Widespread grey matter changes and hemodynamic correlates to interictal epileptiform discharges in pharmacoresistant mesial temporal epilepsy
Widespread grey matter changes and hemodynamic correlates to interictal epileptiform discharges in pharmacoresistant mesial temporal epilepsy
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DOI：
10.1007/s00415-013-6841-2
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发表时间：
2013-06-01
影响因子：
6
通讯作者：
Hauf, Martinus
中科院分区：
文献类型：
--
作者：
Wiest, Roland;Estermann, Lea;Hauf, Martinus
局灶性癫痫发作最常发生在颞叶。为了提高对耐药性颞叶癫痫患者的诊断和治疗，更好地了解潜在的功能和结构网络是非常重要的。在内侧颞叶癫痫（MTLE）中，广泛的功能网络参与癫痫发作的发生和传播。在这项研究中，我们分析了空间分布的血流动力学相关（HC）发作间期癫痫样放电的同步EEG/fMRI记录和相对灰质体积（rGMV）减少10例MTLE。HC发生在海马的癫痫发作区以外，在同侧岛/盖，颞极和外侧新皮质，小脑，沿着中央沟和双侧扣带回。在颞中回、颞下回、海马钩回、小脑前叶、扣带回后部和扣带回中检测到rGMV降低。沿着沿着癫痫发作区同侧的中脑边缘网络检测到HC和降低的rGMV之间的重叠。我们的结论是，发作间期癫痫活动在MTLE诱导广泛的代谢变化的功能网络参与MTLE癫痫发作活动。这些功能网络在空间上与显示相对灰质体积减少的区域重叠。
Focal onset epilepsies most often occur in the temporal lobes. To improve diagnosis and therapy of patients suffering from pharmacoresistant temporal lobe epilepsy it is highly important to better understand the underlying functional and structural networks. In mesial temporal lobe epilepsy (MTLE) widespread functional networks are involved in seizure generation and propagation. In this study we have analyzed the spatial distribution of hemodynamic correlates (HC) to interictal epileptiform discharges on simultaneous EEG/fMRI recordings and relative grey matter volume (rGMV) reductions in 10 patients with MTLE. HC occurred beyond the seizure onset zone in the hippocampus, in the ipsilateral insular/operculum, temporo-polar and lateral neocortex, cerebellum, along the central sulcus and bilaterally in the cingulate gyrus. rGMV reductions were detected in the middle temporal gyrus, inferior temporal gyrus and uncus to the hippocampus, the insula, the posterior cingulate and the anterior lobe of the cerebellum. Overlaps between HC and decreased rGMV were detected along the mesolimbic network ipsilateral to the seizure onset zone. We conclude that interictal epileptic activity in MTLE induces widespread metabolic changes in functional networks involved in MTLE seizure activity. These functional networks are spatially overlapping with areas that show a reduction in relative grey matter volumes.