Structural and functional asymmetry of medial temporal subregions in unilateral temporal lobe epilepsy: A 7T MRI study
Structural and functional asymmetry of medial temporal subregions in unilateral temporal lobe epilepsy: A 7T MRI study
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DOI：
10.1002/hbm.24530
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发表时间：
2019-06-01
影响因子：
4.8
通讯作者：
Davis, Kathryn A.
中科院分区：
文献类型：
--
作者：
Shah, Preya;Bassett, Danielle S.;Davis, Kathryn A.
内侧颞叶癫痫(TLE)是一种常见的神经系统疾病，影响海马区和周围的内侧颞叶(MTL)。尽管先前的研究已经分析了TLE患者的全脑网络扭曲，但尚未研究亚区水平MTL的功能网络结构。在这项研究中，我们利用高分辨率7TT2加权磁共振成像(MRI)和静息状态BOLD-fMRI来表征单侧难治性TLE患者和健康对照组MTL亚区的体积不对称和功能网络不对称。我们将TLE组细分为内侧颞叶硬化患者(TLE-MTS)和MRI阴性的非TLE患者(TLE-NL)。使用自动多图谱分割管道，我们为每个受试者描绘了每个半球10个MTL亚区。我们发现两组之间的体积不对称模式明显不同，TLE-MTS表现出与同侧海马区体积减少相对应的体积不对称，而TLE-NL除了同侧整个海马区体积轻微下降外，没有表现出明显的体积不对称。我们还发现CA1亚区和整个海马区的功能网络不对称模式明显不同，TLE-NL患者表现出的不对称对应于同侧连接性的增加，而TLE-MTS患者表现出的不对称对应于同侧连接性的降低。我们的发现提供了初步证据，表明MTL内基于功能神经成像的网络特性可以区分TLE亚型。高分辨率MRI有可能改善TLE患者潜在的脑网络破坏的定位，这些患者是手术切除的候选者。
Mesial temporal lobe epilepsy (TLE) is a common neurological disorder affecting the hippocampus and surrounding medial temporal lobe (MTL). Although prior studies have analyzed whole-brain network distortions in TLE patients, the functional network architecture of the MTL at the subregion level has not been examined. In this study, we utilized high-resolution 7T T2-weighted magnetic resonance imaging (MRI) and resting-state BOLD-fMRI to characterize volumetric asymmetry and functional network asymmetry of MTL subregions in unilateral medically refractory TLE patients and healthy controls. We subdivided the TLE group into mesial temporal sclerosis patients (TLE-MTS) and MRI-negative nonlesional patients (TLE-NL). Using an automated multi-atlas segmentation pipeline, we delineated 10 MTL subregions per hemisphere for each subject. We found significantly different patterns of volumetric asymmetry between the two groups, with TLE-MTS exhibiting volumetric asymmetry corresponding to decreased volumes ipsilaterally in all hippocampal subfields, and TLE-NL exhibiting no significant volumetric asymmetries other than a mild decrease in whole-hippocampal volume ipsilaterally. We also found significantly different patterns of functional network asymmetry in the CA1 subfield and whole hippocampus, with TLE-NL patients exhibiting asymmetry corresponding to increased connectivity ipsilaterally and TLE-MTS patients exhibiting asymmetry corresponding to decreased connectivity ipsilaterally. Our findings provide initial evidence that functional neuroimaging-based network properties within the MTL can distinguish between TLE subtypes. High-resolution MRI has potential to improve localization of underlying brain network disruptions in TLE patients who are candidates for surgical resection.