The Application Of The Resting State FMRI Technology In Intractable Temporal Iobe Epilepsy

Objective To provide theoretical basis for the pathophysiological mechanism research of patients with intractable temporal lobe epilepsy(ITLE) by using noninvasive testing technology in vivo brain function:(1) To explore the changes of hippocampal functional connectivity(FC) in patients with intractable temporal lobe epilepsy with resting state functional magnetic resonance imaging(rs‐f MRI);(2) To explore the alterations of brain function in patients with intractable temporal lobe epilepsy from the perspective of the node degree of complex network with the resting state functional magnetic resonance imaging technology and graph theoretical analysis(GTA).Methods(1) From August 2013 to May 2014, eighteen patients with ITLE, admitted to our hospital, in the meantime, eighteen normal controls were chosen in our study; the f MRI data of the ITLE group and normal control group were obtained; the preprocess was performed by the software of statistical parametric maps; analysis of the resting state functional connectivity were performed by selecting the left and right hippocampus as the regions of interest(ROIs), finally, the differences of hippocampal functional connectivity were compared between ITLE group and normal control group.(2) After the f MRI data was obtained from fifteen patients with ITLE and fifteen normal controls, format conversion was performed the software of MRIConverter, then the data were processed by using the Network Construction which is a functional modules of GRETNA, then the node degree was acquired by using the Network Analysis modules, and then, the significant differences of brain regions were obtained by performing independent sample t‐test.Results(1) When the left hippocampus was selected as ROI, noteworthy enhanced functional connectivity in the ITLE group was observed in the right cuneus, noteworthy weakened functional connectivity was observed in the bilateral caudate nucleus, bilateral septal area and right restus, as compared with those in the normal control group(P<0.05); When the right hippocampus was selected as ROI, noteworthy enhanced functional connectivity in the ITLE group was observed the bilateral cuneus, bilateral lingual gyrus and left calcarine, noteworthy weakened functional connectivity was observed in the bilateral superior temporal gyrus, left supramarginal gyrus, left precentral gyrus, right middle temporal gyrus and left postcentral gyrus, as compared with those in the normal control group(P<0.05).(2) Compared with the normal controls, significant differences were observed in the left dorsolateral superior frontal gyrus, left insula, bilateral hippocampus, bilateral posterior cingulate cortex, right amygdaloid nucleus, bilateral pallidum, left precuneus and bilateral superior temporal gyrus in patients of ITLE based on the graph theoretical analysis(P<0.05).Conclusion(1) Hippocampal dysfunction of patients with ITLE could be detected based on the rs‐f MRI, which reveals that the hippocampus plays an crucial role in the epilepsy network of patients with ITLE.(2) Brain areas of significant change degree in patients with ITLE could be found by the GTA based on the rs‐f MRI technology; these brain areas may beform the neural basis of clinical symptoms. Therefore, Rs ‐ f MRI techniques as a non‐invasive living brain function detection technology provides a new angle for brain function and FC of the different brain areas in patients with ITLE, which makes it possible to further study the pathophysiological mechanisms of "epilepsy network" in patients with epilepsy.