLE group, on rfMRI, patients's ReHo was increased in left precentral gyrus, left posterior central gyrus, bilateral occipital lobe, left ceneus, left cerebellum, left temporal lobe, bilateral limbic lobe,posterior cingutate, right frontal lobe; and the results were reduced in left cerebellum, right superior frontal gyrus, right anterior cingutate(BA32), right superior temporal lobe, right cerebellum, right insula(BA13).(3),On DTI, compared with the controls, patients's ADC was increased in bilateral frontal gyrus, bilateral cerebellum, left temporal, right limbic lobe,posterior cingutate, there were some regions showed ADC reduced, but it had no statistical significance (p<0.05); meanwhile, TLE group's FA increased in left inferior frontal gyrus, left cerebellum, left occipital lobe, left precuneus, left apical lobe(BA7), right temporal, right cerebellum, right cingulategyrus, but the regions of left frontal gyrus, left occipital lobe, left cerebellum, right temporal lobe, right cerebellum, right cingulategyrus(BA24) showed FA reduction.(4),In TLE group, patients'ALFF and ADC active signals had postive correlation in bilateral cerebellum and right occipital lobe, and in right temporal lobe they were negative.(5),The average memory quotient(MQ) of TLE patients was 97.90, among which the result of male and female were 94.00 and 100.31; the control group's average MQ was 115.50, the MQ was 114.43 for men,116.33 for women. The MQ and short-term memory showed obvious statistical difference between two groups.[Conclusions]:(1),The default mode network still persists in TLE patients' brain, but the pattern of the network was changed because of the damages of some brain areas.(2),The decline of the ratio of FA/ADC account for the TLE patients'some cerebral microstructures exist damages.(3),In TLE group, there was correlation in bilateral frontal gyrus, temporal lobe, posterior cingutate and cerebellum between rfMRI and DTI restults.(4),With the results of image examinations and neuropsychological test, it suggested that the TLE patients's cognitive impairment which may result from the damages of their brain microstructures and neural default mode network.