Hippocampal cell density and subcortical metabolism in temporal lobe epilepsy
Hippocampal cell density and subcortical metabolism in temporal lobe epilepsy
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DOI：
10.1111/j.1528-1157.1999.tb00734.x
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发表时间：
1999-04-01
期刊：
影响因子：
5.6
通讯作者：
Sperling, MR
中科院分区：
文献类型：
--
作者：
Dlugos, DJ;Jaggi, J;Sperling, MR
目的：研究颞叶癫痫(TLE)患者海马区细胞密度与皮质下代谢的关系，探讨皮质下功能与海马兴奋性调节之间的可能联系。方法：采用[F-18]-氟代脱氧葡萄糖正电子发射断层扫描(18-FDG-PET)测定39例难治性TLE患者的皮质及皮质下局部脑葡萄糖代谢率(CMRglu)。测量CMRglu与切除的颞叶的同侧和对侧。结果：双侧丘脑、壳核、苍白球、同侧尾状核的CMRglu与肺门细胞密度呈显著正相关。双侧丘脑和壳核的齿状颗粒细胞密度与CMRglu呈显著正相关。在任何皮质区域，包括海马区，细胞密度与CMRglu之间没有显著的相关性。结论：我们假设海马区细胞丢失导致丘脑和基底节的传出突触活性降低，导致这些结构中神经元活性降低，从而导致代谢降低。这种突触活动具有重要的双侧成分。TLE患者皮质下低代谢可能增强了内侧颞叶放电的致痫潜能。
Purpose: Correlations between hippocampal cell density and subcortical metabolism in patients with temporal lobe epilepsy (TLE) were studied to explore possible Links between subcortical function and the regulation of hippocampal excitability.Methods: Resected hippocampal cell densities were correlated with cortical and subcortical regional cerebral metabolic rate fur glucose (CMRglu), as measured by [F-18]-fluorodeoxyglucose positron emission tomography (18-FDG-PET), in 39 patients with intractable TLE who underwent anterior temporal lobectomy (ATL). CMRglu was measured ipsilateral and contralateral to the resected temporal lobe. Linear regression techniques were used for statistical analysis.Results: Hilar cell densities correlated positively and significantly with CMRglu in the bilateral thalamus, putamen and globus pallidus, and the ipsilateral caudate. Dentate granule cell densities correlated positively and significantly with CMRglu in the bilateral thalamus and putamen. There was no significant correlation between cell densities and CMRglu in any cortical region, including the hippocampus.Conclusions: We postulate that hippocampal cell loss results in decreased efferent synaptic activity to the thalamus and basal ganglia, causing decreased neuronal activity in these structures with consequent hypometabolism. This synaptic activity has a significant bilateral component. Subcortical hypometabolism in patients with TLE may reinforce the epileptogenic potential of mesial temporal lobe discharges.