Lateralization of temporal lobe epilepsy using resting functional magnetic resonance imaging connectivity of hippocampal networks.
Lateralization of temporal lobe epilepsy using resting functional magnetic resonance imaging connectivity of hippocampal networks.
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DOI：
10.1111/j.1528-1167.2012.03590.x
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发表时间：
2012-09
期刊：
影响因子：
5.6
通讯作者：
Abou-Khalil B
中科院分区：
文献类型：
--
作者：
Morgan VL;Sonmezturk HH;Gore JC;Abou-Khalil B
早期手术治疗对难治性颞叶癫痫（TLE）的治疗是有利的。TLE手术的成功依赖于癫痫发作的准确定侧。本研究的目的是确定是否静息功能MRI（fMRI）的海马连接映射有潜力，以补充传统的术前评估区分左，右TLE。此外，我们试图确定是否相同的网络可以区分患者的有利和不利的术后结果。对21名TLE患者和15名健康对照者进行静息fMRI采集。患者包括7例左侧TLE和7例右侧TLE患者，术后无癫痫发作，5例左侧TLE和2例右侧TLE患者术后复发癫痫发作。确定每个受试者的每个海马的功能连接图，并在对照组和无癫痫发作的左、右TLE患者之间进行比较。然后在癫痫复发的TLE患者中对确定的一个网络进行量化。右侧海马和右侧丘脑腹外侧核之间的静息功能连接是区分无癫痫发作的左侧和右侧TLE患者的最具统计学意义的网络，具有高灵敏度和特异性。无癫痫发作的左侧TLE患者的这种连通性也显著高于健康对照组。最后，手术后癫痫复发的7名患者中有6名在该网络中具有连接值，而不像那些没有癫痫发作的患者。这项研究确定了一个区域，在腹外侧核的右丘脑的连接，以campi分离左，右TLE受试者。这表明，通过该网络对静息状态功能性MRI连接的量化可能是TLE偏侧化的潜在指标，可添加到其他术前MRI评估中。需要在更大的独立队列中进行进一步验证。
Early surgical intervention can be advantageous in the treatment of refractory temporal lobe epilepsy (TLE). The success of TLE surgery relies on accurate lateralization of the seizure onset. The purpose of this study was to determine whether resting functional MRI (fMRI) connectivity mapping of the hippocampus has the potential to complement conventional presurgical evaluations in distinguishing left from right TLE. In addition, we sought to determine whether this same network might separate patients with favorable from unfavorable postoperative outcomes. Resting fMRI acquisitions were performed on 21 TLE patients and 15 healthy control subjects. The patients included 7 left TLE and 7 right TLE patients with seizure free post-operative outcome, and 5 left TLE and 2 right TLE patients with recurring seizures after surgery. Functional connectivity maps to each hippocampus were determined for each subject and were compared between the controls and the seizure free left and right TLE patients. The one network identified was then quantified in the TLE patients with recurring seizures. The resting functional connectivity between the right hippocampus and the ventral lateral nucleus of the right thalamus was the most statistically significant network to distinguish between seizure free left and right TLE patients with high sensitivity and specificity. This connectivity was also significantly greater in the seizure free left TLE patients than the healthy controls. Finally, six of the seven patients where seizures recurred after surgery had connectivity values in this network unlike those who were seizure free. This study identified a region in the ventral lateral nucleus of the right thalamus whose connectivity to the hippocampi separates left from right TLE subjects. This suggests that the quantification of resting state functional MRI connectivity across this network may be a potential indicator of lateralization of TLE that may be added to other presurgical MRI assessments. Further validation in a larger, independent cohort is required.
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影响因子：
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作者：
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