Diehl Beate, Busch Robyn M, Duncan John S, Piao Zhe, Tkach Jean, Lüders Hans O
Neurological Institute, Epilepsy Center, The Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Epilepsia. 2008 Aug;49(8):1409-18. doi: 10.1111/j.1528-1167.2008.01596.x. Epub 2008 Apr 4.
To use Diffusion Tensor Imaging (DTI) to explore structural integrity and connectivity of the uncinate fasciculus (UF) in patients with temporal lobe epilepsy (TLE) and its relationship to memory performance.
DTI and UF reconstruction were performed in 28 patients with TLE (18 left, 10 right) and 10 normal controls. Differences between left and right UF fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values and correlations between DTI measures and memory scores in the TLE groups were computed.
In controls, FA was higher in the left than right UF (p < 0.01). In left TLE, FA values were lower and ADC values higher than controls in the left UF and ADC values were higher in the right UF (all p < 0.05). In right TLE, ADCs were higher in the left and right UF compared to controls, and FA was reduced in the left UF (all p < 0.05). In left TLE, ADCs in the left UF were negatively correlated with Auditory Immediate (p < 0.05) and Delayed Memory (p < 0.01). Visual Delayed Memory was positively correlated with reduced FA in the ROI of the right UF and increased radial diffusivities (p < 0.05). No significant correlations were found in right TLE. Thus, DTI values correlated with memory scores in the expected direction in patients with left TLE.
Abnormal diffusion measures in the UF ipsilateral to the epileptogenic zone suggest that integrity of the UF is related to memory performance in patients with left TLE. Larger sample sizes are needed to evaluate structure-function correlations further.
运用扩散张量成像（DTI）技术探究颞叶癫痫（TLE）患者钩束（UF）的结构完整性和连通性及其与记忆表现的关系。
对28例TLE患者（18例左侧发病，10例右侧发病）和10名正常对照者进行DTI及UF重建。计算TLE组左右侧UF的分数各向异性（FA）值和表观扩散系数（ADC）值之间的差异以及DTI测量值与记忆分数之间的相关性。
在对照组中，左侧UF的FA高于右侧（p < 0.01）。在左侧TLE患者中，左侧UF的FA值低于对照组，ADC值高于对照组，右侧UF的ADC值也更高（均p < 0.05）。在右侧TLE患者中，与对照组相比，左右侧UF的ADC均更高，左侧UF的FA降低（均p < 0.05）。在左侧TLE患者中，左侧UF的ADC与听觉即刻记忆（p < 0.05）和延迟记忆（p < 0.01）呈负相关。视觉延迟记忆与右侧UF感兴趣区FA降低及径向扩散率增加呈正相关（p < 0.05）。右侧TLE患者未发现显著相关性。因此，左侧TLE患者的DTI值与记忆分数在预期方向上相关。
致痫区同侧UF的扩散测量异常表明，左侧TLE患者UF的完整性与记忆表现相关。需要更大样本量进一步评估结构 - 功能相关性。
