中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2015, Vol. 10 ›› Issue (7): 1107-1112.doi: 10.4103/1673-5374.160104

• 原著:脑损伤修复保护与再生 • 上一篇    下一篇

减少神经纤维损害的选择性海马-杏仁核切除：基于大脑连接的纤维成像评估

  

  • 收稿日期:2015-06-10 出版日期:2015-07-24 发布日期:2015-07-24
  • 基金资助:

    韩国国家研究基金项目

Planning for selective amygdalohippocampectomy involving less neuronal fiber damage based on brain connectivity using tractography

Seung-Hak Lee 1, Mansu Kim 2, Hyunjin Park 3   

  1. 1 Department of Electronic Electrical and Computer Engineering, Sungkyunkwan University, Suwon, Republic of Korea
    2 Graduate School of Human ICT Convergence, Sungkyunkwan University, Suwon, Republic of Korea
    3 School of Electronic and Electrical Engineering, Sungkyunkwan University, Suwon, Republic of Korea
  • Received:2015-06-10 Online:2015-07-24 Published:2015-07-24
  • Contact: Hyunjin Park, Ph.D., hyunjinp@skku.edu
  • Supported by:

    This study was supported by the National Research Foundation of Korea, No. 20100023233.

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摘要：

颞叶切除是外科干预癫痫的重要手段，其中选择性海马-杏仁核切除是广泛使用的一种术式。在实施选择性海马-杏仁核切除过程中，如何最大限度减少神经纤维的损害是值得研究的课题。我们建议基于磁共振弥散成像选择行海马-杏仁核切除的颞下回切口入路。纳入来源于PPMI数据库(www.ppmi-info.org)的20名正常被试的弥散张量成像。应用纤维跟踪算法提取颞叶、海马和杏仁核神经纤维信息。从纤维数量和中介中心度角度分析神经纤维信息。将切口与手术靶区间的距离视为手术路径的长度。颞中回和颞上回比颞下回有更高的连接度，因此不适合作为切口实施区。颞下回与手术靶区间的距离比颞中回与手术靶区间的距离短。因此，颞下回适合作为切口实施区。从颞下回切口避开更重要的脑区，缩短至海马和杏仁核靶区的距离，从而降低对神经纤维的损害。

关键词: 神经再生, 癫痫, 选择性海马-杏仁核切除, 弥散张量成像, 连接, 中介中心度, MRI, 网络分析, 颞叶手术, 神经纤维

Abstract:

Temporal lobe resection is an important treatment option for epilepsy that involves removal of potentially essential brain regions. Selective amygdalohippocampectomy is a widely performed temporal lobe surgery. We suggest starting the incision for selective amygdalohippocampectomy at the inferior temporal gyrus based on diffusion magnetic resonance imaging (MRI) tractography. Diffusion MRI data from 20 normal participants were obtained from Parkinson’s Progression Markers Initiative (PPMI) database (www.ppmi-info.org). A tractography algorithm was applied to extract neuronal fiber information for the temporal lobe, hippocampus, and amygdala. Fiber information was analyzed in terms of the number of fibers and betweenness centrality. Distances between starting incisions and surgical target regions were also considered to explore the length of the surgical path. Middle temporal and superior temporal gyrus regions have higher connectivity values than the inferior temporal gyrus and thus are not good candidates for starting the incision. The distances between inferior temporal gyrus and surgical target regions were shorter than those between middle temporal gyrus and target regions. Thus, the inferior temporal gyrus is a good candidate for starting the incision. Starting the incision from the inferior temporal gyrus would spare the important (in terms of betweenness centrality values) middle region and shorten the distance to the target regions of the hippocampus and amygdala.

Key words: nerve regeneration, epilepsy, selective amygdalohippocampectomy, diffusion tensor imaging, tractography, connectivity, betweenness centrality, magnetic resonance imaging, network analysis, temporal lobe surgery, neuronal fibers, neural regeneration