Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
NeuroImaging Network (NIN), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
Acta Neurol Belg. 2020 Dec;120(6):1323-1331. doi: 10.1007/s13760-019-01074-x. Epub 2019 Jan 11.
Mesial temporal lobe epilepsy (mTLE) is a chronic focal epileptic disorder characterized by recalcitrant seizures often necessitating surgical intervention. Identifying the laterality of seizure focus is crucial for pre-surgical planning. We implemented diffusion MRI (DMRI) connectometry to identify differences in white matter connectivity in patients with left and right mTLE relative to healthy control subjects.
We enrolled 12 patients with right mTLE, 12 patients with left mTLE, and 12 age/sex matched healthy controls (HCs). We used DMRI connectometry to identify local connectivity patterns of white matter tracts, based on quantitative anisotropy (QA). We compared QA of white matter to reconstruct tracts with significant difference in connectivity between patients and HCs and then between patients with left and right mTLE.
Right mTLE patients show higher anisotropy in left inferior longitudinal fasciculus (ILF) and forceps minor and lower QA in genu of corpus callosum (CC), bilateral corticospinal tracts (CSTs), and bilateral middle cerebellar peduncles (MCPs) compared to HCs. Left mTLE patients show higher anisotropy in genu of CC, bilateral CSTs, and right MCP and decreased anisotropy in forceps minor compared to HCs. Compared to patients with right mTLE, left mTLE patients showed increased and decreased connectivity in some major tracts.
Our study showed the pattern of microstructural disintegrity in mTLE patients relative to HCs. We demonstrated that left and right mTLE patients have discrepant alternations in their white matter microstructure. These results may indicate that left and right mTLE have different underlying pathologic mechanisms.
内侧颞叶癫痫（mTLE）是一种慢性局灶性癫痫疾病，其特征为顽固的癫痫发作，通常需要手术干预。确定癫痫灶的侧别对于术前规划至关重要。我们实施弥散磁共振成像（DMRI）连接测量，以确定左、右侧 mTLE 患者相对于健康对照者（HCs）的白质连接差异。
我们纳入了 12 例右侧 mTLE 患者、12 例左侧 mTLE 患者和 12 例年龄/性别匹配的健康对照者（HCs）。我们使用 DMRI 连接测量，基于各向异性分数（QA）识别白质的局部连接模式。我们比较了白质的 QA，以重建在患者与 HCs 之间、以及在左、右侧 mTLE 患者之间连接存在显著差异的白质束。
与 HCs 相比，右侧 mTLE 患者的左侧下纵束（ILF）和小内囊束的各向异性分数较高，而胼胝体膝部（CC）、双侧皮质脊髓束（CSTs）和双侧小脑上脚（MCPs）的 QA 较低。左侧 mTLE 患者的 CC 膝部、双侧 CSTs 和右侧 MCP 的各向异性分数较高，而小内囊束的各向异性分数较低。与右侧 mTLE 患者相比，左侧 mTLE 患者在一些主要束中有更多和更少的连接。
本研究显示了 mTLE 患者相对于 HCs 的微观结构不完整性模式。我们证明了左、右侧 mTLE 患者的白质微观结构存在不同的改变。这些结果可能表明左、右侧 mTLE 具有不同的潜在病理机制。
