国际抗癫痫联盟（ILAE）海马硬化类型中不同的苔藓纤维发芽模式。
Different mossy fiber sprouting patterns in ILAE hippocampal sclerosis types.
作者信息
Schmeiser Barbara, Li Jinmei, Brandt Armin, Zentner Josef, Doostkam Soroush, Freiman Thomas M
机构信息
Department of Neurosurgery, University Medical Center, Albert-Ludwigs-University, Breisacher Strasse 64, 79106 Freiburg im Breisgau, Germany.
Institute of Neuropathology, Friedrich-Alexander-University, Schwabachanlage 6, 91054 Erlangen, Germany; Department of Neurology, West China Hospital, West China Medical School, Sichuan University, Chengdu, China.
出版信息
Epilepsy Res. 2017 Oct;136:115-122. doi: 10.1016/j.eplepsyres.2017.08.002. Epub 2017 Aug 8.
OBJECTIVE
Hippocampal sclerosis (HS) is the most prevalent pathology in temporal lobe epilepsy (TLE) characterized by segmental neuronal cell loss in the cornu ammonis (CA) 1-4. In addition, migration of granule cells and reorganization of their axons is observed, known as granule cell dispersion (GCD) and mossy fiber sprouting (MFS). The loss of mossy fibers` (MF) target cells in CA4 and CA3 was considered to be causative for MFS. The ILAE HS (International League Against Epilepsy) classification identifies three subtypes with different cell loss patterns in CA1-4. We studied the relation of ILAE HS subtypes to GCD and MFS to corroborate clinico-pathological subgroups in a large retrospective single-center series.
MATERIAL AND METHODS
Hippocampal specimen of 319 patients were screened, 214 could be used for analysis. Immunohistochemical stainings for semi-quantitative analysis of neuronal cell loss (NeuN) and MFS (synaptoporin) were performed. Presurgical data were available from patient files and seizure outcome was classified according to Engel score after surgery.
RESULTS
In 39 patients (18%) no neuronal cell loss (ILAE no-HS), no GCD and no MFS was observed. In 154 patients (72%) severe neuronal cell loss was seen in CA1, CA4 and CA3 (ILAE HS 1, typical HS); in addition extensive GCD and MFS was observed. In 17 patients (8%) cell loss was seen predominantly in CA1 (ILAE HS 2); despite different cell loss pattern these hippocampi also showed GCD and MFS. In 4 patients (2%) cell loss was predominately detected in CA3 and CA4 (ILAE HS type 3), consecutively GCD and MFS were observed. Longer epilepsy duration and younger age at surgery was more often associated with ILAE HS 2 and febrile convulsions were completely absent in ILAE no-HS. Yet, seizure onset, age at initial precipitating injury and postsurgical seizure outcome did not show any significant association with ILAE HS subtypes.
CONCLUSION
GCD and MFS might develop independently from the neuronal cell loss of MF target cells.
目的
海马硬化（HS）是颞叶癫痫（TLE）中最常见的病理改变，其特征为海马角（CA）1-4节段性神经元细胞丢失。此外，还观察到颗粒细胞迁移及其轴突重组，即颗粒细胞弥散（GCD）和苔藓纤维出芽（MFS）。CA4和CA3区苔藓纤维（MF）靶细胞的丢失被认为是MFS的病因。国际抗癫痫联盟（ILAE）的HS分类识别出CA1-4区具有不同细胞丢失模式的三种亚型。我们研究了ILAE HS亚型与GCD和MFS的关系，以在一个大型回顾性单中心系列中证实临床病理亚组。
材料与方法
筛选319例患者的海马标本，214例可用于分析。进行免疫组织化学染色以对神经元细胞丢失（NeuN）和MFS（突触素）进行半定量分析。术前数据可从患者病历中获得，术后癫痫发作结果根据Engel评分进行分类。
结果
39例患者（18%）未观察到神经元细胞丢失（ILAE无HS）、无GCD和无MFS。154例患者（72%）在CA1、CA4和CA3区出现严重神经元细胞丢失（ILAE HS 1，典型HS）；此外，还观察到广泛的GCD和MFS。17例患者（8%）的细胞丢失主要见于CA1区（ILAE HS 2）；尽管细胞丢失模式不同，但这些海马也显示出GCD和MFS。4例患者（2%）的细胞丢失主要在CA3和CA4区检测到（ILAE HS 3型），随后观察到GCD和MFS。癫痫发作持续时间较长和手术时年龄较小更常与ILAE HS 2相关，ILAE无HS患者完全没有热性惊厥。然而，癫痫发作起始、首次促发损伤时的年龄和术后癫痫发作结果与ILAE HS亚型均无显著关联。
结论
GCD和MFS可能独立于MF靶细胞的神经元细胞丢失而发生。
Zotero 插件