Amygdala Enlargement in Patients with Mesial Temporal Lobe Epilepsy without Hippocampal Sclerosis.
Amygdala Enlargement in Patients with Mesial Temporal Lobe Epilepsy without Hippocampal Sclerosis.
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DOI：
10.3389/fneur.2013.00166
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发表时间：
2013
影响因子：
3.4
通讯作者：
Cendes F
中科院分区：
文献类型：
--
作者：
Coan AC;Morita ME;de Campos BM;Yasuda CL;Cendes F
目的：无MRI异常的内侧颞叶癫痫(MTLE-NL)患者对基础病理的定义和术前评估提出了挑战。在最近的一项研究中，我们观察到14%的MTLE患者有明显的杏仁核增大(AE)，这些患者的MRI表现为海马区硬化。灰质体积(GMV)增加的区域可能代表与致痫区相关的结构异常或发育异常的一部分。我们的目标是使用后处理MRI技术寻找MTLE-NL中未检测到的GMV增加的区域，以更好地了解这种情况的病理生理学。方法：对66例MTLE-NL患者和82例正常对照进行目测分析。使用VBM8/SPM8进行基于体素的形态测量(VBM)组分析，以寻找GMV增加的区域。然后，我们使用Freesurfer软件和T2松弛测量法进行自动杏仁核体积测量，以确认VBM的发现。结果：基于体素的形态计量组分析显示，与对照组相比，MTLE-NL组杏仁核体积增加。个体容量分析证实8例(12%)患者存在AE。总体而言，在所有癫痫患者和明确的癫痫灶中，有4例(57%)的癫痫灶同侧体积显著增加。这些结果通过二次VBM分析交叉验证，包括根据体积数据的患者亚组。T2松弛测量显示，在任何患有明显AE的个体中，杏仁核均未显示高信号。合并和不合并急性脑脊髓炎的患者之间无临床差异。讨论：这项探索性研究表明，12%的MTLE-NL患者发生了AE。这一发现支持了一种假设，即可能有一组MTLE-NL患者的杏仁核扩大可能与癫痫的发生过程有关。进一步的研究是必要的，但这一发现可能对理解MTLE-NL非常重要。
Purpose: Patients with mesial temporal lobe epilepsy (MTLE) without MRI abnormalities (MTLE-NL) represent a challenge for definition of underlying pathology and for presurgical evaluation. In a recent study we observed significant amygdala enlargement (AE) in 14% of MTLE patients with MRI signs of hippocampal sclerosis. Areas of gray matter volume (GMV) increase could represent structural abnormalities related to the epileptogenic zone or part of a developmental abnormality. Our objective was to look for undetected areas of increased GMV in MTLE-NL using post processing MRI techniques to better understand the pathophysiology of this condition. Methods: We evaluated 66 patients with MTLE-NL on visual analysis and 82 controls. Voxel-based morphometry (VBM) group analysis was performed with VBM8/SPM8 looking for areas of increased GMV. We then performed automatic amygdala volumetry using FreeSurfer software and T2 relaxometry to confirm VBM findings. Results: Voxel-based morphometry group-analysis demonstrated increased amygdala volume in the MTLE-NL group compared to controls. Individual volumetric analysis confirmed AE in eight (12%) patients. Overall, from all patients with AE and defined epileptic focus, four (57%) had the predominant increased volume ipsilateral to the epileptic focus. These results were cross-validated by a secondary VBM analysis including subgroups of patients according to the volumetric data. T2 relaxometry demonstrated no amygdala hyperintense signal in any individual with significant AE. There were no clinical differences between patients with and without AE. Discussion: This exploratory study demonstrates the occurrence of AE in 12% of patients with MTLE-NL. This finding supports the hypothesis that there might be a subgroup of patients with MTLE-NL in which the enlarged amygdala could be related to the epileptogenic process. Further studies are necessary but this finding could be of great importance in the understanding of MTLE-NL.
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影响因子：
11
作者：
Bower, SPC;Vogrin, SJ;Cook, MJ
通讯作者：
Cook, MJ
影响因子：
5.6
作者：
Bell ML;Rao S;So EL;Trenerry M;Kazemi N;Stead SM;Cascino G;Marsh R;Meyer FB;Watson RE;Giannini C;Worrell GA
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Worrell GA
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Riederer, F.;Lanzenberger, R.;Baumgartner, C.
通讯作者：
Baumgartner, C.
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作者：
GLOOR, P;OLIVIER, A;HOROWITZ, S
通讯作者：
HOROWITZ, S
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作者：
Sylaja, PN;Radhakrishnan, K;Sarma, PS
通讯作者：
Sarma, PS