Dlugos D J, Jaggi J, O'Connor W M, Ding X S, Reivich M, O'Connor M J, Sperling M R
Division of Neurology, Children's Hospital of Philadelphia, PA 19104, USA.
Epilepsia. 1999 Apr;40(4):408-13. doi: 10.1111/j.1528-1157.1999.tb00734.x.
Correlations between hippocampal cell density and subcortical metabolism in patients with temporal lobe epilepsy (TLE) were studied to explore possible links between subcortical function and the regulation of hippocampal excitability.
Resected hippocampal cell densities were correlated with cortical and subcortical regional cerebral metabolic rate for glucose (CMRglu), as measured by [18F]-fluorodeoxyglucose positron emission tomography (18-FDG-PET), in 39 patients with intractable TLE who underwent anterior temporal lobectomy (ATL). CMRglu was measured ipsilateral and contralateral to the resected temporal lobe. Linear regression techniques were used for statistical analysis.
Hilar cell densities correlated positively and significantly with CMRglu in the bilateral thalamus, putamen and globus pallidus, and the ipsilateral caudate. Dentate granule cell densities correlated positively and significantly with CMRglu in the bilateral thalamus and putamen. There was no significant correlation between cell densities and CMRglu in any cortical region, including the hippocampus.
We postulate that hippocampal cell loss results in decreased efferent synaptic activity to the thalamus and basal ganglia, causing decreased neuronal activity in these structures with consequent hypometabolism. This synaptic activity has a significant bilateral component. Subcortical hypometabolism in patients with TLE may reinforce the epileptogenic potential of mesial temporal lobe discharges.
研究颞叶癫痫（TLE）患者海马细胞密度与皮质下代谢之间的相关性，以探索皮质下功能与海马兴奋性调节之间的可能联系。
对39例行前颞叶切除术（ATL）的顽固性TLE患者，将切除的海马细胞密度与通过[18F] - 氟脱氧葡萄糖正电子发射断层扫描（18 - FDG - PET）测量的皮质和皮质下区域脑葡萄糖代谢率（CMRglu）进行相关性分析。CMRglu在切除颞叶的同侧和对侧进行测量。采用线性回归技术进行统计分析。
海马门区细胞密度与双侧丘脑、壳核、苍白球以及同侧尾状核的CMRglu呈显著正相关。齿状颗粒细胞密度与双侧丘脑和壳核的CMRglu呈显著正相关。在任何皮质区域，包括海马，细胞密度与CMRglu之间均无显著相关性。
我们推测海马细胞丢失导致向丘脑和基底神经节的传出突触活动减少，从而导致这些结构中的神经元活动减少，进而引起代谢减低。这种突触活动具有显著的双侧成分。TLE患者的皮质下代谢减低可能会增强内侧颞叶放电的致痫潜力。
