Quantification of Thalamic Atrophy and Connectivity in Medial Temporal Lobe Epile

内侧颞叶癫痫丘脑萎缩和连接的量化

• 批准号: 8526782
• 负责人: Daniel S. Barron
• 金额: $ 2.9万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCIENCE CENTER
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-04-01 至 2016-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8526782
• 关键词: Adult; Anatomy; Animal Model; Anisotropy; Area; Atrophic; Brain; Brain Injuries; Caring; Clinical; Collaborations; Consensus; Data; Diffusion; Diffusion Magnetic Resonance Imaging; Epilepsy; Evaluation; Exposure to; Failure; Fellowship; Functional disorder; Future; Goals; Hippocampus (Brain); Human; Image Analysis; Individual; Investigation; Ipsilateral; Learning; Literature; Magnetic Resonance Imaging; Manuscripts; Measurable; Measurement; Measures; Medial; Medial Dorsal Nucleus; Meta-Analysis; Methods; Nuclear; Operative Surgical Procedures; Outcome; Partial Epilepsies; Pathology; Pathway interactions; Patient Care; Patients; Research; Research Methodology; Research Personnel; Research Training; Rest; Sclerosis; Seeds; Seizures; Staging; Structure; Temporal Lobe; Temporal Lobe Epilepsy; Testing; Thalamic structure; Therapeutic; Tissues; Training; Visual; base; clinical care; improved; meetings; morphometry; neuroimaging; novel therapeutic intervention; research study; software development; statistics; success; white matter

DESCRIPTION (provided by applicant): The goal of this fellowship is for the applicant (Daniel S. Barron) to learn advanced neuroimaging research methods and to gain significant exposure to clinical epilepsy care. The applicant will receive training in structural, functional, and diffuion magnetic resonance image analysis methods; he will use these methods to quantify extra-hippocampal pathology in medial temporal lobe epilepsy (MTLE). MTLE is the most common type of epilepsy referred to surgical centers and the most common localization- related epilepsy in adults. (Tellez-Zenteno et al., 2012). The most common pathology in MTLE is hippocampal sclerosis (HS). (Wieser, 2004) When it is the sole pathology observed on visual inspection of magnetic resonance images, HS is a predictor of positive surgical outcome. (Engel, 2008) Conversely, extra-hippocampal pathology is a predictor of poorer outcome and is, in fact, a contraindication for surgery. (Thom et al., 2010) Extra-hippocampal pathology is often subtle and goes visually undetected on the pre-surgical evaluation, thus extra-hippocampal pathology continues to contribute to surgical failure. (Thom et al., 2010) Quantitative, targeted analyses of extrahippocampal pathology could guide the pre-surgical evaluation, inform new therapeutic interventions, and mitigate surgical failure. Thus far such attempts have met with limited success and represent a critical barrier to improved pre-surgical evaluation and patient care. Our immediate research goal is to define regions of extra-hippocampal pathology in MTLE-HS with the long- term goal of understanding surgical failure. Our recent meta-analysis of 24 voxel-based morphometry experiments (manuscript in review) demonstrated the most consistent area of extra-hippocampal pathology in MTLE is the medial dorsal nucleus of the thalamus (MDN). We hypothesize that MTLE is associated with selective tissue damage in the MDN related to increased functional and anatomical connectivity between the MDN and the hippocampus. To test this hypothesis we will perform the following analyses on MTLE-HS patient data: Aim 1. We will measure changes in MDN volume using structural MR data. Aim 2. We will measure anatomic connectivity in white matter tracts connecting the hippocampus and MDN using diffusion MR data. Aim 3. We will measure functional connectivity between the hippocampus and MDN using region-seeded analyses of resting-state functional MR data. To learn these neuroimaging analysis methods, the applicant will leverage intra-mural and extra-mural courses and collaborations. The applicant will also have clinical exposure to the pathophysiology, clinical care, and surgical treatment of MTLE. This research training will allow the applicant to learn neuroimaging analysis methods he will use as a neuroimaging researcher and epileptologist.

描述（由申请人提供）：该奖学金的目标是让申请人（Daniel S. Barron）学习先进的神经影像研究方法并大量接触临床癫痫护理。申请人将接受结构、功能和扩散磁共振图像分析方法的培训；他将使用这些方法来量化内侧颞叶癫痫 (MTLE) 的海马外病理学。 MTLE 是手术中心最常见的癫痫类型，也是成人中最常见的定位相关癫痫。 （Tellez-Zenteno 等人，2012）。 MTLE 最常见的病理是海马硬化 (HS)。 (Wieser, 2004) 当 HS 是通过磁共振图像目视检查观察到的唯一病理学时，HS 是手术结果阳性的预测因子。 (Engel, 2008) 相反，海马外病理是较差结果的预测因素，实际上是手术的禁忌症。 (Thom et al., 2010) 海马外病理通常很微妙，在术前评估中无法通过视觉检测到，因此海马外病理继续导致手术失败。 （Thom 等人，2010）定量、有针对性的分析 海马外病理学可以指导手术前评估，为新的治疗干预措施提供信息，并减轻手术失败。迄今为止，此类尝试取得的成功有限，并且成为改善术前评估和患者护理的关键障碍。 我们近期的研究目标是确定 MTLE-HS 中海马外病理区域，长期目标是了解手术失败。我们最近对 24 个基于体素的形态测量实验（手稿正在审阅）进行的荟萃分析表明，MTLE 中海马外病理学最一致的区域是丘脑内侧背核 (MDN)。我们假设 MTLE 与 MDN 中的选择性组织损伤有关，而 MDN 与海马之间的功能和解剖连接性增加有关。为了检验这一假设，我们将对 MTLE-HS 患者数据进行以下分析： 目标 1. 我们将使用结构 MR 数据测量 MDN 体积的变化。 目标 2。我们将使用扩散 MR 数据测量连接海马体和 MDN 的白质束的解剖连接性。 目标 3。我们将使用静息态功能 MR 数据的区域种子分析来测量海马体和 MDN 之间的功能连接。 为了学习这些神经影像分析方法，申请人将利用校内和校外的课程和合作。申请人还将临床接触 MTLE 的病理生理学、临床护理和手术治疗。该研究培训将使申请人能够学习他将作为神经影像研究员和癫痫病学家使用的神经影像分析方法。