Cortical reorganization in malformations of cortical development
Cortical reorganization in malformations of cortical development
复制标题
皮质发育畸形中的皮质重组
作者：
J. Burneo;R. Kuzniecky;M. Bebin;R. Knowlton
背景资料：由于关键感觉、运动和认知功能的不可预测定位，对临床重要脑功能区皮质发育畸形（MCDs）患者的癫痫手术进行评价是一项挑战。脑磁图（MEG）源定位诱发场可以解决是否存在初级感觉模态的功能重组在MCDs。研究方法：对MRI证实的罗兰和距状皮质MCDs患者进行了148通道全头MEG研究，以确定初级体感和视觉皮质的定位。当定位与一般解剖学或侏儒规则的预期形成对比时，考虑重组，并针对对照进行定义。结果：12例患者（n = 12）进行了研究。6人有局灶性皮质发育不良，2人有多小脑回和脑回畸形，4人有孤立性多小脑回。在皮质发育不良的患者中，躯体感觉皮质位于罗兰区之外。在两例多小脑回和回脑畸形患者中，只要回脑裂的存在没有扭曲解剖结构，躯体感觉皮层仍保留在罗兰区。在孤立性多微脑回症患者中，躯体感觉皮层被映射，没有重组的证据。结论：在患有涉及罗兰区和距状区的癫痫性MCD的患者中，如果MCD是由于异常的神经元或神经胶质增殖（即，皮质发育不良）但可能不是由异常皮质组织引起的MCD（即，polymicrogyria）。
Background: The evaluation for epilepsy surgery of patients with malformations of cortical development (MCDs) in areas of clinically important cerebral function is a challenge because of the unpredictable localization of critical sensory, motor, and cognitive function. Magnetoencephalography (MEG) source localization of evoked fields can address whether functional reorganization of primary sensory modalities exists in MCDs. Methods: Consecutive patients with MRI-demonstrated rolandic and calcarine cortex MCDs were identified who had a 148-channel whole-head MEG study to identify the localization of primary somatosensory and visual cortices. Reorganization was considered when localization contrasted that expected upon general anatomic or homuncular rules and was defined against controls. Results: Twelve patients (n = 12) were studied. Six had focal cortical dysplasia, two had polymicrogyria and schizencephaly, and four had isolated polymicrogyria. In the patients with cortical dysplasias, the somatosensory cortices were identified outside the rolandic area. In the two patients with polymicrogyria and schizencephaly, the somatosensory cortices remained in the rolandic areas as long as the anatomy was not distorted by the presence of the schizencephalic cleft. In the patients with isolated polymicrogyria, the somatosensory cortex was mapped without evidence of reorganization. Conclusion: In patients with epileptic MCDs involving rolandic and calcarine regions, cortical function may be reorganized if the MCDs are due to an abnormal neuronal or glial proliferation (i.e., cortical dysplasia) but may not be in MCDs caused by abnormal cortical organization (i.e., polymicrogyria).
皮质发育不良和癫痫：使用单光子发射计算机断层扫描和正电子发射断层扫描的功能成像。
影响因子：
2.6
作者：
Toczek,MariaT;Theodore,WilliamH
通讯作者：
Theodore,WilliamH