钠离子通道阻滞剂药物治疗颞叶癫痫相关的脑功能复杂网络的变化

doi:10.3969/j.issn.1006-5725.2025.02.015

Abstract

Abstract:

Objective To investigate the changes in the complex network of brain functions associated with sodium channel blocker （SCB） treatment and the neural mechanisms underlying the effects on executive control functions. Methods Twenty-one patients with temporal lobe epilepsy taking SCB （TLE-SCB） and 12 patients with temporal lobe epilepsy not taking SCB （TLE-N） were enrolled in the study along with 18 healthy controls （HC）. Resting-state functional magnetic resonance imaging （rsfMRI） and attentional network testing （ANT） were completed， and graph theoretic methods were applied to study the changes in the complex networks of brain function in the three groups of subjects， and to investigate the relationship between changes in brain networks and executive function. Results The TLE-SCB and TLE-N groups showed executive function impairment compared to the HC group. Analysis of brain network topological properties showed that multiple node median centrality was reduced in the TLE-SCB group compared to the TLE-N group （all Bonferroni corrected， P < 0.017）； right amygdala node clustering coefficient， and local efficiency of the left suboccipital gyrus were reduced （t = -2.953， P = 0.006； t = -2.597， P = 0.0142）. The TLE-SCB compared to the HC group had decreased multiple node median centrality （all Bonferroni corrected， P < 0.017）； increased node clustering coefficients in the left orbital middle frontal gyrus （t = 2.861， P = 0.007）； and decreased localized efficiency in the left inferotemporal gyrus （t = -2.870， P = 0.007）. The TLE-N group compared to the HC group had decreased right paracentral lobule mediator centrality， local efficiency increased （t = 2.644， P = 0.013； t = 3.464， P = 0.002）； right amygdala node clustering coefficient increased （t = 2.884， P = 0.007）. Correlation analysis showed that decreased centrality of left suboccipital gyrus mediators was negatively correlated with executive efficiency in the TLE-SCB group （P = 0.045， r = -0.441）. Conclusion Patients using SCB medication showed impairment of brain functional network topological properties， with the left suboccipital gyrus as an important node； altered brain functional network topological properties may underlie the network of cognitive impairment in SCB.

Key words: temporal lobe epilepsy, sodium channel blocker, graph theory, complex network, executive control function

CLC Number:

R742.1

Cuimi LUO,Zirong CHEN,Dongying HUANG,Jin′ou. ZHENG. Changes in complex networks of brain functions associated with sodium channel blocker drug treatment in temporal lobe epilepsy[J]. The Journal of Practical Medicine, 2025, 41(2): 250-257.

Figures/Tables 6

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Fig.2

References 25

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项目	TLE		HC组（n = 18）	Z/H/χ ² 值	P值
项目	TLE?SCB组（n = 21）	TLE?N组（n = 12）	HC组（n = 18）	Z/H/χ ² 值	P值
人口学特征
年龄［M（P₂₅，P₇₅）］/岁	28.00（21.00，35.50）	29.50（24.50，51.25）	30.50（20.75，42.25）	1.219	0.544
性别（男/女）/例	3/18	5/7	7/11	3.961	0.138
教育年限［M（P₂₅，P₇₅）］/年	12.00（9.00，15.00）	9.00（7.00，12.00）	13.00（8.75，15.00）	5.893	0.053
临床特征
定位（右/左）/例	11/10	10/2	-	3.384	0.133
发病年龄［M（P₂₅，P₇₅）］/岁	22.00（15.50，31.50）	24.00（19.00，48.75）	-	-0.861	0.389
病程［M（P₂₅，P₇₅）］/年	5.00（3.00，7.00）	4.50（2.00，6.75）	-	-0.851	0.395
发作频率［M（P₂₅，P₇₅）］/（次/月）	1.67（0.33，3.17）	2.00（0.67，3.33）	-	-0.432	0.666
单/多药治疗［M（P₂₅，P₇₅）］/例	1.00（1.00，2.00）	1.00（1.00，1.00）	-	-1.269	0.205

项目	TLE-SCB组（n = 21）	TLE-N组（n = 12）	HC组（n = 18）	组间差值95% CI	P值
聚类系数	0.203	0.200	0.203	（-0.003 ~ 0.009）^?；（-0.007 ~ 0.007）^# （-0.010 ~ 0.005）^△	0.321^?；0.947^# 0.485^△
最短路经长度	0.777	0.746	0.736	（-0.036 ~ 0.099）^?；（-0.010 ~ 0.091）^# （-0.031 ~ 0.050）^△	0.409^?；0.125^# 0.649^△
Gamma	0.651	0.679	0.736	（-0.123 ~ 0.067）^?；（-0.171 ~ 0.001）^# （-0.148 ~ 0.033）^△	0.552^?；0.052^# 0.207^△
Lambda	0.396	0.400	0.397	（-0.016 ~ 0.010）^?；（-0.010 ~ 0.010）^# （-0.010 ~ 0.015）^△	0.666^?；0.978^# 0.675^△
Sigma	0.564	0.586	0.633	（-0.107 ~ 0.066）^?；（-0.148 ~ 0.009）^# （-0.133 ~ 0.035）^△	0.634^?；0.082^# 0.245^△
全局效率	0.175	0.181	0.183	（-0.018 ~ 0.005）^?；（-0.017 ~ 0.001）^# （-0.008 ~ 0.006）^△	0.248^?；0.086^# 0.733^△
局部效率	0.252	0.254	0.258	（-0.012 ~ 0.008）^?；（-0.014 ~ 0.002）^# （-0.011 ~ 0.003）^△	0.693^?；0.174^# 0.256^△

项目节点		TLE		HC组（n = 18）	P值	t值
项目节点		TLE-SCB组（n = 21）	TLE-N组（n = 12）	HC组（n = 18）	P值	t值
介数中心性	ORBmid.L	7.541 ± 5.859	15.430 ± 9.265	-	0.015	-2.580
	ORBsupmed.R	10.520 ± 6.042	19.840 ± 8.484	-	< 0.001	-3.941
	IOG.L	7.943 ± 6.983	16.226 ± 11.341	-	0.011	-2.727
	ITG.R	35.635 ± 26.361	61.450 ± 24.316	-	0.011	-2.721
	SPG.L	13.672 ± 9.981	-	28.044 ± 21.616	0.010	-2.733
	PAL.L	9.998 ± 10.234	-	21.140 ± 16.282	0.013	-2.599
	ITG.L	22.181 ± 18.012	-	40.906 ± 24.046	0.009	-2.777
	PCL.R	-	31.932 ± 21.774	16.471 ± 9.943	0.013	2.644
节点聚类系数	AMYG.R	0.141 ± 0.071	0.206 ± 0.037	-	0.005	-3.054
	AMYG.R	-	0.206 ± 0.037	0.147 ± 0.064	0.007	2.884
	ORBmid.L	0.234 ± 0.041	-	0.195 ± 0.043	0.007	2.861
节点效率	IOG.L	0.186 ± 0.023	0.206 ± 0.019	-	0.009	-2.793
	ITG.L	0.196 ± 0.030	-	0.219 ± 0.015	0.007	-2.870
	PCL.R	-	0.222 ± 0.014	0.202 ± 0.017	0.002	3.464

项目	TLE		HC组（n = 18）	F值	P值
项目	TLE-SCB组（n = 21）	TLE-N组（n = 12）	HC组（n = 18）	F值	P值
箭头不一致的反应时间	709.73 ± 90.54	754.65 ± 161.43	687.10 ± 135.25	1.043	0.360
箭头一致的反应时间	602.96 ± 78.82	641.87 ± 139.99	607.06 ± 138.90	0.458	0.636
执行控制［（RT_{不一致条件}- RT_一致条件）］	106.77 ± 35.97	112.78 ± 34.97	80.04 ± 27.36	4.619	0.015^*

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Changes in complex networks of brain functions associated with sodium channel blocker drug treatment in temporal lobe epilepsy

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