Frequent seizures are associated with a network of gray matter atrophy in temporal lobe epilepsy with or without hippocampal sclerosis.
Frequent seizures are associated with a network of gray matter atrophy in temporal lobe epilepsy with or without hippocampal sclerosis.
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DOI：
10.1371/journal.pone.0085843
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Cendes F
中科院分区：
文献类型：
--
作者：
Coan AC;Campos BM;Yasuda CL;Kubota BY;Bergo FP;Guerreiro CA;Cendes F
颞叶癫痫（TLE）伴海马硬化（HS）患者可通过MRI定量分析检测到弥漫性细微灰质（GM）萎缩。然而，目前尚不清楚病因和癫痫发作频率是否与这种萎缩有关。我们的目的是评估GM萎缩的发生率和癫痫发作频率的影响，在TLE患者和正常的MRI（TLE-NL）或HS的MRI体征（TLE-HS）。我们评估了一组连续的172例单侧TLE-HS或TLE-NL患者（通过海马体积测定和信号定量确定）（122例TLE-HS和50例TLE-NL）加上一组82名健康个体。在3 T MRI中使用VBM 8/SPM 8进行基于体素的形态测量。在前一年中有多达三次复杂部分性癫痫发作且没有全身强直阵挛性癫痫发作的患者被认为是罕见癫痫发作。那些不符合这些标准的人被认为是经常癫痫发作。TLE-HS患者的GM萎缩更明显，包括同侧颞叶内侧结构、颞叶、双侧丘脑和中央前/后回。TLE-NL患者的GM萎缩更为轻微，包括同侧眶额皮质、双侧丘脑和中央前/后回。TLE-HS和TLE-NL均显示对侧脑桥GM体积增加。与不常发作的TLE-HS患者相比，频繁发作的TLE-HS患者颞外区域的GM萎缩更明显。患有TLE-NL和罕见癫痫发作的患者没有检测到GM萎缩。在TLE-HS和TLE-NL中，癫痫持续时间与海马外区域的GM萎缩相关。尽管弥漫性网络GM萎缩发生在TLE-HS和TLE-NL中，但这在TLE-HS和频繁癫痫发作的患者中明显更明显。这些结果表明，TLE的新皮质萎缩与持续的癫痫发作和癫痫持续时间有关，而丘脑萎缩更可能与最初的致痫过程有关。
Patients with temporal lobe epilepsy (TLE) with hippocampal sclerosis (HS) have diffuse subtle gray matter (GM) atrophy detectable by MRI quantification analyses. However, it is not clear whether the etiology and seizure frequency are associated with this atrophy. We aimed to evaluate the occurrence of GM atrophy and the influence of seizure frequency in patients with TLE and either normal MRI (TLE-NL) or MRI signs of HS (TLE-HS). We evaluated a group of 172 consecutive patients with unilateral TLE-HS or TLE-NL as defined by hippocampal volumetry and signal quantification (122 TLE-HS and 50 TLE-NL) plus a group of 82 healthy individuals. Voxel-based morphometry was performed with VBM8/SPM8 in 3T MRIs. Patients with up to three complex partial seizures and no generalized tonic-clonic seizures in the previous year were considered to have infrequent seizures. Those who did not fulfill these criteria were considered to have frequent seizures. Patients with TLE-HS had more pronounced GM atrophy, including the ipsilateral mesial temporal structures, temporal lobe, bilateral thalami and pre/post-central gyri. Patients with TLE-NL had more subtle GM atrophy, including the ipsilateral orbitofrontal cortex, bilateral thalami and pre/post-central gyri. Both TLE-HS and TLE-NL showed increased GM volume in the contralateral pons. TLE-HS patients with frequent seizures had more pronounced GM atrophy in extra-temporal regions than TLE-HS with infrequent seizures. Patients with TLE-NL and infrequent seizures had no detectable GM atrophy. In both TLE-HS and TLE-NL, the duration of epilepsy correlated with GM atrophy in extra-hippocampal regions. Although a diffuse network GM atrophy occurs in both TLE-HS and TLE-NL, this is strikingly more evident in TLE-HS and in patients with frequent seizures. These findings suggest that neocortical atrophy in TLE is related to the ongoing seizures and epilepsy duration, while thalamic atrophy is more probably related to the original epileptogenic process.
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影响因子：
3.4
作者：
Coan AC;Morita ME;de Campos BM;Yasuda CL;Cendes F
通讯作者：
Cendes F
影响因子：
5.7
作者：
Bonilha, L;Rorden, C;Li, LM
通讯作者：
Li, LM
影响因子：
5.6
作者：
Bell ML;Rao S;So EL;Trenerry M;Kazemi N;Stead SM;Cascino G;Marsh R;Meyer FB;Watson RE;Giannini C;Worrell GA
通讯作者：
Worrell GA
影响因子：
4.2
作者：
Barron, Daniel S.;Fox, P. Mickle;Laird, Angela R.;Robinson, Jennifer L.;Fox, Peter T.
通讯作者：
Fox, Peter T.
影响因子：
3.7
作者：
Blumenfeld, H;McNally, KA;Spencer, SS
通讯作者：
Spencer, SS