Bonilha Leonardo, Rorden Chris, Castellano Gabriela, Pereira Fabrício, Rio Pablo A, Cendes Fernando, Li Li M
Laboratory of Neuroimaging, State University of Campinas, Campinas, Brazil.
Arch Neurol. 2004 Sep;61(9):1379-84. doi: 10.1001/archneur.61.9.1379.
Conventional volumetric studies have shown that brain structures functionally and anatomically related to the hippocampus are smaller in patients with drug-refractory medial temporal lobe epilepsy (MTLE).
To determine the extent of gray matter atrophy in the brains of patients with MTLE and to examine the pattern of atrophy.
We performed a voxel-based morphometric study of 43 consecutive patients with unilateral drug-refractory MTLE (21 patients with right-sided MTLE and 22 patients with left-sided MTLE) whose magnetic resonance images showed signs of unilateral hippocampal atrophy. The data from the patients with MTLE were compared with the data from 49 healthy control subjects to identify differences between groups in gray matter concentration (GMC).
Academic hospital's epilepsy clinic.
We observed that patients with left- and right-sided MTLE exhibited GMC reduction in the hippocampus ipsilateral to the seizure origin. In addition, we found GMC reduction in the ipsilateral parahippocampal and isocortical temporal regions. Patients with MTLE also showed GMC reduction in subcortical nuclei such as the thalamus and caudate, in the cerebellum, in the midbrain, and in parieto-occipital regions.
Patients with MTLE exhibit a reduction in GMC in regions outside the temporal lobe, specifically in areas that are connected to the hippocampus and parahippocampal region, suggesting an anatomical route for atrophy.
传统的体积研究表明，药物难治性内侧颞叶癫痫（MTLE）患者中，与海马体在功能和解剖上相关的脑结构较小。
确定MTLE患者大脑中灰质萎缩的程度，并检查萎缩模式。
我们对43例连续的单侧药物难治性MTLE患者（21例右侧MTLE患者和22例左侧MTLE患者）进行了基于体素的形态学研究，这些患者的磁共振图像显示单侧海马萎缩迹象。将MTLE患者的数据与49名健康对照者的数据进行比较，以确定两组之间灰质浓度（GMC）的差异。
学术医院的癫痫诊所。
我们观察到，左侧和右侧MTLE患者在癫痫起源同侧的海马体中GMC降低。此外，我们发现同侧海马旁和颞叶等皮质区域的GMC降低。MTLE患者在丘脑和尾状核等皮质下核、小脑、中脑以及顶枕区域也表现出GMC降低。
MTLE患者在颞叶以外的区域，特别是在与海马体和海马旁区域相连的区域，GMC降低，提示存在萎缩的解剖学途径。
