Contralateral interictal spikes are related to tapetum damage in left temporal lobe epilepsy.
Contralateral interictal spikes are related to tapetum damage in left temporal lobe epilepsy.
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作者：
Pustina D;Doucet G;Skidmore C;Sperling M;Tracy J
在颞叶癫痫（TLE）中，大多数患者的致痫灶是局灶性和单侧的。局灶性TLE的一个关键特征是在右半球和对侧“健康”半球均存在亚临床癫痫样活动。这种间期活动在临床上很重要，因为它可能反映病理的扩散，可能导致继发性癫痫发生。白质通路在这一过程中所起的作用尚不清楚。我们比较了三个半球间白质束（前连合、穹窿和绒毡层），以确定与对侧间隔尖峰存在最相关的通路。40例单侧左或右TLE患者根据是否存在对侧间段尖峰进行分类。对每个通道的扩散特性（分数各向异性，FA和平均扩散率，MD）进行方差分析。分析显示左TLE患者双侧间期尖峰有较低的FA和较高的MD在绒毡层。RTLE患者没有表现出这种效果。其他束与双侧活动无显著关联。BOLD功能连通性数据显示，双侧患者的同位外侧颞区（而非内侧颞区）可靠相关，独立于侧侧。我们的研究结果表明，在研究的小束中，只有绒毡层与对侧癫痫样活动有关，这表明该结构与癫痫发作和继发性癫痫发生有关。我们描述了两种可能解释这种关联的机制（抑制信号的中断或向健康半球携带癫痫样信号的毒性作用），但也承认可能有其他竞争因素在起作用。我们还报道了双侧尖峰的TLE患者双颞叶外侧连通性增加。我们目前的结果可以看作是汇集了重要的功能和结构数据，以阐明局灶性单侧癫痫对侧间期活动的基础。
In temporal lobe epilepsy (TLE) the epileptogenic focus is focal and unilateral in the majority of patients. A key characteristic of focal TLE is the presence of sub-clinical epileptiform activity in both the ictal and contralateral "healthy" hemisphere. Such interictal activity is clinically important as it may reflect the spread of pathology, potentially leading to secondary epileptogenesis. The role played by white matter pathways in this process are unknown. We compared three interhemispheric white matter tracts (anterior commissure, fornix, and tapetum) to determine the pathway most associated with the presence of contralateral interictal spikes. Forty patients with unilateral left or right TLE were categorized based on the presence or absence of contralateral interictal spikes. ANOVAs were run on diffusion properties from each tract (fractional anisotropy, FA; and mean diffusivity, MD). The analyses revealed that left TLE patients with bilateral interictal spikes had lower FA and higher MD in the tapetum. RTLE patients did not show this effect. No significant associations with bilateral activity was observed for the other tracts. BOLD functional connectivity data revealed that homotopic lateral, not mesial, temporal areas were reliably correlated in bilateral patients, independent of ictal side. Our results indicate that, among the tracts investigated, only the tapetum was associated with contralateral epileptiform activity, implicating this structure in seizures and possible secondary epileptogenesis. We describe two mechanisms that might explain this association (the interruption of inhibitory signals or the toxic effect of carrying epileptiform signals toward the healthy hemisphere), but also acknowledge other rival factors that may be at work. We also report that TLE patients with bilateral spikes had increased lateral bi-temporal lobe connectivity. Our current results can be seen as bringing together important functional and structural data to elucidate the basis of contralateral interictal activity in focal, unilateral epilepsy.
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影响因子：
5.6
作者：
Kemmotsu N;Girard HM;Bernhardt BC;Bonilha L;Lin JJ;Tecoma ES;Iragui VJ;Hagler DJ Jr;Halgren E;McDonald CR
通讯作者：
McDonald CR
影响因子：
4.8
作者：
Doucet, Gaelle;Osipowicz, Karol;Sharan, Ashwini;Sperling, Michael R.;Tracy, Joseph I.
通讯作者：
Tracy, Joseph I.
影响因子：
2.5
作者：
DEMETER, S;ROSENE, DL;VANHOESEN, GW
通讯作者：
VANHOESEN, GW
影响因子：
--
作者：
HUGHES, JR
通讯作者：
HUGHES, JR
DOI：
10.3174/ajnr.a1650
发表时间：
2009-10
期刊：
AJNR. American journal of neuroradiology
影响因子：
--
作者：
Ahmadi ME;Hagler DJ Jr;McDonald CR;Tecoma ES;Iragui VJ;Dale AM;Halgren E
通讯作者：
Halgren E