Extrahippocampal gray matter loss and hippocampal deafferentation in patients with temporal lobe epilepsy.
Extrahippocampal gray matter loss and hippocampal deafferentation in patients with temporal lobe epilepsy.
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DOI：
10.1111/j.1528-1167.2009.02506.x
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发表时间：
2010-04
期刊：
影响因子：
5.6
通讯作者：
Halford JJ
中科院分区：
文献类型：
--
作者：
Bonilha L;Edwards JC;Kinsman SL;Morgan PS;Fridriksson J;Rorden C;Rumboldt Z;Roberts DR;Eckert MA;Halford JJ
内侧颞叶癫痫（MTLE）与海马外脑萎缩有关。MTLE脑损伤的机制尚不清楚。癫痫发作可能导致神经元损伤，但另一种可能的解释是海马连接丧失引起的神经传递障碍。本研究旨在探讨MTLE患者海马神经分离与脑萎缩的关系。对23例单侧MTLE患者（8例左侧，15例右侧）和34名健康对照者进行了三种不同的MRI研究：(1)基于体素的形态学（VBM），(2)弥散张量成像（DTI）和(3)概率神经束造影（PT）。VBM用于确定对照组和患者之间区域灰质体积（GMV）的差异。DTI的体素分析评估了分数各向异性（FA）、平均扩散率（MD）和海马PT的差异。计算了感兴趣区域（ROI） GMV和海马周围FA和MD的z分数（以量化海马纤维完整性）。通过对ROI Z评分与海马纤维完整性的关联，探讨海马神经分离与区域GMV之间的关系。MTLE患者海马周围和边缘区的GMV和FA显著减少。在边缘区MTLE患者海马PT减少。海马连接丧失与区域GMV萎缩有显著关系，包括壳核、苍白球、颞中下区、杏仁核和小脑半球。MTLE患者海马断连与局部脑萎缩有关。这些结果表明，海马神经分化在MTLE的海马外脑损伤中起一定作用。
Medial temporal epilepsy (MTLE) is associated with extrahippocampal brain atrophy. The mechanisms underlying brain damage in MTLE are unknown. Seizures may lead to neuronal damage, but another possible explanation is deafferentation from loss of hippocampal connections. This study aimed to investigate the relationship between hippocampal deafferentation and brain atrophy in MTLE. Three different MRI studies were performed involving 23 patients with unilateral MTLE (8 left and 15 right) and 34 healthy controls: (1) voxel-based morphometry (VBM), (2) diffusion tensor imaging (DTI) and (3) probabilistic tractography (PT). VBM was employed to define differences in regional gray matter volume (GMV) between controls and patients. Voxel-wise analyses of DTI evaluated differences in fractional anisotropy (FA), mean diffusivity (MD) and hippocampal PT. Z-scores were computed for regions-of-interest (ROI) GMV and perihippocampal FA and MD (to quantify hippocampal fiber integrity). The relationship between hippocampal deafferentation and regional GMV was investigated through the association between ROI Z scores and hippocampal fiber integrity. Patients with MTLE exhibited a significant reduction in GMV and FA in perihippocampal and limbic areas. There was a decrease in hippocampal PT in patients with MTLE in limbic areas. A significant relationship between loss of hippocampal connections and regional GMV atrophy was found involving the putamen, pallidum, middle and inferior temporal areas, amygdala and ceberellar hemisphere. There is a relationship between hippocampal disconnection and regional brain atrophy in MTLE. These results indicate that hippocampal deafferentation plays a contributory role in extrahippocampal brain damage in MTLE.
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DOI：
10.1097/00001648-199001000-00010
发表时间：
1990-01-01
期刊：
Epidemiology (Cambridge, Mass.)
影响因子：
--
作者：
Rothman, K J
通讯作者：
Rothman, K J
影响因子：
5.7
作者：
Bernasconi, N;Duchesne, S;Bernasconi, A
通讯作者：
Bernasconi, A
影响因子：
4.8
作者：
Sutula, TP;Hagen, J;Pitkänen, A
通讯作者：
Pitkänen, A
影响因子：
5.7
作者：
Bonilha, L;Rorden, C;Li, LM
通讯作者：
Li, LM
影响因子：
5.6
作者：
Mueller, SG;Laxer, KD;Weiner, MW
通讯作者：
Weiner, MW