Multi-mode Research Of The Resting State FMRI And PET-CT For Refractory TLE Patients Between Onset Period

Objective1.Using the resting state fMRI technology which based on Low Frequency AmplitudeAlgorithm (ALFF) for brain function research of refractory temporal lobe epilepsy(TLE) patients between onset period, analysis of its characteristic brain functionchange in the resting state and discuss its potential pathophysiologic mechanisms.2.Through Statistical Parametric Mapping（SPM） methods analysis the brain18F-FDG PET-CT images of refractory TLE patients between onset period, explorethe value of SPM to find abnormal brain metabolism regions and determine the sidefor refractory TLE patients preoperatively.Materials and Methods1.Select16cases of the refractory TLE patients which comply with diagnostic criteriaand20cases of healthy controls which matched with age and gender for MRI scanand resting state fMRI tests. Using DPARSF software to analyze the resting statedata，then calculate and compare the ALFF changing brain areas of the above twogroups，and analysis of the correlation of the ALFF changing brain areas and thelength of the disease.2.Select12cases of the refractory TLE patients which comply with diagnostic criteriaand12cases of healthy controls which matched with age and gender for18F-FDGPET-CT examination. Using SPM8post-processing software analysis of18F-FDGPET-CT image data. Analysis of the increased metabolism or reduced metabolismbrain areas of epilepsy patients compared to healthy controls. And analysis of eachpatient with epilepsy relative to healthy control group increased metabolic reduce ormetabolic brain regions; utilize ROI method epileptic foci be given lateral positioning,and compare the two methods for ROI and SPM epileptic patient positioningapplications. Results1.Compared to the healthy controls，the whole brain ALFF value of refractory TLEpatients which rised in brain areas mainly distributed in the pons, the midbrain and thesurrounding regions, right frontal and temporal lobe, anterior cingulate, the left side ofthe caudate nucleus、putamen， occipital lobe and so on.The ALFF value whichreduced in brain areas mainly distributed in posterior cingulate, precuneus, inferiorparietal lobule, the medial prefrontal lobe, left frontal lobe and so on(p<0.05). Thepositive correlation of brain regions between the refractory TLE patients and courseof the disease mainly distributed in the right superior temporal gyrus and the leftinferior frontal gyrus. On the opposite,which showed negative correlation of brainregions mainly distributed in the medial prefrontal cortex, the right inferior parietallobule, the left temporal lobe and so on(p<0.05).2.SPM method in addition to reducing the external metabolites found in the temporallobe, accompanied by ipsilateral or bilateral frontal and parietal metabolism decrease;and found partial contralateral hippocampus, parahippocampal gyrus and temporallobe partial metabolism of glucose metabolism was hypermetabolism.Conclusion1.In the resting state， There are abnormal brain function networks widely exist inthe refractory TLE patients between onset period,and have a certain correlation withthe course of the disease. Its may be related to the pathogenesis. The ALFFanalytical method can effectively reflect the abnormal neurological functionnetwork of the TLE patients and can help explain the pathophysiology of therefractory TLE.2.patients with TLE hippocampus, parahippocampal gyrus and other parts ALFFactivity increased, suggesting that RS-fMRI has some epileptic foci positioning value.3.ALFF activities to reduce brain areas are mainly located in the DMN, and with theonset of TLE patients with increased duration of activity tends to reduce the level ofthe default network.4.The18F-FDG PET-CT using SPM is an convenient and effective method for thelocalization of mesial temporal lobe epilepsy, in addition to metabolic abnormalitiescan be found in the temporal lobe, but also help to identify brain regions outside the temporal lobe metabolic abnormalities, preoperative evaluation of brain function inpatients with epilepsy and postoperative prognosis more help.5.TLE patients SPM analysis and ALFF analysis has a certain position value, the twocan complement each other.