Characterization of hippocampal sclerosis in individuals with calcified Neurocysticercosis

钙化性脑囊虫病患者的海马区硬化特征 摘要 全球癫痫的大部分负担发生在世界贫穷地区，反映出癫痫患病率增加。 危险因素，如围产期脑损伤、创伤性脑损伤和神经系统感染 包括脑囊虫病(NCC)。NCC在大多数发展中国家都是地方病，而NCC的流行 与普通患者相比，NCC患者的癫痫发作和癫痫持续增加。 人口。癫痫在囊虫病流行地区和慢性局灶性癫痫病例中更为普遍。 与寄生虫病变的定位有关的符号学是常见的。或许更有趣的是， 来自难治性癫痫和NCC患者的信息表明，在某些患者中，寄生虫可能是 通过诱导海马区损伤参与癫痫的发生，海马区可成为癫痫发作的部位。我们 建议利用现有的228名钙化性脑囊虫病患者队列作为 以及50名没有脑部受累的脊柱病变的对照患者，以证明这种联系 NCC和海马硬化症之间的关系，并描述其临床、神经生理学和 这些个体中与海马区硬化相关的神经影像特征。参与者将拥有 非对比颅脑MRI对海马区的评估及MRI形态计量学分析 可用于描述特定的新皮质和皮质下萎缩模式(使用容量磁共振成像 和皮质厚度测量)，并确定这些患者的HS是否具有特定的模式 在内侧颞叶癫痫或其他非特异性模式中发现CA2节段性改变。EEG和视频EEG将 以确定致痫区域的位置是否与癫痫的位置相关 HS或其他地方的钙化病变。可能与HS相关的所有因素的频率(包括但 不限于发作的时间、先前发作的累计次数、发作的类型、次数和 脑钙化和脑电异常的定位)将在患有和 没有HS的话。如果NCC相关的HS是致痫区域，并且与MTLE中的HS相似，那么它将 为临床研究最常见的顽固性癫痫的发病机制提供了机会。

Characterization of Hippocampal Sclerosis in Individuals With Calcified Neurocysticercosis ABSTRACT Most of the global burden of epilepsy occurs in poor regions of the world, reflecting increased prevalence of risk factors such as perinatal brain damage, traumatic brain injury, and infections of the nervous system including neurocysticercosis (NCC). NCC is endemic in most developing countries, and the prevalence of seizures and epilepsy is consistently increased in individuals with NCC when compared to the general population. Epilepsy is more prevalent in cysticercosis-endemic regions, and cases of chronic focal seizures semiologically related to the localization of a parasitic lesion are frequent. Perhaps more interestingly, information from patients with refractory epilepsy and NCC suggests that in some patients parasites might be involved in epileptogenesis by inducing hippocampal damage, which can become the site of seizure onset. We propose to take advantage of an existing cohort of 228 patients with calcified cerebral cysticercosis lesions as well as 50 control patients with spinal pathologies without cerebral involvement, to demonstrate the association between NCC and hippocampal sclerosis, and to characterize the clinical, neurophysiological, and neuroimaging characteristics associated with hippocampal sclerosis in these individuals. Participants will have hippocampal assessment by non-contrasted brain MRI, and computational morphometry analysis of MRI will be used to characterize specific neocortical and subcortical patterns of atrophy (with the use of volumetric MRI and cortical thickness measures) and to determine whether HS in these patients has the specific pattern of CA2 sparing found in mesial temporal lobe epilepsy or another, non-specific pattern. EEG and Video EEG will be performed to determine whether the location of the epileptogenic region correlates with the location of the HS or a calcified lesion elsewhere. The frequencies of all factors potentially associated with HS (including but not restricted to time with seizures, cumulative number of previous seizures, type of seizures, number and localization of brain calcifications, and EEG abnormalities) will be compared between individuals with and without HS. If NCC-associated HS is the epileptogenic region, and is similar to the HS in MTLE it would provide an opportunity to study epileptogenesis clinically for the most common form of intractable epilepsy.