Whole-brain voxel-based statistical analysis of gray alter and white matter in temporal lobe epilepsy
Whole-brain voxel-based statistical analysis of gray alter and white matter in temporal lobe epilepsy
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DOI：
10.1016/j.neuroimage.2004.06.015
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发表时间：
2004-10-01
期刊：
影响因子：
5.7
通讯作者：
Bernasconi, A
中科院分区：
文献类型：
--
作者：
Bernasconi, N;Duchesne, S;Bernasconi, A
基于人工标记选定解剖结构的体积MRI研究提供了体内证据，表明与颞叶癫痫（TLE）相关的大脑异常超出了海马体。基于体素的形态测量法（VBM）是一种全自动图像分析技术，可以在没有预先感兴趣区域的情况下识别受试者组之间灰质（GM）和白质（WM）的区域差异。本研究的目的是确定TLE全脑GM和WM的变化，并探讨这些异常与临床参数的关系。我们研究了85例药理学上难治性TLE和单侧海马萎缩患者和47例年龄和性别匹配的健康对照。40例患者癫痫发作病灶位于右侧，45例位于左侧。使用一般线性模型获得患者与对照组GM和WM浓度差异的学生t检验统计图。对TLE人群进行癫痫持续时间、发病年龄、发热性惊厥和继发性全身性癫痫发作的进一步回归分析。基于体素的形态测量显示，TLE的GM病理扩展到海马以外的其他边缘区域，如扣带和丘脑，以及边缘外区域，特别是额叶。白质减少只发生在癫痫病灶的同侧，包括颞、内嗅和外嗅区域。这种结构变化模式提示在药理学上难治性TLE患者中，优先涉及额叶通路的断开。(C) 2004爱思唯尔公司版权所有。
Volumetric MRI studies based on manual labeling of selected anatomical structures have provided in vivo evidence that brain abnormalities associated with temporal lobe epilepsy (TLE) extend beyond the hippocampus. Voxel-based morphometry (VBM) is a fully automated image analysis technique allowing identification of regional differences in gray matter (GM) and white matter (WM) between groups of subjects without a prior region of interest. The purpose of this study was to determine whole-brain GM and WM changes in TLE and to investigate the relationship between these abnormalities and clinical parameters. We studied 85 patients with pharmacologically intractable TLE and unilateral hippocampal atrophy and 47 age- and sex-matched healthy control subjects. The seizure focus was right sided in 40 patients and left sided in 45. Student's t test statistical maps of differences between patients' and controls' GM and WM concentrations were obtained using a general linear model. A further regression against duration of epilepsy, age of onset, presence of febrile convulsions, and secondary generalized seizures was performed with the TLE population. Voxel-based morphometry revealed that GM pathology in TLE extends beyond the hippocampus involving other limbic areas such as the cingulum and the thalamus, as well as extralimbic areas, particularly the frontal lobe. White matter reduction was found only ipsilateral to the seizure focus, including the temporopolar, entorhinal, and perirhinal areas. This pattern of structural changes is suggestive of disconnection involving preferentially frontolimbic pathways in patients with pharmacologically intractable TLE. (C) 2004 Elsevier Inc. All rights reserved.