Progression in temporal lobe epilepsy - Differential atrophy in mesial temporal structures
Progression in temporal lobe epilepsy - Differential atrophy in mesial temporal structures
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DOI：
10.1212/01.wnl.0000169066.46912.fa
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发表时间：
2005-07-26
期刊：
影响因子：
9.9
通讯作者：
Bernasconi, A
中科院分区：
文献类型：
--
作者：
Bernasconi, N;Natsume, J;Bernasconi, A
目的：确定难治性颞叶癫痫（TLE）患者海马、杏仁核和内嗅皮质萎缩与癫痫持续时间、继发性全身性癫痫发作和儿童期长期热性惊厥之间的关系。研究方法：对86例TLE患者和44例年龄和性别匹配的健康对照者进行海马、杏仁核和内嗅皮质的容积MRI检查。采用线性回归分析探讨容积测量值与临床参数之间的关系。结果如下：在简单回归分析中，癫痫持续时间与癫痫病灶同侧海马（r（2）= 0.19，p < 0.001）、内嗅皮质（r（2）= 0.11，p = 0.002）和杏仁核（r（2）= 0.15，p < 0.001）萎缩相关，而与癫痫发作时的年龄无关。回归函数预测复发性癫痫发作时间（时间= 0）导致海马和内嗅皮层的y截距< 0，但杏仁核的y截距与0无差异。有热性惊厥病史的患者癫痫发作同侧海马体积较小（p < 0.001）。未发现热性惊厥与内嗅皮质和杏仁核体积或继发性全身性癫痫发作与任何内侧颞叶体积之间的关系。结论：与癫痫持续时间相关的内侧颞叶进行性体积损失不仅限于海马，还影响内嗅皮层和杏仁核。
Objective: To determine the relationship between hippocampal, amygdalar, and entorhinal cortex atrophy and duration of epilepsy, presence of secondary generalized seizures, and prolonged childhood febrile convulsions in patients with pharmacologically intractable temporal lobe epilepsy (TLE). Methods: Volumetric MRI of the hippocampus, amygdale, and entorhinal cortex were performed in 86 consecutive patients with TLE and 44 age- and sex-matched healthy control subjects. Linear regression analysis was used to explore the relation between the volumetric measurements and the clinical parameters. Results: In simple regressions, duration of epilepsy but not age at seizure onset was related to hippocampal (r(2) = 0.19, p < 0.001), entorhinal cortex (r(2) = 0.11, p = 0.002), and amygdalar (r(2) = 0.15, p < 0.001) atrophy ipsilateral to the seizure focus. Prediction of the regression function to time of onset of recurrent seizures (time = 0) resulted in a y intercept of < 0 for the hippocampus and the entorhinal cortex but was not different from 0 for the amygdala. Patients with a positive history of febrile convulsions had smaller hippocampal volumes ipsilateral to the seizure (p < 0.001). No relationship was found between febrile convulsions and entorhinal cortex and amygdalar volumes or between secondary generalization of seizures and any mesial temporal volume. Conclusion: Progressive volume loss in the mesial temporal lobe in relation to duration of epilepsy is not limited to the hippocampus but affects the entorhinal cortex and the amygdala.