Mueller S G, Laxer K D, Barakos J, Cheong I, Garcia P, Weiner M W
Center for Imaging of Neurodegenerative Diseases and Department of Radiology, University of California, San Francisco, CA 94121, USA.
Neuroimage. 2009 Jun;46(2):353-9. doi: 10.1016/j.neuroimage.2009.02.020. Epub 2009 Feb 26.
Extrafocal structural abnormalities have been consistently described in temporal lobe epilepsy (TLE) with mesial temporal lobe sclerosis (TLE-MTS). In TLE without MTS (TLE-no) extrafocal abnormalities are more subtle and often require region of interest analyses for their detection. Cortical thickness measurements might be better suited to detect such subtle abnormalities than conventional whole brain volumetric techniques which are often negative in TLE-no. The aim of this study was to seek and characterize patterns of cortical thinning in TLE-MTS and TLE-no.
T1 weighted whole brain images were acquired on a 4 T magnet in 66 subjects (35 controls, 15 TLE-MTS, 16 TLE-no). Cortical thickness measurements were obtained using the FreeSurfer software routine. Group comparisons and correlation analyses were done using the statistical routine of FreeSurfer (FDR, p=0.05).
TLE-MTS and TLE-no showed both widespread temporal and extratemporal cortical thinning. In TLE-MTS, the inferior medial and posterior temporal regions were most prominently affected while lateral temporal and opercular regions were more affected in TLE-no. The correlation analysis showed a significant correlation between the ipsilateral hippocampal volume and regions of thinning in TLE-MTS and between inferior temporal cortical thickness and thinning in extratemporal cortical regions in TLE-no.
The pattern of thinning in TLE-no was different from the pattern in TLE-MTS. This finding suggests that different epileptogenic networks could be involved in TLE-MTS and TLE and further supports the hypothesis that TLE-MTS and TLE-no might represent two distinct TLE syndromes.
在伴有内侧颞叶硬化的颞叶癫痫（TLE-MTS）中，一直有关于局灶外结构异常的描述。在不伴有内侧颞叶硬化的颞叶癫痫（TLE-no）中，局灶外异常更为细微，通常需要进行感兴趣区域分析才能检测到。与传统的全脑容积技术相比，皮质厚度测量可能更适合检测此类细微异常，而传统技术在TLE-no中往往呈阴性。本研究的目的是寻找并描述TLE-MTS和TLE-no中皮质变薄的模式。
在66名受试者（35名对照、15名TLE-MTS、16名TLE-no）中，使用4T磁体采集T1加权全脑图像。使用FreeSurfer软件程序获得皮质厚度测量值。使用FreeSurfer的统计程序进行组间比较和相关性分析（FDR，p = 0.05）。
TLE-MTS和TLE-no均表现出广泛的颞叶和颞外皮质变薄。在TLE-MTS中，颞叶内侧下部和后部区域受影响最明显，而在TLE-no中，颞叶外侧和岛盖区域受影响更大。相关性分析显示，TLE-MTS中同侧海马体积与变薄区域之间存在显著相关性，而在TLE-no中，颞下皮质厚度与颞外皮质区域变薄之间存在显著相关性。
TLE-no中的变薄模式与TLE-MTS中的模式不同。这一发现表明，不同的致痫网络可能参与了TLE-MTS和TLE，进一步支持了TLE-MTS和TLE-no可能代表两种不同的TLE综合征的假说。
