Voxel-based optimized morphometry (VBM) of gray and white matter in temporal lobe epilepsy (TLE) with and without mesial temporal sclerosis
Voxel-based optimized morphometry (VBM) of gray and white matter in temporal lobe epilepsy (TLE) with and without mesial temporal sclerosis
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DOI：
10.1111/j.1528-1167.2006.00512.x
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发表时间：
2006-05-01
期刊：
影响因子：
5.6
通讯作者：
Weiner, MW
中科院分区：
文献类型：
--
作者：
Mueller, SG;Laxer, KD;Weiner, MW
目的：在有海马硬化证据的颞叶癫痫 (TLE) (TLE-MTS) 中，体积灰质 (GM) 和白质 (WM) 异常不仅限于海马，还存在于海马外结构中。对于不伴海马硬化的 TLE（TLE-no）患者的海马外体积异常知之甚少。在本研究中，我们使用优化的基于体素的形态测量（VBM），带或不带调制，目的如下：（a）识别 TLE-MTS 和 TLE-no 中海马体以外的 WM 和 GM 异常； (b) 确定 TLE-MTS 和 TLE-no 之间的颞外 WM 和 GM 异常是否不同。方法：在 26 名 TLE-MTS（平均年龄，35.6 +/- 9.7 岁）、17 名 TLE-no（平均年龄，35.6 +/- 11.1 岁）和 30 名健康对照（平均年龄，30.3 岁）中进行了有或没有调制的 GM 和 WM 的优化 VBM +/- 11.1 岁）。结果：在 TLE-MTS 中，与对照组相比，同侧边缘系统、同侧和对侧新皮质区、丘脑、小脑、内囊和脑干的 GM/WM 体积和浓度降低。相比之下，TLE-no 和对照之间或 TLE-no 和 TLE-MTS 之间没有发现 GM/WM 体积/浓度差异。结论：在 TLE-MTS 中，优化的 VBM 显示同侧海马以及同侧和对侧海马外区域的 GM 和 WM 体积广泛减少。相比之下，在 TLE-no 中没有发现 GM/WM 体积或浓度降低。这进一步支持了以下假设：TLE-no 是与 TLE-MTS 不同的临床病理实体，并且本身可能具有异质性。
Purpose: In temporal lobe epilepsy (TLE) with evidence of hippocampal sclerosis (TLE-MTS) volumetric gray (GM) and white (WM) matter abnormalities are not restricted to the hippocampus but also are found in extrahippocampal structures. Less is known about extrahippocampal volumetric abnormalities in TLE without hippocampal sclerosis (TLE-no). In this study, we used optimized voxel-based morphometry (VBM) with and without modulation with the following aims: (a) to identify WM and GM abnormalities beyond the hippocampus in TLE-MTS and TLE-no; and (b) to determine whether extratemporal WM and GM abnormalities differ between TLE-MTS and TLE-no.Methods: Optimized VBM of GM and WM with and without modulation was performed in 26 TLE-MTS (mean age, 35.6 +/- 9.7 years), 17 TLE-no (mean age, 35.6 +/- 11.1 years), and 30 healthy controls (mean age, 30.3 +/- 11.1 years).Results: In TLE-MTS, GM/WM volume and concentration reductions were found in the ipsilateral limbic system, ipsi- and contralateral neocortical regions, thalamus, cerebellum, internal capsule, and brainstem when compared with controls. In contrast, no differences of GM/WM volumes/concentrations were found between TLE-no and controls or between TLE-no and TLE-MTS.Conclusions: In TLE-MTS, optimized VBM showed extensive GM and WM volume reductions in the ipsilateral hippocampus and in ipsi- and contralateral extrahippocampal regions. In contrast, no GM/WM volume or concentration reductions were found in TLE-no. This further supports the hypothesis that TLE-no is a distinct clinicopathologic entity from TLE-MTS and probably heterogeneous in itself.