A worldwide ENIGMA study on epilepsy-related gray and white matter compromise across the adult lifespan
A worldwide ENIGMA study on epilepsy-related gray and white matter compromise across the adult lifespan
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一项关于成人一生中与癫痫相关的灰质和白质损害的全球 ENIGMA 研究
DOI：
10.1101/2024.03.02.583073
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发表时间：
2024
期刊：
影响因子：
--
通讯作者：
Chen J
中科院分区：
文献类型：
--
作者：
Chen J
目的颞叶癫痫（TLE）通常与中颞叶病理和灰质和白质结构的广泛改变有关。尽管TLE的时间演变尚不明确，但证据支持其为进行性疾病。这项enigma癫痫研究利用多模态磁共振成像（MRI）数据来研究TLE患者在整个成人寿命中的结构改变。我们绘制了灰质和白质变化的图表，并探索了两个区域中与年龄相关的变化的协方差。方法研究了769名TLE患者和885名健康对照者，年龄范围为17-73岁，来自多个国际站点。为了评估TLE潜在的非线性寿命变化，我们统一了数据，并将中位数分裂评估与灰质和白质年龄相关变化的横截面滑动窗口分析相结合。协方差分析检验了灰质和白质寿命曲线的耦合性。结果：在TLE中，年龄与广泛的皮质-皮质下区域的灰质厚度/体积下降有关，延伸到中颞叶疾病中心之外。白质的变化也广泛分布在多个脑束中，颞缘纤维的影响最大。虽然变化跨越了成人时间窗口，但在55岁后，皮质厚度、皮质下体积和分数各向异性的变化加速（均下降），平均扩散率（增加）。协方差分析显示白质束和皮层下结构与皮层区域之间有很强的边缘关联。本研究强调了TLE对灰质和白质结构的寿命变化的深远影响，并在生命的后期加速衰老相关过程。我们的发现激发了未来在整个生命周期的纵向研究，并强调了及时诊断和干预患者的重要性。
ObjectivesTemporal lobe epilepsy (TLE) is commonly associated with mesiotemporal pathology and widespread alterations of grey and white matter structures. Evidence supports a progressive condition although the temporal evolution of TLE is poorly defined. This ENIGMA-Epilepsy study utilized multimodal magnetic resonance imaging (MRI) data to investigate structural alterations in TLE patients across the adult lifespan. We charted both grey and white matter changes and explored the covariance of age-related alterations in both compartments.MethodsWe studied 769 TLE patients and 885 healthy controls across an age range of 17–73 years, from multiple international sites. To assess potentially non-linear lifespan changes in TLE, we harmonized data and combined median split assessments with cross-sectional sliding window analyses of grey and white matter age-related changes. Covariance analyses examined the coupling of grey and white matter lifespan curves.ResultsIn TLE, age was associated with a robust grey matter thickness/volume decline across a broad cortico-subcortical territory, extending beyond the mesiotemporal disease epicentre. White matter changes were also widespread across multiple tracts with peak effects in temporo-limbic fibers. While changes spanned the adult time window, changes accelerated in cortical thickness, subcortical volume, and fractional anisotropy (all decreased), and mean diffusivity (increased) after age 55 years. Covariance analyses revealed strong limbic associations between white matter tracts and subcortical structures with cortical regions.ConclusionsThis study highlights the profound impact of TLE on lifespan changes in grey and white matter structures, with an acceleration of aging-related processes in later decades of life. Our findings motivate future longitudinal studies across the lifespan and emphasize the importance of prompt diagnosis as well as intervention in patients.