Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, USA.
Epilepsia. 2012 Jun;53(6):1033-43. doi: 10.1111/j.1528-1167.2012.03447.x. Epub 2012 Apr 3.
To characterize differences in brain structure and their patterns of age-related change in individuals with chronic childhood/adolescent onset temporal lobe epilepsy compared with healthy controls.
Subjects included participants with chronic temporal lobe epilepsy (n = 55) of mean childhood/adolescent onset and healthy controls (n = 53), age 14-60 years. Brain magnetic resonance imaging (MRI) studies (1.5 T) were processed using FreeSurfer to obtain measures of lobar thickness, area, and volume as well as volumes of diverse subcortical structures and cerebellum. Group differences were explored followed by cross-sectional lifespan modeling as a function of age.
Anatomic abnormalities were extensive in participants with chronic temporal lobe epilepsy including distributed subcortical structures (hippocampus, thalamus, caudate, and pallidum), cerebellar gray and white matter, total cerebral gray and white matter; and measures of cortical gray matter thickness, area, or volume in temporal (medial, lateral) and extratemporal lobes (frontal, parietal). Increasing chronologic age was associated with progressive changes in diverse cortical, subcortical, and cerebellar regions for both participants with epilepsy and controls. Age-accelerated changes in epilepsy participants were seen in selected areas (third and lateral ventricles), with largely comparable patterns of age-related change across other regions of interest.
Extensive cortical, subcortical, and cerebellar abnormalities are present in participants with mean chronic childhood/adolescent onset temporal lobe epilepsy implicating a significant neurodevelopmental impact on brain structure. With increasing chronologic age, the brain changes occurring in epilepsy appear to proceed in a largely age-appropriate fashion compared to healthy controls, the primary exception being age-accelerated ventricular expansion (lateral and third ventricles). These cumulative structural abnormalities appear to represent a significant anatomic burden for persons with epilepsy, the consequences of which remain to be determined as they progress into elder years.
比较慢性儿童/青少年期起病的颞叶癫痫患者与健康对照者的脑结构差异及其与年龄相关的变化模式。
研究对象包括平均起病于儿童/青少年期的慢性颞叶癫痫患者（n = 55）和健康对照者（n = 53），年龄 14-60 岁。使用 FreeSurfer 对脑磁共振成像（MRI）研究（1.5T）进行处理，以获得脑叶厚度、面积和体积以及各种皮质下结构和小脑体积的测量值。探讨了组间差异，然后进行了作为年龄函数的横断生命历程建模。
慢性颞叶癫痫患者的解剖异常广泛，包括分布于皮质下结构（海马体、丘脑、尾状核和苍白球）、小脑灰质和白质、总脑灰质和白质；以及颞叶（内侧、外侧）和颞叶外（额、顶）皮质的灰质厚度、面积或体积的测量值。对于癫痫患者和对照组，随着年龄的增长，各种皮质下和小脑区域的结构都发生了渐进性变化。在一些选定的区域（第三脑室和外侧脑室）中，癫痫患者的年龄加速变化，而其他感兴趣区域的年龄相关性变化模式基本相似。
在平均起病于儿童/青少年期的慢性颞叶癫痫患者中存在广泛的皮质、皮质下和小脑异常，这表明脑结构受到了重大的神经发育影响。随着年龄的增长，癫痫患者大脑的变化似乎在很大程度上以与健康对照组相似的方式发生，主要的例外是年龄加速的脑室扩张（外侧和第三脑室）。这些累积的结构异常似乎代表了癫痫患者的重要解剖负担，随着年龄的增长，它们的后果仍有待确定。
