Network atrophy in temporal lobe epilepsy - A voxel-based morphometry study
Network atrophy in temporal lobe epilepsy - A voxel-based morphometry study
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DOI：
10.1212/01.wnl.0000324264.96100.e0
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发表时间：
2008-08-05
期刊：
影响因子：
9.9
通讯作者：
Baumgartner, C.
中科院分区：
文献类型：
--
作者：
Riederer, F.;Lanzenberger, R.;Baumgartner, C.
背景资料：最近的证据表明，颞叶癫痫影响神经网络，而不是一个单一的颞叶内的结构。因此，在内侧颞叶癫痫（mTLE）与海马硬化灰质异常已被发现超出了海马的海马外区域，通过基于体素的形态测量（VBM）。相反，在隐源性或MRI阴性的TLE（cTLE）没有一致的灰质异常VBM studies have been reported.Methods：我们使用优化的VBM与调制检测灰质异常相比，健康对照患者与mTLE和cTLE。22例mTLE患者（右/左TLE 13：9）、17例cTLE患者（右/左TLE 7：10）和12例健康对照者参加了这项研究。GMV降低在左侧癫痫病灶患者中更为广泛，包括左侧海马旁回和上级颞回、额叶、小脑和右侧扣带回。在cTLE中，在额叶和眶额皮质、小脑、新皮质颞区和右侧海马旁皮质中观察到GMV降低。再次，左侧癫痫灶的患者有一个更广泛和广泛的GMV减少，包括区域，如右侧和左侧cingulum.Conclusion：我们发现了明显的神经元网络损伤的证据内侧颞叶癫痫（mTLE）和隐源性TLE（cTLE），这是更广泛的左侧癫痫灶的患者。扣带回萎缩是左侧mTLE和cTLE的常见特征，而不是右侧mTLE和cTLE。
Background: Recent evidence suggests that temporal lobe epilepsy affects a neuronal network rather than a single circumscribed structure within the temporal lobe. Thus, in mesial temporal lobe epilepsy (mTLE) with hippocampal sclerosis gray matter abnormalities have been found beyond the hippocampus in extrahippocampal regions by means of voxel-based morphometry (VBM). On the contrary, in cryptogenic or MRI-negative TLE (cTLE) no consistent gray matter abnormalities in VBM studies have been reported.Methods: We used optimized VBM with modulation to detect gray matter abnormalities compared to healthy controls in patients with mTLE and cTLE. Twenty-two patients with mTLE (right/left TLE 13: 9), 17 patients with cTLE (right/left TLE 7: 10), and 12 healthy controls were enrolled in the study.Results: In mTLE we found decreased gray matter volume (GMV) beyond the hippocampus in the ipsilateral thalamus. GMV decrease was more widespread in patients with left-sided seizure focus including the left parahippocampal and superior temporal gyrus, frontal regions, cerebellum, and the right cingulum. In cTLE, decreased GMV was observed in the frontal and orbitofrontal cortex, the cerebellum, neocortical temporal regions, and in the right parahippocampal cortex. Again, patients with left-sided seizure focus had a more widespread and extensive GMV decrease including regions such as the right and left cingulum.Conclusion: We found evidence for distinct neuronal network damage in mesial temporal lobe epilepsy (mTLE) and cryptogenic TLE (cTLE) which is more widespread in patients with left-sided seizure focus. Atrophy of the cingulum was a common feature in left-but not in right-sided mTLE and cTLE.