Increasing structural atrophy and functional isolation of the temporal lobe with duration of disease in temporal lobe epilepsy.
Increasing structural atrophy and functional isolation of the temporal lobe with duration of disease in temporal lobe epilepsy.
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DOI：
10.1016/j.eplepsyres.2014.12.006
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发表时间：
2015-02
影响因子：
2.2
通讯作者：
Kang H
中科院分区：
文献类型：
--
作者：
Morgan VL;Conrad BN;Abou-Khalil B;Rogers BP;Kang H
由于耐药性癫痫发作和手术治疗的利用不足，大量颞叶癫痫（TLE）患者经历数年或数十年的癫痫发作。本研究的目的是用尽可能少的参数生成疾病持续时间的预测模型，以识别和量化TLE进展的重要体积和功能指标。两组受试者包括12例左侧TLE、21例右侧TLE和20例健康对照（持续时间= 0），在3T MRI扫描仪上使用高分辨率T1加权结构MRI和20分钟静息功能MRI扫描进行成像。使用多变量线性回归方法计算疾病持续时间的预测模型，使用49个预测因子，包括从这些图像计算的功能连接和灰质体积。没有一个从完整的数据集开发的模型准确地预测了3到50年的疾病持续时间。然后，我们对35名病程在10至35年之间的受试者进行了回归分析。由此产生的预测模型显示，较长的持续时间与同侧颞叶到对侧颞叶、楔前叶和中扣带回的功能连接减少有关，并且与同侧海马和苍白球体积减少有关。功能和体积参数准确地预测疾病的持续时间在TLE。研究结果表明，TLE与同侧颞叶的逐渐功能隔离和显著的进行性结构萎缩有关，持续时间为10 - 35年。此外，这些变化也可以在这些患者的对侧半球中检测到，但程度较低。
Due to pharmacoresistant seizures and the underutilization of surgical treatments, a large number of temporal lobe epilepsy (TLE) patients experience seizures for years or decades. The goal of this study was to generate a predictive model of duration of disease with the least number of parameters possible in order to identify and quantify the significant volumetric and functional indicators of TLE progression. Two cohorts of subjects including 12 left TLE, 21 right TLE and 20 healthy controls (duration=0) were imaged on a 3T MRI scanner using high resolution T1-weighted structural MRI and 20 minutes of resting functional MRI scanning. Multivariate linear regression methods were used to compute a predictive model of duration of disease using 49 predictors including functional connectivity and gray matter volumes computed from these images. No model developed from the full set of data accurately predicted the duration of disease across the entire range from 3 to 50 years. We then performed the regression on 35 subjects with durations of disease in the range 10 to 35 years. The resulting predictive model showed that longer durations were associated with reductions in functional connectivity from the ipsilateral temporal lobe to the contralateral temporal lobe, precuneus and mid cingulate, and with decreases in volume of the ipsilateral hippocampus and pallidum. Functional and volumetric parameters accurately predicted duration of disease in TLE. The findings suggest that TLE is associated with a gradual functional isolation and significant progressive structural atrophy of the ipsilateral temporal lobe over years of duration in the range of 10–35 years. Furthermore, these changes can also be detected in the contralateral hemisphere in these patients, but to a lesser degree.
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