Progressive white matter changes following anterior temporal lobe resection for epilepsy.
Progressive white matter changes following anterior temporal lobe resection for epilepsy.
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DOI：
10.1016/j.nicl.2013.12.004
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发表时间：
2014
影响因子：
4.2
通讯作者：
Duncan, John S.
中科院分区：
文献类型：
--
作者：
Winston, Gavin P.;Stretton, Jason;Sidhu, Meneka K.;Symms, Mark R.;Duncan, John S.
前颞叶切除术是治疗难治性颞叶癫痫的有效方法。广泛的扩散参数异常，涉及同侧颞叶白色物质和扩展到颞外白色物质已被显示在颞叶癫痫的横断面研究。然而，手术后的纵向变化还没有得到很好的解决。我们系统地评估与对照组相比，TLE患者手术前白色物质的扩散变化，并使用全脑方法在两个时间点（3-4个月，12个月）观察ATLR后的纵向变化。我们发现主要是单侧基线变化的时间和颞外结构与髓鞘形成的改变（减少分数各向异性，增加平均和径向扩散）。手术后，这些变化的进展，从切除颞叶符合沃勒变性传出束。然而，更优越的冠辐射，内部和外部胶囊和附近的道，观察到与可塑性兼容的变化（增加分数各向异性和轴向扩散，减少径向扩散）。左侧TLE患者术后3-4个月和12个月之间几乎没有进展，但右侧TLE患者的变化更广泛，表明该人群的可塑性发生得更慢。这种可塑性的神经心理学相关性应该进一步探索。我们研究颞叶切除术后弥散参数的纵向变化。与沃勒变性一致的变化见于附近的传出束。更优越的是，观察到与塑性相容的扩散变化。这些变化大多出现在左侧手术后3-4个月。右侧手术后可塑性发生更慢，1年时变化更大。
Anterior temporal lobe resection (ATLR) is an effective treatment for refractory temporal lobe epilepsy (TLE). Widespread abnormalities in diffusion parameters involving the ipsilateral temporal lobe white matter and extending into extratemporal white matter have been shown in cross-sectional studies in TLE. However longitudinal changes following surgery have been less well addressed. We systematically assess diffusion changes in white matter in patients with TLE in comparison to controls before surgery and look at the longitudinal changes following ATLR at two timepoints (3–4 months, 12 months) using a whole brain approach. We find predominantly unilateral baseline changes in temporal and extratemporal structures compatible with altered myelination (reduced fractional anisotropy, increased mean and radial diffusivity). Following surgery, these changes progress in efferent tracts from the resected temporal lobe compatible with Wallerian degeneration. However more superiorly in the corona radiata, internal and external capsules and nearby tracts, changes compatible with plasticity are observed (increased fractional anisotropy and axial diffusivity, reduced radial diffusivity). There is little progression between 3–4 months and 12 months following surgery in patients with left TLE, but the changes become more widespread in patients with right TLE suggesting that plasticity occurs more slowly in this population. The neuropsychological correlates of such plasticity should be explored further. We study longitudinal changes in diffusion parameters after temporal lobe resection. Changes consistent with Wallerian degeneration are seen in nearby efferent tracts. More superiorly, diffusion changes compatible with plasticity are observed. Most of these changes are present by 3–4 months following left-sided surgery. Plasticity occurs more slowly after right-sided surgery with greater change by 1 year.
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影响因子：
5.6
作者：
Kemmotsu N;Girard HM;Bernhardt BC;Bonilha L;Lin JJ;Tecoma ES;Iragui VJ;Hagler DJ Jr;Halgren E;McDonald CR
通讯作者：
McDonald CR
影响因子：
4.8
作者：
Smith, SM
通讯作者：
Smith, SM
影响因子：
9.9
作者：
McDonald, C. R.;Hagler, D. J., Jr.;Dale, A. M.
通讯作者：
Dale, A. M.
影响因子：
5.6
作者：
Serles, W;Li, LM;Arnold, DL
通讯作者：
Arnold, DL
影响因子：
5.7
作者：
Liu, Min;Gross, Donald W.;Beaulieu, Christian
通讯作者：
Beaulieu, Christian