Entorhinal cortex in temporal lobe epilepsy - A quantitative MRI study
Entorhinal cortex in temporal lobe epilepsy - A quantitative MRI study
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DOI：
10.1212/wnl.52.9.1870
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发表时间：
1999-06-10
期刊：
影响因子：
9.9
通讯作者：
Reutens, DC
中科院分区：
文献类型：
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作者：
Bernasconi, N;Bernasconi, A;Reutens, DC
背景：内嗅皮层（EC）是海马前旁回的一个独特的解剖和功能区域，在颞叶癫痫（TLE）的发作发生和传播中起作用。在从TLE患者切除的组织中，已经描述了EC中的细胞损失。目的：开发一种标准化的方案，用于使用高分辨率MRI识别EC的解剖边界，并检查TLE中EC的形态学变化；方法：采用t1加权。20例（男性7例）TLE患者（平均年龄34岁）和18例正常对照（平均年龄26岁）的mri。根据病史、视频脑电图和手术结果，11例患者为左侧癫痫灶，9例为右侧癫痫灶。使用标准化的MRI协议测量EC，海马体和杏仁核的体积。采用方差分析（ANOVA）进行检验。癫痫病灶偏侧和半球对这些体积的影响。不对称比率[A(%) - 100 x (R-L)/(R+L)/2]也使用方差分析比较组间差异。结果：正常对照组右EG体积为1247 +/- 127 mm(3)（平均±标准差），左EG体积为1215 +/- 135 mm(3) （p < 0.05）。我们发现，与对照组相比，TLE患者的双侧EC体积减少（p < 0.05）。非对称比检查显示，脑脊液体积的减少在癫痫灶的同侧更大（p < 0.05）。与对照组相比，TLE患者病灶侧海马和杏仁核体积更小（p < 0.05）。结论：采用标准化的EC定量评估方案，单侧TLE患者表现为双侧EC体积减少。然而，这种减少在癫痫病灶的同侧更为严重。
Background: The entorhinal cortex (EC) is a distinct anatomic and functional region of the anterior parahippocampal gyrus, which plays a role in seizure generation and propagation in temporal lobe epilepsy (TLE). In tissue resected from TLE patients, cell loss in the EC has been described. Objectives- To develop a standardized protocol for identifying the anatomic boundaries of the EC using high-resolution MRI and to examine morphologic changes of the EC in TLE; Methods: We performed T1-weighted. MRIs in 20 patients (7 males) with TLE (mean age 34 years) and 18 normal controls (mean-age 26 years). Eleven patients had a left and 9 a right epileptic focus as defined by history, video-EEG, and surgical outcome. The volumes of the EC, the hippocampus, and the amygdala were measured using a standardized MRI protocol. Analysis: of variaanc(ANOVA) was used to examine the. effect of seizure focus lateralization and hemisphere: on these volumes. An asymmetry ratio [A(%) - 100 x (R-L)/(R+L)/2] was also compared between groups using ANOVA. Results: In normal controls the volume of the right EC was 1,247 +/- 127 mm(3) (mean +/- standard deviation), and that of the left EG was 1,215 +/- 135 mm(3) (p > 0.05). We found a bilateral reduction in the volume of the EC in TLE patients compared with controls (p < 0.05). Examination of the asymmetry ratios: showed that the reduction in volume of the EC was greater ipsilateral to the: epileptic focus (p < 0.05). The volumes of the hippocampus and the amygdala were smaller on the side of the focus in TLE patients compared with controls (p < 0.05): Conclusions: With a standardized protocol for the quantitative assessment of the EC,patients with unilateral TLE show bilateral reduction in the volume of the EC. However, this reduction is more severe ipsilateral td the epileptic focus.