Park Kang Min, Kim Tae Hyung, Mun Chi Woong, Shin Kyong Jin, Ha Sam Yeol, Park JinSe, Lee Byung In, Lee Ho-Joon, Kim Sung Eun
Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
Research Institute for Convergence of Biomedical Science and Technology, Pusan National University, Yangsan, Republic of Korea.
J Clin Neurosci. 2018 Sep;55:76-81. doi: 10.1016/j.jocn.2018.06.025. Epub 2018 Jun 27.
The thalamus plays an important role in the modulation of both focal and generalized seizures, but the mechanisms related to seizures may be different among epilepsy syndromes. The aim of this study is to investigate the thalamic atrophy in different epilepsy syndromes. We enrolled a total of 72 patients with epilepsy (22 patients with temporal lobe epilepsy with hippocampal sclerosis, 21 patients with extra-temporal lobe epilepsy, and 29 patients with juvenile myoclonic epilepsy). We analyzed structural volumes of the brain with FreeSurfer 5.1 software, and compared them among subgroups of epilepsy and normal control subjects. Moreover, we quantified correlations between the duration of epilepsy and the structural volumes with age and sex as covariates. The volumes of the ipsilateral hippocampus in temporal lobe epilepsy with hippocampal sclerosis were significantly smaller than those in extra-temporal lobe epilepsy and normal control subjects [analysis of variance (ANOVA), p < 0.001]. Although the volumes of the ipsilateral thalamus were not different from those of normal control subjects, the volumes of the ipsilateral thalamus were negatively correlated with duration of epilepsy in temporal lobe epilepsy with hippocampal sclerosis (r = -0.5, p = 0.02). However, the volumes of interest in extra-temporal lobe epilepsy and juvenile myoclonic epilepsy were not different from those in normal control subjects, and none of these structures were correlated with duration of epilepsy. These findings suggest that the role of the thalamus may be different in thalamo-limbic circuits among epilepsy syndromes.
丘脑在局灶性和全身性癫痫发作的调节中起重要作用，但与癫痫发作相关的机制在不同癫痫综合征中可能有所不同。本研究的目的是调查不同癫痫综合征中的丘脑萎缩情况。我们共纳入了72例癫痫患者（22例伴有海马硬化的颞叶癫痫患者、21例颞叶外癫痫患者和29例青少年肌阵挛癫痫患者）。我们使用FreeSurfer 5.1软件分析大脑的结构体积，并在癫痫亚组和正常对照受试者之间进行比较。此外，我们将癫痫病程与结构体积之间的相关性进行量化，并将年龄和性别作为协变量。伴有海马硬化的颞叶癫痫患者患侧海马的体积显著小于颞叶外癫痫患者和正常对照受试者[方差分析（ANOVA），p<0.001]。虽然患侧丘脑的体积与正常对照受试者无差异，但在伴有海马硬化的颞叶癫痫中，患侧丘脑的体积与癫痫病程呈负相关（r=-0.5，p=0.02）。然而，颞叶外癫痫和青少年肌阵挛癫痫的感兴趣结构体积与正常对照受试者无差异，且这些结构均与癫痫病程无关。这些发现表明，在不同癫痫综合征中，丘脑在丘脑-边缘系统回路中的作用可能不同。
