Impact of mesial temporal lobe resection on brain structure in medically refractory epilepsy.
Impact of mesial temporal lobe resection on brain structure in medically refractory epilepsy.
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内侧颞叶切除对难治性癫痫脑结构的影响。
DOI：
10.1016/j.wneu.2021.06.039
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发表时间：
2021
影响因子：
2
通讯作者：
A. Lozano
中科院分区：
文献类型：
--
作者：
G. Elias;Jurgen Germann;C. Neudorfer;Andrew A. Namasivayam;A. Loh;R. Gramer;G. Ibrahim;T. Valiante;Jennifer C. Tomaszczyk;M. McAndrews;W. Kucharczyk;A. Boutet;A. Lozano
手术切除可降低药物难治性颞叶癫痫的发作频率。然而，这种干预对大脑回路的功能和结构后果知之甚少。我们研究了难治性癫痫患者颞叶内侧切除术后脑回路的结构变化。具体而言，我们使用神经影像学技术来评估1）对侧海马和双侧乳头体体积和2）全脑皮质厚度的变化。（1.6 ± 0.5）年（9名女性，12名男性;平均年龄，39.4 ± 11.5岁）接受了单侧颞叶切除术（14名前颞叶切除术，7名选择性杏仁核切除术）。分别使用Pruessner和Copenhaver协议对未切除的海马结构和双侧乳头体进行盲法手动分割。使用CIVET pipeline.ResultsSurgical切除术与contralesional海马体积减少5%（P< 0.01）和乳头体体积减少9.5%（P= 0.03）相关的全脑皮质厚度估计。此外，在对侧扣带回前、中扣带回和岛叶（P假发现率< 0.01）以及其他颞区、额叶和枕区（P假发现率< 0.05）观察到皮质厚度的显着变化。术后言语记忆功能显着相关的contralesional颞下回皮质厚度变化（R2= 0.39;P= 0.03）。ConclusionsThese结果表明，颞叶内侧切除术与两个体积损失备用Papez电路和整个大脑皮质厚度的变化。
ObjectiveSurgical resection can decrease seizure frequency in medically intractable temporal lobe epilepsy. However, the functional and structural consequences of this intervention on brain circuitry are poorly understood. We investigated structural changes that occur in brain circuits after mesial temporal lobe resection for refractory epilepsy. Specifically, we used neuroimaging techniques to evaluate changes in 1) contralesional hippocampal and bilateral mammillary body volume and 2) brain-wide cortical thickness.MethodsSerial T1-weighted brain magnetic resonance images were acquired before and after surgery (1.6 ± 0.5 year interval) in 21 patients with temporal lobe epilepsy (9 women, 12 men; mean age, 39.4 ± 11.5 years) who had undergone unilateral temporal lobe resection (14 anterior temporal lobectomy; 7 selective amygdalohippocampectomy). Blinded manual segmentation of the unresected hippocampal formation and bilateral mammillary bodies was performed using the Pruessner and Copenhaver protocols, respectively. Brain-wide cortical thickness estimates were computed using the CIVET pipeline.ResultsSurgical resection was associated with a 5% reduction in contralesional hippocampal volume (P< 0.01) and a 9.5% reduction in mammillary body volume (P= 0.03). In addition, significant changes in cortical thickness were observed in contralesional anterior and middle cingulate gyrus and insula (Pfalse discovery rate< 0.01) as well as in other temporal, frontal, and occipital regions (Pfalse discovery rate< 0.05). Postoperative verbal memory function was significantly associated with cortical thickness change in contralesional inferior temporal gyrus (R2= 0.39;P= 0.03).ConclusionsThese results indicate that mesial temporal lobe resection is associated with both volume loss in spared Papez circuitry and changes in cortical thickness across the brain.
使用多变量数据缩减来预测内侧颞叶癫痫患者的术后记忆力下降
影响因子：
2.6
作者：
St-Laurent;McCormick;Mišić;Giannoylis;McAndrews
通讯作者：
McAndrews