Cross hippocampal influence in mesial temporal lobe epilepsy measured with high temporal resolution functional magnetic resonance imaging.
Cross hippocampal influence in mesial temporal lobe epilepsy measured with high temporal resolution functional magnetic resonance imaging.
复制标题
用高时间分辨率的功能磁共振成像测量的中颞叶癫痫中的跨海马影响。
DOI：
10.1111/j.1528-1167.2011.03196.x
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发表时间：
2011-09
期刊：
影响因子：
5.6
通讯作者：
Abou-Khalil B
中科院分区：
文献类型：
--
作者：
Morgan VL;Rogers BP;Sonmezturk HH;Gore JC;Abou-Khalil B
内侧颞叶癫痫（mTLE）是一种慢性疾病，其自发性癫痫发作持续数年甚至数十年。许多结构和功能的变化已被检测到在整个大脑的癫痫发作的重点和远端区域在这段时间内，可能反映了癫痫网络的发展。静息态功能磁共振成像（fMRI）连接映射有可能阐明和量化这些网络。左右海马之间的网络很可能是最容易受到长期癫痫传播效应影响的变化之一。因此，本研究的目的是使用高时间分辨率fMRI量化mTLE中跨海马的影响，并确定其与疾病持续时间的关系。在静息状态（发作间期）下采集19例mTLE患者（左侧13例，右侧6例）颞叶的功能MRI图像，时间分辨率为500 ms。使用结构定义和功能定义的边界在每个受试者的图像上识别左右海马。每对区域的跨海马影响以两种方式量化：（1）非定向海马功能连接，计算为左右海马区域平均时间序列之间的Pearson相关性，以及（2）格兰杰因果关系（GC）侧化测量，其通过确定时间优先性暗示定向影响。这些指标中的每一项均与受试者的年龄、发病年龄和疾病持续时间相关，以研究与疾病进展的关系。使用结构或功能定义的区域，左和右mTLE患者之间的海马连接性没有显著差异。在所有患者中，海马连接与发病年龄或疾病持续时间无显著相关性。然而，随着疾病持续时间的增加，10年后（9例患者），海马连接线性增加。使用功能定义的区域，GC偏侧性在右侧mTLE中比左侧mTLE增加，表明左侧海马对右侧海马的影响大于右侧对左侧海马的影响。这也与发病年龄呈正相关。此外，像海马连接一样，GC偏侧性和疾病持续时间之间的关系在疾病持续10年后发生变化。在这段时间之后，GC偏侧性在3/3例右侧mTLE患者中为阳性（左侧影响右侧），而GC偏侧性在5/6例左侧mTLE患者中为阴性（右侧影响左侧）。这项研究揭示了功能磁共振成像功能连接和因果关系的影响，左右海马和疾病的持续时间在mTLE。在发作间期状态，半球间海马连接最初被破坏，然后随着癫痫进展超过10年而线性增加。这种连接性的增加似乎是由于对侧海马的癫痫灶施加更多的影响，同侧海马。这些发现可能对理解癫痫网络的功能发育和可能预测mTLE的手术结果具有意义。
Mesial temporal lobe epilepsy (mTLE) is a chronic disorder with spontaneous seizures recurring for years, or even decades. Many structural and functional changes have been detected in both the seizure focus and distal regions throughout the brain over this duration that may reflect the development of epileptogenic networks. Resting state functional Magnetic Resonance Imaging (fMRI) connectivity mapping has the potential to elucidate and quantify these networks. The network between the left and right hippocampus may very likely be one of the most susceptible to changes due to long term seizure propagation effects. Therefore, the objective of this study was to quantify cross hippocampal influence in mTLE using high temporal resolution fMRI, and to determine its relationship with disease duration. Functional MRI images were acquired in the resting (interictal) state with 500 ms temporal resolution across the temporal lobes of 19 mTLE patients (13 left, 6 right). The left and right hippocampus was identified on each subject’s images using both structurally defined and functionally defined boundaries. The cross hippocampal influence was quantified in two ways for each pair of regions: (1) the non-directional hippocampal functional connectivity calculated as the Pearson’s correlation between the average time series in the left and the right hippocampus regions, and (2) the Granger causality (GC) laterality measure which implies directional influence by determining temporal precedence. Each of these measures was correlated with age, age of onset and disease duration across subjects to investigate relationship to disease progression. The hippocampal connectivity was not significantly different between the left and right mTLE patients using either the structurally or the functionally defined regions. Across all patients, hippocampal connectivity was not significantly correlated with age of onset or duration of disease. However, as duration of disease increased after 10 years (9 patients), the hippocampal connectivity increased linearly. Using the functionally defined regions, the GC laterality was increased in the right mTLE over the left mTLE, indicating that the left hippocampus was influencing the right hippocampus more than the right influencing left. This was also positively correlated with age of onset. Furthermore, like hippocampal connectivity, the relationship between GC laterality and duration of disease changes after 10 years duration of disease. After this duration, the GC laterality was positive in the 3 out of 3 right mTLE patients (left influencing right), while the GC laterality was negative in 5 of 6 left mTLE patients (right influencing left). This study reveals a relationship between fMRI functional connectivity and causal influence of the left and right hippocampus and duration of disease in mTLE. During the interictal state, the interhemispheric hippocampal connectivity initially is disrupted and then linearly increases as the epilepsy progresses longer than 10 years. This increase in connectivity appears to be due to the hippocampus contralateral to the epileptogenic focus exerting more influence over the ipsilateral hippocampus. These findings may have implications in understanding the functional development of epileptic networks and possibly prediction of surgical outcome of mTLE.
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