Département de Neurosciences, Université de Montréal, Montréal, Québec, Canada; Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada; Service de Neurochirurgie, Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada.
Barcelona Beta Brain Research Center, Foundation Pasqual Maragall, Barcelona, Spain.
Neuroimage Clin. 2018 May 31;19:727-733. doi: 10.1016/j.nicl.2018.05.033. eCollection 2018.
In temporal lobe epilepsy (TLE), advanced neuroimaging techniques reveal anomalies extending beyond the temporal lobe such as thinning of fronto-central cortices. Operculo-insular epilepsy (OIE) is an under-recognized and poorly characterized condition with the potential of mimicking TLE. In this work, we investigated insular and extra-insular cortical thickness (CT) changes in OIE.
All participants (14 patients with refractory OIE, 9 age- and sex-matched patients with refractory TLE and 26 healthy controls) underwent a T1-weighted acquisition on a 3 T MRI. Anatomical images were processed with Advanced Normalization Tools. Between-group analysis of CT was performed using a two-sided -test (threshold of p < 0.05 after correction for multiple comparisons; cut-off threshold of 250 voxels) between (i) patients with OIE vs TLE, and (ii) patients with OIE vs healthy controls.
Significant widespread thinning was observed in OIE patients as compared with healthy controls mainly in the ipsilateral insula, peri-rolandic region, orbito-frontal area, mesiotemporal structures and lateral temporal neocortex. Contralateral cortical shrinkage followed a similar albeit milder and less diffuse pattern.The CT of OIE patients was equal or reduced relative to the TLE group for every cortical region analyzed. Thinning was observed diffusely in OIE patients, predominantly inboth insulae and the ipsilateral occipito-temporal area.
Our results reveal structural anomalies extending beyond the operculo-insular area in OIE.
在颞叶癫痫（TLE）中，先进的神经影像学技术揭示了超出颞叶的异常，如额-中央皮质变薄。岛盖下癫痫（OIE）是一种认识不足且特征描述较差的病症，具有模仿 TLE 的潜力。在这项工作中，我们研究了 OIE 中岛叶和岛外皮质厚度（CT）的变化。
所有参与者（14 例难治性 OIE 患者、9 例年龄和性别匹配的难治性 TLE 患者和 26 名健康对照者）均在 3T MRI 上进行 T1 加权采集。解剖图像使用高级归一化工具进行处理。使用双侧 t 检验（校正多重比较后 p < 0.05 的阈值；250 个体素的截止阈值）对 CT 进行组间分析，比较（i）OIE 患者与 TLE 患者之间，以及（ii）OIE 患者与健康对照组之间。
与健康对照组相比，OIE 患者的 CT 显示广泛而明显的变薄，主要位于同侧岛叶、旁中央区、眶额区、内侧颞叶结构和外侧颞叶新皮质。对侧皮质萎缩呈类似但更轻微和不那么弥漫的模式。OIE 患者的 CT 在分析的每个皮质区域均等于或低于 TLE 组。OIE 患者的 CT 弥漫性变薄，主要累及双侧岛叶和同侧枕颞叶区。
我们的结果揭示了 OIE 中超出岛盖下区域的结构异常。
