Center for Imaging of Neurodegenerative Diseases, San Francisco, California, USA.
Epilepsia. 2010 Aug;51(8):1436-45. doi: 10.1111/j.1528-1167.2009.02413.x. Epub 2009 Dec 1.
The thalamus plays an important role in seizure propagation in temporal lobe epilepsy (TLE). This study investigated how structural abnormalities in the focus, ipsilateral thalamus and extrafocal cortical structures relate to each other in TLE with mesiotemporal sclerosis (TLE-MTS) and without hippocampal sclerosis (TLE-no).
T₁ and high-resolution T₂ images were acquired on a 4T magnet in 29 controls, 15 TLE-MTS cases, and 14 TLE-no. Thalamus volumes were obtained by warping a labeled atlas onto each subject's brain. Deformation-based morphometry was used to identify regions of thalamic volume loss and FreeSurfer for cortical thickness measurements. CA1 volumes were obtained from high-resolution T₂ images. Multiple regression analysis and correlation analyses for voxel- and vertex-based analyses were performed in SPM2 and FreeSurfer.
TLE-MTS had bilateral volume loss in the anterior thalamus, which was correlated with CA1 volume and cortical thinning in the mesiotemporal lobe. TLE-no had less severe volume loss in the dorsal lateral nucleus, which was correlated with thinning in the mesiotemporal region but not with extratemporal thinning.
The findings suggest that seizure propagation from the presumed epileptogenic focus or regions close to it into the thalamus occurs in TLE-MTS and TLE-no and results in circumscribed neuronal loss in the thalamus. However, seizure spread beyond the thalamus seems not to be responsible for the extensive extratemporal cortical abnormalities in TLE.
丘脑在颞叶癫痫（TLE）的发作传播中起着重要作用。本研究调查了中颞叶硬化（TLE-MTS）和无海马硬化（TLE-no）的 TLE 中，病灶、同侧丘脑和皮质外结构的结构异常之间如何相互关联。
在 4T 磁体上采集 29 名对照者、15 名 TLE-MTS 病例和 14 名 TLE-no 的 T₁ 和高分辨率 T₂ 图像。通过将标记的图谱变形到每个受试者的大脑上来获得丘脑体积。变形基形态计量学用于识别丘脑体积损失的区域，FreeSurfer 用于皮质厚度测量。从高分辨率 T₂ 图像中获得 CA1 体积。SPM2 和 FreeSurfer 中的多元回归分析和体素和顶点分析的相关分析。
TLE-MTS 在前丘脑有双侧体积损失，与 CA1 体积和中颞叶皮质变薄相关。TLE-no 在背外侧核的体积损失较轻，与中颞叶区域的变薄相关，但与颞外变薄无关。
研究结果表明，发作从假定的致痫灶或其附近区域传播到丘脑在 TLE-MTS 和 TLE-no 中发生，并导致丘脑的局灶性神经元丧失。然而，发作向丘脑以外的传播似乎不是导致 TLE 广泛颞外皮质异常的原因。
