Sanches Patrícia, Fujisao Elaine Keiko, Braga Aline M S, Cristaldo Nathalia Raquel, Dos Reis Roberto, Yamashita Seizo, Betting Luiz Eduardo
Departamento de Neurologia, Psicologia e Psiquiatria, Faculdade de Medicina de Botucatu - UNESP - Univ Estadual Paulista, Brazil; Departamento de Doenças Tropicais e Diagnóstico por Imagem, Faculdade de Medicina de Botucatu - UNESP - Univ Estadual Paulista, Brazil.
Departamento de Neurologia, Psicologia e Psiquiatria, Faculdade de Medicina de Botucatu - UNESP - Univ Estadual Paulista, Brazil.
Epilepsy Res. 2017 May;132:100-108. doi: 10.1016/j.eplepsyres.2017.03.004. Epub 2017 Mar 25.
Quantitative techniques of diffusion analysis allow for an in-vivo investigation of the physiopathology of epilepsies. The objective of this study was to evaluate the variation of the main diffusion parameters and explore differences between two methodologies of voxel-wise analysis comparing a group of patients with mesial temporal lobe epilepsy (MTLE) with controls.
24 patients with a diagnosis of MTLE were selected. All patients and a control group of 36 individuals were submitted to 3T magnetic resonance imaging. Diffusion parameters were obtained from the raw images. Based on the tensors, a customized template was created, and images were registered into standard space. Voxel-based comparisons between patients and controls was performed by whole brain voxel-wise analysis and tract-based spatial statistics (TBSS). Tract-specific analysis (TSA) was performed in the mostly damaged fasciculi.
10 patients presented with right hippocampal sclerosis (HS), 11 with left HS and 3 with bilateral HS with left predominance. Whole brain voxel-wise analysis showed abnormalities mainly localized in the temporal lobes (total volume of 3859mm). TBSS showed more widespread abnormalities (21931mm). TSA pointed to abnormalities situated essentially in the temporal stem topography. Fractional anisotropy (FA) and radial diffusivity (RD) were the parameters that showed more abnormalities.
Whole brain voxel-wise analysis was more restricted than TBSS. The methods were complementary stressing the significance of the findings. The abnormalities were more frequently observed in FA and RD indicating the need for using several diffusion parameters for the investigation of patients with MTLE.
扩散分析的定量技术有助于对癫痫的生理病理学进行体内研究。本研究的目的是评估主要扩散参数的变化，并探索体素分析的两种方法之间的差异，比较一组内侧颞叶癫痫（MTLE）患者与对照组。
选择24例诊断为MTLE的患者。所有患者和36名个体的对照组均接受3T磁共振成像检查。从原始图像中获取扩散参数。基于张量创建定制模板，并将图像配准到标准空间。通过全脑体素分析和基于纤维束的空间统计学（TBSS）对患者和对照组进行基于体素的比较。在受损最严重的纤维束中进行纤维束特异性分析（TSA）。
10例患者表现为右侧海马硬化（HS），11例为左侧HS，3例为双侧HS且左侧为主。全脑体素分析显示异常主要位于颞叶（总体积为3859mm）。TBSS显示出更广泛的异常（21931mm）。TSA指出异常主要位于颞叶干区域。分数各向异性（FA）和径向扩散率（RD）是显示出更多异常的参数。
全脑体素分析比TBSS更具局限性。这些方法具有互补性，强调了研究结果的重要性。在FA和RD中更频繁地观察到异常，表明在研究MTLE患者时需要使用多种扩散参数。
