Thalamic volume reduction in drug-naive patients with new-onset genetic generalized epilepsy.
Thalamic volume reduction in drug-naive patients with new-onset genetic generalized epilepsy.
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DOI：
10.1111/epi.13955
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发表时间：
2018-01
期刊：
影响因子：
5.6
通讯作者：
Richardson MP
中科院分区：
文献类型：
--
作者：
Perani S;Tierney TM;Centeno M;Shamshiri EA;Yaakub SN;O'Muircheartaigh J;Carmichael DW;Richardson MP
遗传性全身性癫痫（GGE）患者的大脑在磁共振成像（MRI）中有细微的形态学异常，特别是在丘脑。然而，目前尚不清楚GGE患者的大脑形态异常是疾病期间反复发作的结果，还是抗癫痫药物（aed）治疗的结果，或者与这些因素无关。因此，我们测量了一组发病时患有AED的GGE患者的脑形态测量。我们假设，与年龄匹配的健康对照相比，发病时未使用药物的患者有灰质变化。我们对29例新发GGE的AED患者的丘脑、壳核、尾状体、苍白体、海马、楔前叶、前额叶皮层、中央前皮层和扣带的灰质体积进行了定量测量，并将其与32例年龄匹配的健康对照进行了比较。随后，我们比较了两组之间发现的灰质体积不同的大脑结构的形状。与健康对照相比，新发GGE AED患者的丘脑是唯一显示灰质体积减少的结构。形状分析显示，丘脑表现出收缩，其分布不均匀，但特别影响到包括前、上、后、下区域的圆周带，而内侧和外侧区域则不受影响。在AED初始患者中，丘脑结构异常在GGE的初始发病时就存在，这表明丘脑结构异常是GGE的内在特征，而不是AED或疾病持续时间的结果。
Patients with genetic generalized epilepsy (GGE) have subtle morphologic abnormalities of the brain revealed with magnetic resonance imaging (MRI), particularly in the thalamus. However, it is unclear whether morphologic abnormalities of the brain in GGE are a consequence of repeated seizures over the duration of the disease, or are a consequence of treatment with antiepileptic drugs (AEDs), or are independent of these factors. Therefore, we measured brain morphometry in a cohort of AED‐naive patients with GGE at disease onset. We hypothesize that drug‐naive patients at disease onset have gray matter changes compared to age‐matched healthy controls. We performed quantitative measures of gray matter volume in the thalamus, putamen, caudate, pallidum, hippocampus, precuneus, prefrontal cortex, precentral cortex, and cingulate in 29 AED‐naive patients with new‐onset GGE and compared them to 32 age‐matched healthy controls. We subsequently compared the shape of any brain structures found to differ in gray matter volume between the groups. The thalamus was the only structure to show reduced gray matter volume in AED‐naive patients with new‐onset GGE compared to healthy controls. Shape analysis revealed that the thalamus showed deflation, which was not uniformly distributed, but particularly affected a circumferential strip involving anterior, superior, posterior, and inferior regions with sparing of medial and lateral regions. Structural abnormalities in the thalamus are present at the initial onset of GGE in AED‐naive patients, suggesting that thalamic structural abnormality is an intrinsic feature of GGE and not a consequence of AEDs or disease duration.
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影响因子：
5.7
作者：
O'Muircheartaigh J;Vollmar C;Traynor C;Barker GJ;Kumari V;Symms MR;Thompson P;Duncan JS;Koepp MJ;Richardson MP
通讯作者：
Richardson MP
影响因子：
5.7
作者：
Patenaude, Brian;Smith, Stephen M.;Kennedy, David N.;Jenkinson, Mark
通讯作者：
Jenkinson, Mark
影响因子：
5.6
作者：
Blumenfeld, H
通讯作者：
Blumenfeld, H
影响因子：
5.7
作者：
Fischl, Bruce
通讯作者：
Fischl, Bruce
影响因子：
5.6
作者：
Berg, Anne T.;Berkovic, Samuel F.;Scheffer, Ingrid E.
通讯作者：
Scheffer, Ingrid E.