Abnormal Functional Connectivity And Decreased White Matter Fiber Structure Within Alertness Network In Patients With Right-sided Temporal Lobe Epilepsy: A Study Of Multimode Functional Magnetic Resonance

Background: Patients with temporal lobe epilepsy(TLE)often suffer from alertness alterations.However,specific regions connected with alertness remain controversial,and whether these regions have structural impairment is also elusive.This study aimed to conducte using resting-state functional magnetic resonance imaging(rs-fMRI),diffusion tensor imaging(DTI),and attentional network testing(ANT).The right-sided temporal lobe epilepsy(rTLE)patients were alerted to the functional connectivity between the network and the white matter fiber structure and normal people,to understand the functionalconnectivity and possible structural basis of the alert network in rTLE patients,and to explore its significance.Methods: Whole brain rs-fMRI,DTI and 3D_T1 scans and ANT tests were performed on 47 patients with rTLE and 34 healthy controls matched with patient groups according to gender,age and years of education.The functional connectivity(FC)analysis method and the definitive white matter fiber tracing method were used to compare the functional imaging differences between the two groups and to explore the white matter fiber integrity in brain regions with functional connectivity differences.To further analyze related analysis between the clinical data of abnormal FC brain area zFC value,fractional anisotropy(FA),fiber number(FN)value,fiber length(FL)value and ANT,duration of disease in rTLE patients.Results:(1)Compared with the healthy control group,the response time of the rTLE patient group was significantly prolonged without prompting or double cues,but there was no statistical difference in the alert response time between the two groups;(2)rTLE patient group and seed point function The descending brain regions were in the right inferior parietal lobules,amygdala,and insular cortex,and no areas with increased FC were found;(3)The brain regions with decreased FA values ??in the rTLE patient group were in the right insula and right tarsal Right hippocampus gyrus and amygdala,right superior temporal gyrus and right sacral pole;FN value decreased brain area on right insula and right tarsal;FL value decreased brain area on right hippocampal gyrus And amygdala.No brain regions with increased FA,FN,and FL were found;(4)The FA values ??of the right insula and the sacrum of the rTLE group were negatively correlated with the course of the disease(P < 0.05).No abnormal brain was found.There was a correlation between FA values ??in other brainregions,zFC value,FN value,and FL value,clinical data such as ANT and disease course.Concussion: Intrinsic alertness and phase alertness of rTLE patients were significantly impaired,but there was no difference in the entire alertness between the two groups.The alert network had right inferior parietal lobe,abnormal amygdala and insular functional connectivity,and was not due to disease duration or alertness.Changes in time,right hippocampal gyrus,bungee,insular and amygdala at the white matter fiber damage,abnormal functional connectivity and damaged white matter fibers may affect the incidence of rTLE through the alert network.1.Intrinsic and phase alertness of rTLE patients were significantly impaired,but there was no difference in entire alertness function;2.There was a decrease functional connections in right apical lobar,amygdala and insular within the alert network;The white matter fibers in right hippocampal gyrus,bungee lobe and amygdaloid nucleus are damaged;3.The course of the disease is related to the damage of the white matter fiber microstructure between the right insula and the bony pole.