DTI OF POST-ICTAL CHANGES IN PATIENTS WITH TEMPORAL LOBE EPILEPSY

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 前言：行为学观察表明，癫痫发作具有显著的短期功能后果，持续时间长达24小时。许多癫痫患者发作后瘫痪持续几个小时，有时甚至一天或更长时间。据认为，这种发作后状态与细胞变化，如浮肿有关。因此，在癫痫发作后使用扩散张量成像(DTI)进行测量可能会显示出特定的扩散系数差异，这可以用来帮助定位癫痫灶。此外，长期顽固性癫痫会导致神经元死亡和最终的硬化症。由于DTI可以测量这种硬化性病变所产生的变化，比较长期癫痫患者和正常对照组的纤维束变化可能有助于我们理解难治性癫痫发作如何改变正常的皮质组织。 方法：采用全脑DTI对癫痫患者的脑白质束改变进行测量。在这项研究中，我们有两个特别的目的：(1)用DTI测量局灶性颞叶癫痫(TLE)患者发作后弥散系数的变化；(2)比较长期TLE患者与正常对照组发作期白质纤维束的DTI测量结果。 结论这项工作具有潜在的临床和生物学影响。使用非侵入性方法更有效地识别癫痫发作部位将为癫痫的治疗做出重大贡献，因为它既提供了更准确的切除靶区，又提供了评估白质恶化程度的定量指标。此外，神经通路结构的成功建模和本地化应该推动一项平行的基础科学工作，以澄清使用DTI测量的宏观信号的细胞基础。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. INTRODUCTION: Behavioral observations show that epileptic seizures have significant short term functional consequences lasting up to 24 hours following the seizure itself. Many epileptic patients suffer from a post-ictal paresis that lasts for several hours, and occasionally for a day or more. It is thought that this post-ictal state correlates with cellular changes such as edema. Thus measurements using diffusion tensor imaging (DTI) during the post-ictal period may reveal specific differences in diffusivity, which could be used to aid in the localization of seizure foci. In addition, long-term, intractable epilepsy causes neuronal death and eventual sclerosis. Since DTI can measure changes produced by such sclerotic lesions, a comparison of the changes in the fiber tracts in patients with long-term epilepsy with those of normal controls may aid in our understanding of how intractable seizures alter normal cortical organization. METHODS: We are using whole brain DTI to make measurements of white matter tract changes in epileptic patients. In this study, we have two specific aims: (1) to use DTI to measure post-ictal changes in diffusivity in focal temporal lobe epilepsy (TLE) and (2) to compare the inter-ictal DTI measurements of white matter fiber tracts in patients with long-term TLE with those of normal subjects. CONCLUSIONThis work has the potential for both clinical and biological impact. Identifying seizure loci more effectively using non-invasive methods would be a significant contribution to the treatment of epilepsy by providing both more accurate target regions for resection as well as quantitative metrics for assessing the degree of white matter deterioration. In addition, successful modeling and localization of neural pathway structures should motivate a parallel basic science effort to clarify the cellular basis of the macroscopic signals measured using DTI.