Diagnostic Imaging, Hospital for Sick Children, Toronto, ON, Canada; Division of Neurology, Hospital for Sick Children, Toronto, ON, Canada.
Epilepsia. 2014 Apr;55(4):519-27. doi: 10.1111/epi.12540. Epub 2014 Feb 11.
Developmental differences in structure and function have been reported along the hippocampal subregions. The aims of this study were to determine if there were volumetric differences in hippocampal head (HH), body (HB), tail (HT), and total hippocampus (TotH)) in children with nonlesional localization-related epilepsy relative to controls, and the relation between hippocampal subregions with episodic memory and clinical parameters.
Forty-eight children with nonlesional localization-related epilepsy, consisting of 29 left-sided and 19 right-sided epilepsy, and 27 healthy controls were recruited. All patients and controls underwent volumetric T1-weighted imaging, and verbal and nonverbal memory testing. The volume of hippocampal subregions was compared between patients and controls. The associations between left hippocampal subregions with verbal memory; right hippocampal subregions with nonverbal memory; and hippocampal subregions with age, age at seizure onset, and seizure frequency were assessed.
Patients with left-sided epilepsy had smaller left HH (p = 0.003) and HB (p = 0.012), right HB (p = 0.021) and HT (p = 0.015), and right TotH (p = 0.020) volumes. Those with right-sided epilepsy had smaller right HT (p = 0.018) volume. There were no statistically significant differences between verbal and nonverbal memory in left-sided and right-sided epilepsy relative to controls (all p > 0.025). In left-sided epilepsy, there was a significant association between left HH volume with verbal memory (β = 0.492, p = 0.001). There was no significant association between left and right hippocampal subregions with verbal and nonverbal memory, respectively, in right-sided epilepsy and controls (all p > 0.002). In left-sided and right-sided epilepsy, there was no significant association between hippocampal subregions with age, age at seizure onset, and seizure frequency (all p > 0.002).
We have found hippocampal volume reduction, but did not identify a gradient in the severity of volume reduction along the hippocampal axis in children with localization-related epilepsy. Further study is needed to clarify if there are volumetric changes within the cornu ammonis subfields and dentate gyrus. A PowerPoint slide summarizing this article is available for download in the Supporting Information section here.
已有研究报道，沿海马亚区结构和功能存在发育差异。本研究旨在确定无病变致痫灶的局灶性相关癫痫患儿的海马头部（HH）、体部（HB）、尾部（HT）和总海马（TotH）是否存在体积差异，并确定海马亚区与情景记忆和临床参数的关系。
招募了 48 名无病变致痫灶的局灶性相关癫痫患儿，其中 29 名为左侧癫痫，19 名为右侧癫痫，27 名为健康对照。所有患者和对照均接受了 T1 加权容积成像和言语及非言语记忆测试。比较了患者和对照组之间海马亚区的体积。评估了左侧海马亚区与言语记忆的关系；右侧海马亚区与非言语记忆的关系；以及海马亚区与年龄、癫痫发作起始年龄和癫痫发作频率的关系。
左侧癫痫患儿的左侧 HH（p=0.003）和 HB（p=0.012）、右侧 HB（p=0.021）和 HT（p=0.015）以及右侧 TotH（p=0.020）体积较小。右侧癫痫患儿的右侧 HT（p=0.018）体积较小。与对照组相比，左侧和右侧癫痫患儿的言语记忆和非言语记忆之间无统计学显著差异（均 p>0.025）。在左侧癫痫中，左侧 HH 体积与言语记忆之间存在显著相关性（β=0.492，p=0.001）。在右侧癫痫和对照组中，左侧和右侧海马亚区与言语记忆和非言语记忆之间均无显著相关性（均 p>0.002）。在左侧和右侧癫痫中，海马亚区与年龄、癫痫发作起始年龄和癫痫发作频率之间无显著相关性（均 p>0.002）。
我们发现了海马体积减小，但未在局灶性相关癫痫患儿的海马轴上发现体积减小程度的梯度。需要进一步的研究来阐明在角回亚区和齿状回内是否存在体积变化。本文的幻灯片摘要可在支持信息部分下载。
