OLFACTION IN EPILEPSY

描述：（改编自研究者摘要） 颞叶癫痫（TLE）的皮质受损， 对于这种疾病的难治形式（例如，颞叶切除术或TLR）。 尽管许多研究已经检查了TLE和TLE患者的嗅觉功能， TLR患者，结果还远没有定论。在阈值的情况下 测量，例如，一些研究报告说，TLE降低敏感性， 其他报告说，TLE增加敏感性，还有人发现没有 TLE对敏感性的影响。TLR也是如此。 不幸的是，嗅觉测试的未知或可疑的可靠性， 通常被采用，双边测试一直是规则，而不是 例外情况（双侧测试分数反映了功能较好的一侧， 鼻子），太少的受试者已被评估，和数量或位置的 TLE对脑组织的损害还没有量化。此外，只有一个 例外的是，没有采用TLR前/后设计。因此，非常基本 关于TLE和TLR对嗅觉能力的影响的问题仍然存在， 无人回应例如，一些嗅觉能力（例如，检测 灵敏度），而不是其它（例如，气味识别），很大程度上不敏感 中央颞叶病变的联系吗嗅觉功能是否双侧改变， 只在癫痫灶的一侧TLE相关的嗅觉在多大程度上 损失，如果存在，进一步减弱TLR？是心理和生理嗅觉 气味刺激引起的脑电活动变化反映的损失？ 拟议的研究旨在为这些问题提供明确的答案， 其他基本问题，并由假设驱动，复杂的嗅觉 任务更可能受到颞叶病变的影响， 嗅觉任务在这项工作中，鼻子的每一侧将分别进行测试 在一个相对较大的TLE患者组中， TLR后将采用定量MRI评估关系，如果 任何，测试措施和损坏的体积和位置之间，或 切除的组织除了更好地了解 TLE和TLR对人类嗅觉功能的影响，这项工作可能会导致 开发一种简单而廉价的非侵入性手段， 建立TLE发作位点。

DESCRIPTION: (Adapted from the Investigator's Abstract) The primary olfactory cortex is compromised in temporal lobe epilepsy (TLE) and by surgical treatment for intractable forms of this disease (e.g., temporal lobe resection or TLR). Although a number of studies have examined olfactory function in both TLE and TLR patients, the results are far from conclusive. In the case of threshold measures, for example, some studies report that TLE decreases sensitivity, other report that TLE increases sensitivity, and still others find no influences of TLE on sensitivity at all. The same is true for TLR. Unfortunately, olfactory tests of unknown or questionable reliability have typically been employed, bilateral testing has been the rule rather than the exception (bilateral test scores reflect the better functioning side of the nose), too few subjects have been evaluated, and the amount or location of brain tissue damaged by TLE has not been quantified. Furthermore, with only one exception, pre-/post TLR designs have not been employed. Thus, very basic questions regarding the influence of TLE and TLR on the ability to smell remain unanswered. For example, are some olfactory abilities (e.g., detection sensitivity), but not others (e.g., odor identification), largely insensitive to central temporal lobe lesions? Is olfactory function altered bilaterally or only on the side of the epileptic foci? To what degree is TLE-related olfactory loss, if present, further attenuated by TLR? Are psychophysical olfactory losses mirrored by changes in EEG activity induced by odorous stimuli? The proposed research is designed to provide definitive answers to these and other basic questions, and is driven by the hypothesis that complex olfactory tasks are more likely influenced by temporal lobe lesions than less complex olfactory tasks. In this work, each side of the nose will be tested separately and comprehensively in a comparatively large group of TLE patients before and after TLR. Quantitative MRI will be employed to assess the relationship, if any, between the test measures and the volume and location of damaged or resected tissue. In addition to providing a better understanding of the influences of TLE and TLR on human olfactory function, this work may lead to the development of a simple and inexpensive non-invasive means for better establishing TLE seizure loci.