Multimodal MR Study Of Temporal Lobe Epilepsy And Related Cognitive-affective Disorders

Objective:Multimodal MR method was used to explore the correlation of brain structure and function changes with epilepsy severity and cognitive emotion in temporal lobe epilepsy（TLE）from the aspects of gray and white matter morphology,functional connectivity and white matter network.Methods:This study included 40 patients with clinically diagnosed TLE and 31 healthy controls（HC）matched for age,sex,and education.Voxel-based morphometry（VBM）and surface-based morphometry（Surface-based morphometry,SBM）were used to explore the changes of correlation indicators such as gray matter volume and cortical thickness in TLE.Seed-based functional connectivity（FC）was used to explore the relationship between areas with altered gray matter volume and abnormal brain areas of brain functional connectivity.Brain networks were constructed by using a Diffusion Spectrum Imaging（DSI）method that improves the tracing of crossing fiber tracts.Spearman correlation analysis was used to explore the significance of network local indicators and their correlation with clinical scales.Results:1.Using VBM technology,compared with HC,TLE showed a decrease in the volume of bilateral thalamic gray matter,and the bilateral thalamus was negatively correlated with anxiety and depression clinical scale scores;using SBM technology,compared with HC,TLE showed cortical thickness of the lateral superior frontal gyrus decreased,and the Gyrification Index（GI）of the left inferior parietal lobe,inferior temporal gyrus,and right orbitofrontal cortex increased.2.Using the bilateral thalamus as the seed point for whole-brain FC,it was found that the functional connection between the bilateral frontal lobe and the thalamus was decreased,and the functional connection between the right posterior cerebellar lobe and the thalamus was enhanced.3.In the DSI brain network study,compared with HC,TLE showed increased hierarchy in global indicators;increased node efficiency,decreased shortest path,and changed node clustering coefficients in some brain regions.4.Correlation analysis of brain network indicators with epilepsy severity scale,anxiety scale and cognitive function scale,it was found that the node efficiency of most different brain regions was negatively correlated with cognitive score,and with epilepsy severity and anxiety scale score.There is a negative correlation,and the node efficiency is negatively correlated with the shortest path length.Conclusion:In the TLE group,the volume of bilateral thalamic gray matter was reduced,and there were obvious functional connectivity abnormalities in the FC with the right dorsolateral superior frontal gyrus and the right posterior cerebellar lobe.In the structural network,the left olfactory cortex,middle cingulate gyrus and right border.The efficiency of the last node increased,the local connectivity of the network increased,and there was a significant correlation change with emotional cognition and other aspects.These differential brain regions can be used as imaging evidence to explore the structural and functional changes of TLE,and to further understand the mechanism of TLE and the changes in mood and cognitive function of patients during the development of TLE.