Disentangling hippocampal shape anomalies in epilepsy
Disentangling hippocampal shape anomalies in epilepsy
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DOI：
10.3389/fneur.2013.00131
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发表时间：
2013-01-01
影响因子：
3.4
通讯作者：
Bernasconi, Neda
中科院分区：
文献类型：
--
作者：
Kim, Hosung;Mansi, Tommaso;Bernasconi, Neda
耐药性颞叶癫痫（TLE）和与皮质发育畸形（MCD）相关的癫痫综合征与复杂的海马形态学相关。在这些条件下，体积和位置对整体海马形状的贡献尚未研究。我们提出了一个基于表面的框架，通过测量雅可比行列式来定位体积变化，并通过中轴模型来量化精细尺度的位置和曲率。我们将我们的方法应用于88例TLE患者和78例MCD患者的T1加权三维容积MRI，包括局灶性皮质发育不良（FCD，n = 29），异位（HET，n = 40）和多小脑回（PMG，n = 19）。将患者与46名年龄和性别匹配的健康对照进行比较。基于表面的体积分析显示，严重的同侧萎缩，主要是沿着喙尾侧范围的海马CA1子区。在MCD中，体积变化的模式包括HET和FCD中的双侧CA 1萎缩，以及所有三组中的左侧齿状突肥大。曲率分析显示，颞叶癫痫的后海马内侧弯曲，而在MCD有一个超内侧移动的海马体。尽管TLE和MCD的海马形状异常是体积和位置变化的组合，但它们的性质和分布表明不同的发病机制。
Drug-resistant temporal lobe epilepsy (TLE) and epileptic syndromes related to malformations of cortical development (MCD) are associated with complex hippocampal morphology. The contribution of volume and position to the overall hippocampal shape in these conditions has not been studied. We propose a surface-based framework to localize volume changes through measurement of Jacobian determinants, and quantify fine-scale position and curvature through a medial axis model. We applied our methodology to T1-weighted 3D volumetric MRI of 88 patients with TLE and 78 patients with MCD, including focal cortical dysplasia (FCD, n = 29), heterotopia (HET n = 40), and polymicrogyria (PMG, n = 19). Patients were compared to 46 age- and sex-matched healthy controls. Surface-based analysis of volume inTLE revealed severe ipsilateral atrophy mainly along the rostro-caudal extent of the hippocampal CA1 subfield. In MCD, patterns of volume changes included bilateral CA1 atrophy in HET and FCD, and left dentate hypertrophy in all three groups. The analysis of curvature revealed medial bending of the posterior hippocampus in TLE, whereas in MCD there was a supero-medial shift of the hippocampal body. Albeit hippocampal shape anomalies in TLE and MCD result from a combination of volume and positional changes, their nature and distribution suggest different pathogenic mechanisms.