Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China; Neurosurgical Institute of Fudan University, Shanghai, China; Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China.
Department of Neurosurgery, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, Hubei Province, China.
Epilepsy Behav. 2021 Jan;114(Pt A):107553. doi: 10.1016/j.yebeh.2020.107553. Epub 2020 Nov 28.
This study was conducted to explore the cerebellar substructure volumetric alterations in refractory unilateral temporal lobe epilepsy (TLE) patients and the relationship with clinical factors and cognitive scores.
A total of 48 unilateral refractory TLE patients and 48 age- and gender-matched normal controls (NCs) were retrospectively studied. All subjects underwent high-resolution magnetic resonance imaging (MRI) and automatically segmented volumetric brain information was obtained using volBrain and Data Processing Assistant for Resting-State fMRI (DPARSF) separately. Clinical seizure features and cognitive scores were acquired by a structured review of medical records.
The total volumes (TVs) of bilateral crus I, crus II, and IX were significantly smaller in the refractory unilateral TLE epilepsy patients. The gray matter volumes (GMVs) of cerebellar lobules showed lateralized reduction in ipsilateral III, IX, and contralateral crus II. Contralateral crus II GMV showed significant negative correlation with the duration of epilepsy (r = -0.31, p = 0.035) and positive association with the cognitive scores including long-term memory (LTM) (r = 0.39, p = 0.017), short-term memory (STM) (r = 0.51, p = 0.001) verbal comprehension index (VCI) (r = 0.37, p = 0.024), and perceptual organization index (POI) (r = 0.36, p = 0.030). The voxel-based morphometry (VBM) analysis proved similar results. The contralateral crus I GMV was significantly smaller in the generalized onset group (t = 2.536, p = 0.015).
The lobules of the cerebellar in refractory TLE patients manifest different volumetric change characteristics. Crus II contralateral GMV is negatively correlated with the duration of epilepsy and positively associated with the cognitive scores.
本研究旨在探讨耐药性单侧颞叶癫痫（TLE）患者小脑亚结构体积变化及其与临床因素和认知评分的关系。
回顾性研究了 48 例单侧耐药性 TLE 患者和 48 例年龄和性别匹配的正常对照组（NCs）。所有受试者均接受高分辨率磁共振成像（MRI）检查，并分别使用 volBrain 和 Data Processing Assistant for Resting-State fMRI（DPARSF）自动分割脑容积信息。通过对病历的结构化回顾获取临床发作特征和认知评分。
耐药性单侧 TLE 癫痫患者双侧小脑脚 I、小脑脚 II 和小脑脚 IX 的总容积（TVs）明显较小。小脑叶的灰质体积（GMVs）在同侧 III、IX 和对侧小脑脚 II 出现偏侧性减少。对侧小脑脚 II GMV 与癫痫持续时间呈显著负相关（r=-0.31，p=0.035），与包括长时记忆（LTM）（r=0.39，p=0.017）、短时记忆（STM）（r=0.51，p=0.001）、言语理解指数（VCI）（r=0.37，p=0.024）和知觉组织指数（POI）（r=0.36，p=0.030）在内的认知评分呈正相关。基于体素的形态计量学（VBM）分析得出了类似的结果。全面性发作组对侧小脑脚 I GMV 明显较小（t=2.536，p=0.015）。
耐药性 TLE 患者的小脑叶表现出不同的体积变化特征。对侧小脑脚 II GMV 与癫痫持续时间呈负相关，与认知评分呈正相关。
