Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, NSE MRI Unit, National Society for Epilepsy, Chalfont St Peter SL9 0RJ, UK; Neurology Department, Hospital Universitario Vall d'Hebron, Universitat Autonoma de Barcelona, Paseo Vall d'Hebron, 119, 08035 Barcelona, Spain.
Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, NSE MRI Unit, National Society for Epilepsy, Chalfont St Peter SL9 0RJ, UK; Epilepsy Centre, Department of Neurology, University of Munich, Germany.
Epilepsy Res. 2014 Jul;108(5):978-81. doi: 10.1016/j.eplepsyres.2014.03.001. Epub 2014 Mar 28.
Neuronal networks involved in seizure generation, maintenance and spread of epileptic activity comprise cortico-subcortical circuits. Although epileptic foci vary in location across focal epilepsy syndromes, there is evidence for common structures in the epileptogenic networks. We recently reported evidence from functional neuroimaging for a unique area in the piriform cortex, common to focal epilepsies in humans, which might play a role in modulating seizure activity. In this study, we aimed to identify common areas of structural abnormalities in patients with frontal lobe epilepsy (FLE).
T1-weighted MRI scans of 43 FLE patients and 25 healthy controls were analysed using voxel based morphometry. Differences in regional grey matter volume were examined across the whole brain, and correlated with age at epilepsy onset, duration and frequency of seizures.
We detected areas of increased grey matter volume in the piriform cortex, amygdala and parahippocampal gyrus bilaterally, as well as left mid temporal gyrus of patients relative to controls, which did not correlate with any of the clinical variables tested. No common areas of atrophy were detected across the FLE group.
Structural abnormalities within the piriform cortex and adjacent structures of patients with FLE provide further evidence for the involvement of this area in the epileptogenic network of focal epilepsies. Lack of correlation with duration or age of onset of epilepsy suggests that this area of abnormality is not a consequence of seizure activity.
参与癫痫发作、维持和扩散的神经元网络包括皮质下皮质电路。尽管癫痫灶在局灶性癫痫综合征中的位置各不相同，但在致痫网络中存在共同的结构证据。我们最近从功能神经影像学报告了人类局灶性癫痫中一个独特的梨状皮层区域的证据，该区域可能在调节癫痫活动中发挥作用。在这项研究中，我们旨在确定额叶癫痫（FLE）患者的结构异常的共同区域。
使用基于体素的形态计量学对 43 名 FLE 患者和 25 名健康对照者的 T1 加权 MRI 扫描进行分析。在整个大脑中检查了区域灰质体积的差异，并与癫痫发作的年龄、持续时间和频率相关。
与对照组相比，我们在患者的梨状皮层、杏仁核和双侧海马旁回以及左侧颞中回检测到灰质体积增加的区域，这些区域与测试的任何临床变量均无相关性。在 FLE 组中未发现共同的萎缩区域。
FLE 患者梨状皮层和邻近结构的结构异常进一步证明了该区域在局灶性癫痫的致痫网络中的参与。与癫痫发作的持续时间或发病年龄无相关性表明，该异常区域不是癫痫活动的结果。
