Selective neuronal vulnerability of human hippocampal CA1 neurons: lesion evolution, temporal course, and pattern of hippocampal damage in diffusion-weighted MR imaging
Selective neuronal vulnerability of human hippocampal CA1 neurons: lesion evolution, temporal course, and pattern of hippocampal damage in diffusion-weighted MR imaging
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DOI：
10.1038/jcbfm.2015.137
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发表时间：
2015-11-01
影响因子：
6.3
通讯作者：
Jansen, Olav
中科院分区：
文献类型：
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作者：
Bartsch, Thorsten;Doehring, Juliane;Jansen, Olav
海马区CA1(Cornu Ammonis)选择性地易受各种代谢和细胞毒性损伤，这反映在CA1神经元的迟发性神经元死亡中。CA1神经元这种区域敏感性的基础和机制尚不清楚，影响海马体的人类疾病的相关性也不清楚。采用平移的方法，利用高分辨率磁共振成像技术，对急性神经系统疾病患者海马CA1区的病变演变、时间进程、扩散变化模式和损伤进行了研究。在海马区缺血(n=50)、边缘脑炎(n=30)、癫痫持续状态(n=17)和短暂性全面性遗忘(n=53)患者中，与其他CA区相比，CA1区受到选择性影响。无论损伤的性质如何，CA1神经元的表观弥散系数(ADC)在损伤后48-72小时出现最大下降。缺氧缺血组ADC值明显降低，提示缺氧性损伤对细胞代谢的损害更大。弥散变化的演变表明，CA1弥漫性损害反映了通常在动物模型中观察到的病理生理级联的延迟时间过程。研究人类海马区损伤的影像相关性为深入了解海马区的病理生理学和神经生物学提供了有价值的见解。
The CA1 (cornu ammonis) region of hippocampus is selectively vulnerable to a variety of metabolic and cytotoxic insults, which is mirrored in a delayed neuronal death of CA1 neurons. The basis and mechanisms of this regional susceptibility of CA1 neurons are poorly understood, and the correlates in human diseases affecting the hippocampus are not clear. Adopting a translational approach, the lesion evolution, temporal course, pattern of diffusion changes, and damage in hippocampal CA1 in acute neurologic disorders were studied using high-resolution magnetic resonance imaging. In patients with hippocampal ischemia (n = 50), limbic encephalitis (n = 30), after status epilepticus (n = 17), and transient global amnesia (n = 53), the CA1 region was selectively affected compared with other CA regions of the hippocampus. CA1 neurons exhibited a maximum decrease of apparent diffusion coefficient (ADC) 48 to 72 hours after the insult, irrespective of the nature of the insult. Hypoxic-ischemic insults led to a significant lower ADC suggesting that the ischemic insult results in a stronger impairment of cellular metabolism. The evolution of diffusion changes show that CA1 diffusion lesions mirror the delayed time course of the pathophysiologic cascade typically observed in animal models. Studying the imaging correlates of hippocampal damage in humans provides valuable insight into the pathophysiology and neurobiology of the hippocampus.