Bilateral white matter diffusion changes persist after epilepsy surgery
Bilateral white matter diffusion changes persist after epilepsy surgery
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DOI：
10.1111/j.1528-1167.2007.01006.x
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发表时间：
2007-05-01
期刊：
影响因子：
5.6
通讯作者：
Gross, Donald W.
中科院分区：
文献类型：
--
作者：
Concha, Luis;Beaulieu, Christian;Gross, Donald W.
目的：双侧白色扩散张量成像（DTI）异常已在颞叶癫痫（TLE）和单侧内侧颞叶硬化症（MTS）患者中报道，但尚不清楚这些是功能性还是结构性变化。我们进行了一项纵向研究，在单侧MTS谁是无瘤1年后手术，以确定是否观察到的术前白色物质扩散异常是reversible.Methods：8 TLE患者与单侧MTS谁是无瘤前颞叶切除术后和22名健康受试者被招募。在手术前和1年随访时进行DTI。纤维束成像和感兴趣区域（ROI）分析在穹隆，扣带，胼胝体和外囊的压部。结果：穹窿、扣带回和外囊显示术前双侧扩散参数异常（即，降低的扩散各向异性和增加的平均和垂直扩散率）。在1年的随访中，切除的内侧颞叶结构的同侧穹隆和扣带回显示出沃勒变性的迹象。穹窿、扣带回和外囊的对侧束以及胼胝体的背侧束未能显示其扩散参数的正常化。结论：白色DTI异常对癫痫发作自由度的不可逆性提示潜在的结构异常（例如，轴突/髓磷脂降解）而不是功能变化（例如，由于癫痫发作引起的液体转移）在白色物质中。
Purpose: Bilateral white matter diffusion tensor imaging (DTI) abnormalities have been reported in patients with temporal lobe epilepsy (TLE) and unilateral mesial temporal sclerosis (MTS), but it is unknown whether these are functional or structural changes. We performed a longitudinal study in patients with unilateral MTS who were seizure-free for 1 year after surgery to determine whether the observed presurgical white matter diffusion abnormalities were reversible.Methods: Eight TLE patients with unilateral MTS who were seizure-free after anterior temporal resection and 22 healthy subjects were recruited. DTI was performed before surgery and at 1-year follow-up. Tractography and region-of-interest (ROI) analyses were performed in the fornix, cingulum, genu, and splenium of the corpus callosum and external capsules. Diffusion tensor parameters were compared between groups and before and after surgery in the patient group.Results: The fornix, cingulum, and external capsules showed preoperative bilateral abnormal diffusion parameters (i.e., decreased diffusion anisotropy and increased mean and perpendicular diffusivities). The fornix and cingulum ipsilateral to the resected mesial temporal structures showed signs of wallerian degeneration at 1-year follow-up. The contralateral tracts of the fornix, cingulum, and external capsules, as well as the genu of the corpus callosum, failed to show a normalization of their diffusion parameters.Conclusions: The irreversibility of the white matter DTI abnormalities on seizure freedom suggests underlying structural abnormalities (e.g., axonal/myelin degradation) as opposed to functional changes (e.g., fluid shifts due to seizures) in the white matter.