Widespread extrahippocampal NAA/(Cr plus Cho) abnormalities in TLE with and without mesial temporal sclerosis
Widespread extrahippocampal NAA/(Cr plus Cho) abnormalities in TLE with and without mesial temporal sclerosis
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DOI：
10.1007/s00415-010-5799-6
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发表时间：
2011-04-01
影响因子：
6
通讯作者：
Laxer, Kenneth D.
中科院分区：
文献类型：
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作者：
Mueller, Susanne G.;Ebel, Andreas;Laxer, Kenneth D.
磁共振波谱显示海马外NAA/（Cr+Cho）减少内侧颞叶癫痫（TLE-MTS）和没有（TLE-no）内侧颞叶硬化。由于这些以前的研究有限的大脑覆盖范围，它是，但是，不可能评估TLE-MTS和TLE-no之间的分布和这些异常的程度的差异。本研究使用了三维全脑回波平面光谱成像（EPSI）序列，以解决以下问题：（1）TLE-MTS和TLE-no不同的严重程度和分布的海马外NAA/（Cr+Cho）减少？(2)海马外NAA/（Cr+Cho）降低是否为病灶定侧提供了额外的信息？43例受试者（12例TLE-MTS，13例TLE-no，18例对照）进行了3D EPSI研究。统计参数图（SPM 2）用于识别TLE组和个体患者中NAA/（Cr+Cho）显著降低的区域。TLE-MTS和TLE-no具有广泛的海马外NAA/（Cr+Cho）降低。NAA/（Cr+Cho）降低在TLE-MTS中具有双侧额颞分布，在TLE-no中具有更弥散、不太明确的分布。单个受试者分析中的海马外NAA/（Cr+Cho）降低显示出较大的个体间变异性，并且没有提供额外的焦点偏侧信息。TLE-MTS和TLE-no的海马外NAA/（Cr+Cho）降低既不是局灶性的，也不是均匀的。这降低了他们的价值，重点偏侧，并提出了一个异质性的病因海马外光谱代谢异常的TLE。
MR spectroscopy has demonstrated extrahippocampal NAA/(Cr+Cho) reductions in medial temporal lobe epilepsy with (TLE-MTS) and without (TLE-no) mesial temporal sclerosis. Because of the limited brain coverage of those previous studies, it was, however, not possible to assess differences in the distribution and extent of these abnormalities between TLE-MTS and TLE-no. This study used a 3D whole brain echoplanar spectroscopic imaging (EPSI) sequence to address the following questions: (1) Do TLE-MTS and TLE-no differ regarding severity and distribution of extrahippocampal NAA/(Cr+Cho) reductions? (2) Do extrahippocampal NAA/(Cr+Cho) reductions provide additional information for focus lateralization? Forty-three subjects (12 TLE-MTS, 13 TLE-no, 18 controls) were studied with 3D EPSI. Statistical parametric mapping (SPM2) was used to identify regions of significantly decreased NAA/(Cr+Cho) in TLE groups and in individual patients. TLE-MTS and TLE-no had widespread extrahippocampal NAA/(Cr+Cho) reductions. NAA/(Cr+Cho) reductions had a bilateral fronto-temporal distribution in TLE-MTS and a more diffuse, less well defined distribution in TLE-no. Extrahippocampal NAA/(Cr+Cho) decreases in the single subject analysis showed a large inter-individual variability and did not provide additional focus lateralizing information. Extrahippocampal NAA/(Cr+Cho) reductions in TLE-MTS and TLE-no are neither focal nor homogeneous. This reduces their value for focus lateralization and suggests a heterogeneous etiology of extrahippocampal spectroscopic metabolic abnormalities in TLE.