Sone Daichi, Sato Noriko, Kimura Yukio, Watanabe Yutaka, Okazaki Mitsutoshi, Matsuda Hiroshi
Department of Psychiatry, National Center of Neurology and Psychiatry, Tokyo, Japan.
Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan.
Neuroradiology. 2018 Jun;60(6):635-641. doi: 10.1007/s00234-018-2019-z. Epub 2018 Apr 13.
Although epilepsy in the elderly has attracted attention recently, there are few systematic studies of neuroimaging in such patients. In this study, we used structural MRI and diffusion tensor imaging (DTI) to investigate the morphological and microstructural features of the brain in late-onset temporal lobe epilepsy (TLE).
We recruited patients with TLE and an age of onset > 50 years (late-TLE group) and age- and sex-matched healthy volunteers (control group). 3-Tesla MRI scans, including 3D T1-weighted images and 15-direction DTI, showed normal findings on visual assessment in both groups. We used Statistical Parametric Mapping 12 (SPM12) for gray and white matter structural normalization and comparison and used Tract-Based Spatial Statistics (TBSS) for fractional anisotropy and mean diffusivity comparisons of DTI. In both methods, p < 0.05 (family-wise error) was considered statistically significant.
In total, 30 patients with late-onset TLE (mean ± SD age, 66.8 ± 8.4; mean ± SD age of onset, 63.0 ± 7.6 years) and 40 healthy controls (mean ± SD age, 66.6 ± 8.5 years) were enrolled. The late-onset TLE group showed significant gray matter volume increases in the bilateral amygdala and anterior hippocampus and significantly reduced mean diffusivity in the left temporofrontal lobe, internal capsule, and brainstem. No significant changes were evident in white matter volume or fractional anisotropy.
Our findings may reflect some characteristics or mechanisms of cryptogenic TLE in the elderly, such as inflammatory processes.
尽管老年癫痫最近已引起关注，但对此类患者进行神经影像学系统研究的却很少。在本研究中，我们使用结构磁共振成像（MRI）和扩散张量成像（DTI）来研究晚发性颞叶癫痫（TLE）患者大脑的形态学和微观结构特征。
我们招募了年龄发作>50岁的TLE患者（晚发性TLE组）以及年龄和性别匹配的健康志愿者（对照组）。3特斯拉MRI扫描，包括三维T1加权图像和15方向DTI，两组在视觉评估上均显示正常结果。我们使用统计参数映射12（SPM12）进行灰质和白质结构归一化及比较，并使用基于纤维束的空间统计学（TBSS）进行DTI的各向异性分数和平均扩散率比较。在两种方法中，p<0.05（家族性错误）被认为具有统计学意义。
总共招募了30例晚发性TLE患者（平均±标准差年龄，66.8±8.4；平均±标准差发病年龄，63.0±7.6岁）和40名健康对照者（平均±标准差年龄，66.6±8.5岁）。晚发性TLE组显示双侧杏仁核和前海马灰质体积显著增加，左侧颞额叶、内囊和脑干平均扩散率显著降低。白质体积或各向异性分数无明显变化。
我们的研究结果可能反映了老年隐源性TLE的一些特征或机制，如炎症过程。
