Fojtiková Dagmar, Brázdil Milan, Skoch Antonín, Jírů Filip, Horký Jaroslav, Marecek Radek, Mikl Michal, Krupa Petr
Brno Epilepsy Centre, Department of Neurology, Masaryk University, St. Anne's University Hospital, Brno, Czech Republic.
Epileptic Disord. 2007 Dec;9 Suppl 1:S59-67. doi: 10.1684/epd.2007.0148.
to investigate potential neuronal dysfunction within the thalamus in patients suffering from mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE/HS).
we examined twenty epileptic patients suffering from mesial temporal lobe epilepsy with hippocampal sclerosis (17 females, 3 males) and twenty sex- and age-matched healthy controls. H MR spectroscopic imaging (SI) was performed over the right and left thalamus in all patients and controls. In addition both hippocampi were investigated by the H MR spectroscopic single voxel (SV) technique in both groups.
statistical analysis of compared data in both groups demonstrated that the total thalamic NAA level was significantly decreased in patients with MTLE/HS as compared to healthy controls. Detailed analysis revealed a statistically significant reduction of NAA, NAA/Cr and NAA/(Cr+Cho) ratios in the thalamus ipsilateral to hippocampus affected with hippocampal sclerosis in patients compared to controls, while no significant changes were observed in the thalamus contralateral to sclerotic hippocampus. A comparison of values in ipsilateral and contralateral thalami in patients showed statistically significant difference with lower values of NAA and both ratios in the ipsilateral thalamus. Previously reported reduced hippocampal concentration of NAA, NAA/Cr and NAA/(Cr+Cho) ratios on the side of hippocampal sclerosis compared with contralateral hippocampus in patients and both hippocampi in controls was confirmed.
the present MRS data clearly indicate neuronal dysfunction within the thalamus ipsilateral to the sclerotic hippocampus of patients with mesial temporal lobe epilepsy. In agreement with other recent functional and structural neuroimagings our results confirm the role of the ipsilateral thalamus in the medial temporal/limbic epileptic network.
研究内侧颞叶癫痫伴海马硬化（MTLE/HS）患者丘脑内潜在的神经元功能障碍。
我们检查了20例患有内侧颞叶癫痫伴海马硬化的癫痫患者（17例女性，3例男性）以及20例性别和年龄匹配的健康对照者。对所有患者和对照者的左右丘脑进行了氢磁共振波谱成像（MRSI）。此外，两组均采用氢磁共振波谱单 voxel（SV）技术对双侧海马进行了研究。
两组比较数据的统计分析表明，与健康对照者相比，MTLE/HS患者丘脑的总 NAA 水平显著降低。详细分析显示，与对照者相比，海马硬化侧海马同侧丘脑的 NAA、NAA/Cr 和 NAA/(Cr+Cho) 比值有统计学意义的降低，而硬化海马对侧丘脑未观察到显著变化。患者同侧和对侧丘脑值的比较显示，同侧丘脑的 NAA 及两个比值较低，具有统计学意义的差异。先前报道的患者海马硬化侧海马的 NAA、NAA/Cr 和 NAA/(Cr+Cho) 比值与对侧海马及对照者双侧海马相比降低得到了证实。
目前的 MRS 数据清楚地表明内侧颞叶癫痫患者硬化海马同侧丘脑存在神经元功能障碍。与其他近期的功能和结构神经影像学研究一致，我们的结果证实了同侧丘脑在颞叶内侧/边缘癫痫网络中的作用。
