The Study of Cognitive Function and Language Functional MRI Network Connectivity in Patients with Medial Temporal Lobe Epilepsy
|Keywords||medial temporal lobe epilepsy cognitive function words read task semantic judgetask functional MRI network connectivity|
Objectives：To investigate the cognitive dysfunction, the resting state fMRI function connection, thelanguage task model fMRI brain activation maps and functional MRI language networkconnectivity in Patients with medial temporal lobe epilepsy, and to study correlation betweencognitive function and language fMRI network connectivity.Methods:16medial temporal lobe epilepsy patients accord with diagnostic criteria and16healthy control subjects had been investigated．Epilepsy patientsis divided into the left and rightof epilepsy seizures group. The language IQ, total IQ score and memory quotient adoptingwechsler adult inte]ligence scale-revised in china(WAIS-RC)and Wechsler memoryscale(WMS)were obtained for all subjects. All subjects finished the resting state fMRI datacollection, the fMRI scanning while performing a words reading task or semantic judge task asstimulating patterns, in order to activate the corresponding brain areas. Use SPM99softwareanalyzes the data, and concludes the resting state fMRI function connection, two languages taskfMRI activing maps, the whole brain function connection maps of inferior frontal gyrus as R0I inepilepsy patients and healthy control subjects. The differences of cognitive deficits, the restingstate fMRI function connection, two languages task fMRI activing maps, the whole brainfunction connection maps and fMRI language network connection in epilepsy patients andhealthy control subjects were analysised adopting the independent sample and two sample t-test.Results：1、Cognitive function results: the language IQ, memory IQ and total IQ Score in medialtemporal lobe epilepsy patients were significantly lower than the mean1evel of healthy controlsubjects (P<0.01), performance IQ also was lower than healthy control subjects (P<0.05). But,the language IQ, memory IQ and total IQ Score s were not different significantly between leftmedial temporal lobe epilepsy patient and right medial temporal lobe epilepsy patient (P﹥0.05).2、The resting state fMRI function connection results: In epilepsy groups and healthy controls,the resting state fMRI function connection areas include prefrontal lobe, front cingulategyrus,back cingulate gyrus, precuneus, thalamus, cerebellum, front temporal lobe, brain stem,caudate nucleus and putamen nucleus. Two groups difference is very significant (P <0.01).3、Language fMRI activate map results: In words reading tasks, positive activated differences brainregions include bilateral prefrontal lobe, bilateral cerebellum, bilateral middle temporal gyrus, bilateral front central gyrus, bilateral and front cingulate gyrus. Negative activated differencesbrain regions include precuneus, bilateral back cingulate gyrus, bilateral angular gyrus, bilateralback central gyrus and right auxiliary motor area. In semantic determine tasks, positive activateddifferences brain regions include bilateral prefrontal lobe, left middle temporal gyrus, leftcerebellum, bilateral front central gyrus, bilateral back central gyrus, left auxiliary motorarea,and bilateral front cingulate gyrus. Negative activated differences brain regions include backprefrontal lobe, precuneus, bilateral back cingulate gyrus, front temporal gyrus,right frontcingulate gyrus, bilateral back central gyrus and right auxiliary motor area. two groups differenceis very significant (P <0.01).4、The whole brain function connection map results: In epilepsygroup and healthy controls, network connection brain regions of word reading task include leftSuperior frontal gyrus, middle frontal gyrus, superior temporal gyrus, middle temporalgyrus,right cerebellum, bilateral thalamus,front central gyrus and back central gyrus. Networkconnection brain regions of semantic judge task include bilateral superior frontal gyrus, middlefrontal gyrus, superior temporal gyrus, middle temporal gyrus, front central gyrus, back centralgyrus, auxiliary motor area and cerebellum. Two groups function connection map is same.5、Language fMRI network connection results: Network connection difference brain regions ofword reading task include bilateral front frontal lobe and bilateral back temporal lobe. Networkconnection difference brain regions of semantic judge task include bilateral front frontal lobe,right inferior temporal gyrusbilateral middle temporal gyrus, bilateral cerebellum and leftangular gyrus. Two groups difference is very significant (P <0.01).Conclusion: Patients with medial temporal lobe epilepsy commonly have the cognitive deficits.The right or left origin medial temporal lobe epilepsy patients are damage language function.The resting state fMRI function connection and language fMRI activate strength of epilepsypatients was significantly lower than the healthy controls. But, the whole brain functionconnection map is same in two groups. Epilepsy patients network connection was significantlylower than the healthy controls. Impaired performance on language assessment in epilepsypatients is associated with loss of fMRI language network connectivity.