Hippocampal MRS and subfield volumetry at 7T detects dysfunction not specific to seizure focus.
Hippocampal MRS and subfield volumetry at 7T detects dysfunction not specific to seizure focus.
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DOI：
10.1038/s41598-017-16046-5
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发表时间：
2017-11-23
影响因子：
4.6
通讯作者：
Emir U
中科院分区：
文献类型：
--
作者：
Voets NL;Hodgetts CJ;Sen A;Adcock JE;Emir U
超高场7T MRI对颞叶癫痫（TLE）患者的海马病理定位具有敏感性，但很少对表现正常的临床MRI患者进行评估。我们应用多模态7T MRI来评估局灶性亚场萎缩和脑代谢物偏差是否表征癫痫海马。对12例术前TLE患者（7例mri阴性）和年龄匹配的健康志愿者进行7T扫描。从600μm各向同性分辨率敏感性加权图像中手动分割海马子区。获得海马代谢物光谱以测定谷氨酸、谷氨酰胺、肌醇、NAA、肌酸和胆碱的绝对浓度。我们进行了病例对照分析，使用排列测试来识别个体患者海马成像测量的异常，以评估癫痫发作侧化和神经心理记忆测试分数的临床证据。体积分析发现9/12例（75%）患者海马亚区萎缩，通常影响CA3。7/8例患者代谢物浓度改变，大多数患者谷氨酰胺水平降低（62.5%）。然而，无论是体积还是代谢物的偏差，都不能始终使致痫性海马侧化。相反，较低的耻骨下体积和谷氨酰胺浓度与言语记忆表现受损有关。在7T检测到的海马亚区和代谢异常似乎反映了癫痫发生以外的病理生理过程。尽管诊断贡献有限，但这些标记物有望帮助阐明TLE中的记忆加工。
Ultra high-field 7T MRI offers sensitivity to localize hippocampal pathology in temporal lobe epilepsy (TLE), but has rarely been evaluated in patients with normal-appearing clinical MRI. We applied multimodal 7T MRI to assess if focal subfield atrophy and deviations in brain metabolites characterize epileptic hippocampi. Twelve pre-surgical TLE patients (7 MRI-negative) and age-matched healthy volunteers were scanned at 7T. Hippocampal subfields were manually segmented from 600μm isotropic resolution susceptibility-weighted images. Hippocampal metabolite spectra were acquired to determine absolute concentrations of glutamate, glutamine, myo-inositol, NAA, creatine and choline. We performed case-controls analyses, using permutation testing, to identify abnormalities in hippocampal imaging measures in individual patients, for evaluation against clinical evidence of seizure lateralisation and neuropsychological memory test scores. Volume analyses identified hippocampal subfield atrophy in 9/12 patients (75%), commonly affecting CA3. 7/8 patients had altered metabolite concentrations, most showing reduced glutamine levels (62.5%). However, neither volume nor metabolite deviations consistently lateralized the epileptogenic hippocampus. Rather, lower subiculum volumes and glutamine concentrations correlated with impaired verbal memory performance. Hippocampal subfield and metabolic abnormalities detected at 7T appear to reflect pathophysiological processes beyond epileptogenesis. Despite limited diagnostic contributions, these markers show promise to help elucidate mnemonic processing in TLE.
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影响因子：
11.2
作者：
Emir UE;Larkin SJ;de Pennington N;Voets N;Plaha P;Stacey R;Al-Qahtani K;Mccullagh J;Schofield CJ;Clare S;Jezzard P;Cadoux-Hudson T;Ansorge O
通讯作者：
Ansorge O
影响因子：
11.2
作者：
Briellmann, RS;Berkovic, SF;Jackson, GD
通讯作者：
Jackson, GD
DOI：
10.3174/ajnr.a4116
发表时间：
2015-03
期刊：
AJNR. American journal of neuroradiology
影响因子：
--
作者：
De Ciantis A;Barkovich AJ;Cosottini M;Barba C;Montanaro D;Costagli M;Tosetti M;Biagi L;Dobyns WB;Guerrini R
通讯作者：
Guerrini R
影响因子：
5.3
作者：
Berron, David;Schuetze, Hartmut;Duezel, Emrah
通讯作者：
Duezel, Emrah
影响因子：
3
作者：
Doelken, M. T.;Stefan, H.;Hammen, T.
通讯作者：
Hammen, T.