颞叶癫痫中表观扩散系数与神经心理学测试的相关性
Correlation of apparent diffusion coefficient with neuropsychological testing in temporal lobe epilepsy.
作者信息
Lui Yvonne W, Nusbaum Annette O, Barr William B, Johnson Glyn, Babb James S, Orbach Darren, Kim Alice, Laliotis Georgia, Devinsky Orrin
机构信息
Department of Radiology, NYU Medical Center, 530 First Avenue, New York, NY 10016, USA.
出版信息
AJNR Am J Neuroradiol. 2005 Aug;26(7):1832-9.
BACKGROUND AND PURPOSE
Patients with nonlesional temporal lobe epilepsy have long been known to have abnormalities of memory. Recently, these patients have been shown to have increased diffusivity in the hippocampus. We hypothesized that in these patients, a negative correlation would exist between diffusivity measures of the mesial temporal lobe and performance on neuropsychological tests.
METHODS
Twenty presurgical patients with temporal lobe epilepsy and 20 age- and sex-matched healthy controls underwent MR imaging of the brain. Apparent diffusion coefficient region of interest measures were taken in both hippocampi and parahippocampal gyri by 2 independent observers. Mean whole brain diffusivity was calculated. All patients completed neuropsychological testing. Electroencephalogram and pathology results were collected. Patients and controls were compared with respect to each apparent diffusion coefficient measure. In patients, apparent diffusion coefficients ipsilateral and contralateral to the seizure focus were compared. Associations were assessed between diffusivity measures and neuropsychological scores.
RESULTS
Eleven patients had right-sided seizure foci and 9 had left-sided seizure foci. Patients demonstrated higher apparent diffusion coefficient values than controls over the whole brain, in the hippocampi, and in the parahippocampal gyri (P < .05). Patients demonstrated higher apparent diffusion coefficient within the ipsilateral hippocampus (1.19 +/- 0.22 x 10(-3) s/mm2) and parahippocampal gyrus (1.02 +/- 0.12 x 10(-3) s/mm2) compared with the contralateral side (1.02 +/- 0.16 x 10(-3) s/mm2 and 0.96 +/- 0.09 x 10(-3) s/mm2, respectively) (P < .05). Negative correlations were seen between hippocampal apparent diffusion coefficients and multiple memory tests (P < .05).
CONCLUSION
Quantitative diffusion measurements in the hippocampus correlate with memory dysfunction in patients with temporal lobe epilepsy.
背景与目的
长期以来，人们已知非病灶性颞叶癫痫患者存在记忆异常。最近，这些患者被证明海马区扩散率增加。我们假设，在这些患者中，内侧颞叶扩散率测量值与神经心理学测试表现之间存在负相关。
方法
20例颞叶癫痫术前患者及20例年龄和性别匹配的健康对照者接受脑部磁共振成像。由2名独立观察者在双侧海马和海马旁回进行表观扩散系数感兴趣区测量。计算全脑平均扩散率。所有患者均完成神经心理学测试。收集脑电图和病理结果。比较患者和对照者的各项表观扩散系数测量值。在患者中，比较癫痫灶同侧和对侧的表观扩散系数。评估扩散率测量值与神经心理学评分之间的相关性。
结果
11例患者癫痫灶位于右侧，9例位于左侧。患者在全脑、海马和海马旁回的表观扩散系数值均高于对照者（P < 0.05）。与对侧相比，患者同侧海马（1.19±0.22×10⁻³ s/mm²）和海马旁回（1.02±0.12×10⁻³ s/mm²）的表观扩散系数更高（对侧分别为1.02±0.16×10⁻³ s/mm²和0.96±0.09×10⁻³ s/mm²）（P < 0.05）。海马表观扩散系数与多项记忆测试之间存在负相关（P < 0.05）。
结论
海马区的定量扩散测量与颞叶癫痫患者的记忆功能障碍相关。
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