Corrêa Diogo Goulart, Pereira Mariana, Zimmermann Nicolle, Doring Thomas, Ventura Nina, Rêgo Cláudia, Marcondes Jorge, Alves-Leon Soniza Vieira, Gasparetto Emerson Leandro
Department of Radiology, Hospital Universitário Clementino Fraga Filho, Federal University of Rio de Janeiro, Rua Rodolpho Paulo Rocco 255, Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ 21941-913, Brazil; Clínica de Diagnóstico por Imagem (CDPI), Avenida das Américas, 4666, 302A, 303, 307, 325, 326, Barra da Tijuca, Rio de Janeiro, RJ 2640-102, Brazil.
Department of Radiology, Hospital Universitário Clementino Fraga Filho, Federal University of Rio de Janeiro, Rua Rodolpho Paulo Rocco 255, Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ 21941-913, Brazil.
Epilepsy Behav. 2018 Oct;87:7-13. doi: 10.1016/j.yebeh.2018.08.013. Epub 2018 Aug 24.
The aim of this study was to evaluate white matter (WM) integrity in vivo in patients with unilateral mesial temporal sclerosis (MTS).
Diffusion tensor imaging (DTI) findings from patients with left-sided MTS (L-MTS; N = 14) and right-sided MTS (R-MTS; N = 13), all taking antiepileptic medication, were compared with those from gender- and age-matched controls; DTI was performed along 30 noncollinear directions in a 1.5-T scanner. Tract-based spatial statistics (TBSS) analysis was performed by creating a WM skeleton; 5000-permutation-based inference (threshold, p < 0.05) was used to identify fractional anisotropy (FA) abnormalities. Mean (MD), radial (RD), and axial diffusivities (AD) were projected onto the mean FA skeleton.
Compared with the control groups, patients with MTS had decreased FA affecting widespread WM tracts as well as extensive areas with increased RD, bilaterally and independent of the disease side. Areas with decreased FA and increased RD overlapped substantially. There were no significant differences in DTI parameters between L-MTS and R-MTS patients.
Diffusion tensor imaging abnormalities were observed within and beyond the temporal lobe in patients with MTS. Patients with R- and L-MTS had extensive bilateral abnormalities in comparison to controls. These findings suggest that MTS pathobiology involves diffuse dysfunction of WM tracts, even in areas with no direct connections to the hippocampus.
本研究旨在评估单侧内侧颞叶硬化症（MTS）患者活体白质（WM）的完整性。
将所有正在服用抗癫痫药物的左侧MTS（L-MTS；n = 14）和右侧MTS（R-MTS；n = 13）患者的扩散张量成像（DTI）结果与性别和年龄匹配的对照组进行比较；在1.5-T扫描仪中沿30个非共线方向进行DTI检查。通过创建WM骨架进行基于体素的空间统计学（TBSS）分析；使用基于5000次排列的推断（阈值，p < 0.05）来识别各向异性分数（FA）异常。将平均扩散率（MD）、径向扩散率（RD）和轴向扩散率（AD）投影到平均FA骨架上。
与对照组相比，MTS患者的FA降低，影响广泛的WM束，并且RD增加的区域广泛，双侧均有，且与疾病侧无关。FA降低和RD增加的区域有很大重叠。L-MTS和R-MTS患者之间的DTI参数无显著差异。
在MTS患者的颞叶内外均观察到扩散张量成像异常。与对照组相比，R-MTS和L-MTS患者存在广泛的双侧异常。这些发现表明，MTS的病理生物学涉及WM束的弥漫性功能障碍，即使在与海马体无直接连接的区域也是如此。
