McDonald Carrie R, Hagler Donald J, Ahmadi Mazyar E, Tecoma Evelyn, Iragui Vicente, Gharapetian Lusineh, Dale Anders M, Halgren Eric
Department of Psychiatry, and Multimodal Imaging Laboratory, University of California, San Diego, CA 92093-0841, USA.
Epilepsia. 2008 May;49(5):794-803. doi: 10.1111/j.1528-1167.2008.01539.x. Epub 2008 Feb 7.
To determine the nature and extent of regional cortical thinning in patients with mesial temporal lobe epilepsy (MTLE).
High-resolution volumetric MRIs were obtained on 21 patients with MTLE and 21 controls. Mean cortical thickness was measured within regions of interest and point-by-point across the neocortex using cortical reconstruction and parcellation software.
Bilateral thinning was observed within frontal and lateral temporal regions in MTLE patients relative to controls. The most striking finding was bilateral cortical thinning in the precentral gyrus and immediately adjacent paracentral region and pars opercularis of the inferior frontal gyrus, extending to the orbital region. Within the temporal lobe, bilateral thinning was observed in Heschl's gyrus only. Ipsilateral only thinning was observed in the superior and middle temporal gyri, as well as in the medial orbital cortex. Greater asymmetries in cortical thickness were observed in medial temporal cortex in patients relative to controls. Individual subject analyses revealed that this asymmetry reflected significant ipsilateral thinning of medial temporal cortex in 33% of patients, whereas it reflected ipsilateral thickening in 20% of MTLEs.
Patients with MTLE show widespread, bilateral pathology in neocortical regions that is not appreciated on standard imaging. Future studies are needed that elucidate the clinical implications of neocortical thinning in MTLE.
确定内侧颞叶癫痫（MTLE）患者局部皮质变薄的性质和程度。
对21例MTLE患者和21例对照者进行高分辨率容积磁共振成像（MRI）检查。使用皮质重建和分割软件在感兴趣区域内以及跨新皮质逐点测量平均皮质厚度。
与对照者相比，MTLE患者双侧额叶和颞叶外侧区域出现皮质变薄。最显著的发现是中央前回、紧邻的中央旁区域以及额下回岛盖部双侧皮质变薄，并延伸至眶部区域。在颞叶内，仅在颞横回观察到双侧皮质变薄。仅在颞上回、颞中回以及眶内侧皮质观察到同侧皮质变薄。与对照者相比，患者内侧颞叶皮质厚度的不对称性更大。个体受试者分析显示，这种不对称性在33%的患者中反映为内侧颞叶皮质同侧显著变薄，而在20%的MTLE患者中反映为同侧增厚。
MTLE患者在新皮质区域表现出广泛的双侧病变，这在标准成像中未被发现。需要进一步的研究来阐明MTLE中新皮质变薄的临床意义。
