Preoperative amygdala fMRI in temporal lobe epilepsy.
Preoperative amygdala fMRI in temporal lobe epilepsy.
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DOI：
10.1111/j.1528-1167.2008.01739.x
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发表时间：
2009-02
期刊：
影响因子：
5.6
通讯作者：
Duncan JS
中科院分区：
文献类型：
--
作者：
Bonelli SB;Powell R;Yogarajah M;Thompson PJ;Symms MR;Koepp MJ;Duncan JS
前颞叶切除术（ATLR）使70%的难治性内侧颞叶癫痫（TLE）患者受益，但可能会因情绪障碍而复杂化。我们使用功能性磁共振成像（fMRI）来研究杏仁核在处理TLE情绪中的作用，以及这是否可能是手术后情绪障碍的潜在术前预测标志物。我们研究了54例难治性内侧颞叶癫痫患者由于海马硬化（28右，26左）和21名健康对照使用记忆编码功能磁共振成像范例，其中包括观看恐惧和中性的面孔。21例TLE患者（10例左侧，11例右侧）随后接受了ATLR。术前和术后4个月使用医院焦虑和抑郁量表评估焦虑和抑郁。在观看恐惧的面孔时，健康对照组表现出左侧化，而右侧TLE患者表现出双侧杏仁核激活。与对照组和右侧TLE患者相比，左侧TLE患者的左侧和右侧杏仁核激活显著减少。在右侧TLE患者中，左侧和右侧杏仁核激活与术前焦虑和抑郁水平显着相关，术前右侧杏仁核激活与术后焦虑和抑郁评分变化显着相关，其特征是术前激活程度越高的患者焦虑和抑郁程度增加越多。左颞叶癫痫患者中未观察到这种相关性。恐惧脸fMRI范式是一种可靠的方法，用于可视化杏仁核激活的控制和内侧颞叶癫痫患者。术前右杏仁核的激活预示着右ATLR后的情绪障碍。
Anterior temporal lobe resections (ATLR) benefit 70% of patients with refractory mesial temporal lobe epilepsy (TLE), but may be complicated by emotional disturbances. We used functional magnetic resonance imaging (fMRI) to investigate the role of the amygdala in processing emotions in TLE and whether this may be a potential preoperative predictive marker for emotional disturbances following surgery. We studied 54 patients with refractory mesial TLE due to hippocampal sclerosis (28 right, 26 left) and 21 healthy controls using a memory encoding fMRI paradigm, which included viewing fearful and neutral faces. Twenty-one TLE patients (10 left, 11 right) subsequently underwent ATLR. Anxiety and depression were assessed preoperatively and 4 months postoperatively using the Hospital Anxiety and Depression Scale. On viewing fearful faces, healthy controls demonstrated left lateralized, while right TLE patients showed bilateral amygdala activation. Left TLE patients had significantly reduced activation in left and right amygdalae compared to controls and right TLE patients. In right TLE patients, left and right amygdala activation was significantly related to preoperative anxiety and depression levels, and preoperative right amygdala activation correlated significantly with postoperative change of anxiety and depression scores, characterized by greater increases in anxiety and depression in patients with greater preoperative activation. No such correlations were seen for left TLE patients. The fearful face fMRI paradigm is a reliable method for visualizing amygdala activation in controls and patients with mesial TLE. Activation of the right amygdala preoperatively was predictive of emotional disturbances following right ATLR.
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影响因子：
1.7
作者：
Killgore, WDS;Yurgelun-Todd, DA
通讯作者：
Yurgelun-Todd, DA
影响因子：
64.8
作者：
Morris, JS;Frith, CD;Dolan, RJ
通讯作者：
Dolan, RJ
影响因子：
3.5
作者：
Bartlett, P. A.;Symms, M. R.;Duncan, J. S.
通讯作者：
Duncan, J. S.
影响因子：
5.7
作者：
Powell, H. W. Robert;Parker, Geoff J. M.;Duncan, John S.
通讯作者：
Duncan, John S.
影响因子：
2.6
作者：
Krishnamoorthy, ES;Trimble, MR;Kanner, AM
通讯作者：
Kanner, AM