Mo Jiajie, Zhao Baotian, Adler Sophie, Zhang Jianguo, Shao Xiaoqiu, Ma Yanshan, Sang Lin, Hu Wenhan, Zhang Chao, Wang Yao, Wang Xiu, Liu Chang, Zhang Kai
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Department of Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
Quant Imaging Med Surg. 2021 May;11(5):1782-1795. doi: 10.21037/qims-20-624.
Magnetic resonance imaging (MRI) changes in hippocampal sclerosis (HS) could be subtle in a significant proportion of mesial temporal lobe epilepsy (mTLE) patients. In this study, we aimed to document the structural and functional changes in the hippocampus and amygdala seen in HS patients.
Quantitative features of the hippocampus and amygdala were extracted from structural MRI data in 66 mTLE patients and 28 controls. Structural covariance analysis was undertaken using volumetric data from the amygdala and hippocampus. Functional connectivity (FC) measured using resting intracranial electroencephalography (EEG) was analyzed in 22 HS patients and 16 non-HS disease controls.
Hippocampal atrophy was present in both MRI-positive and MRI-negative HS groups (Mann-Whitney : 7.61, P<0.01; Mann-Whitney : 6.51, P<0.01). Amygdala volumes were decreased in the patient group (Mann-Whitney : 2.92, P<0.05), especially in MRI-negative HS patients (Mann-Whitney : 2.75, P<0.05). The structural covariance analysis showed the normalized volumes of the amygdala and hippocampus were tightly coupled in both controls and HS patients (ρ =0.72, P<0.01). FC analysis indicated that HS patients had significantly increased connectivity (Student's : 2.58, P=0.03) within the hippocampus but decreased connectivity between the hippocampus and amygdala (Student's : 3.33, P=0.01), particularly for MRI-negative HS patients.
Quantitative structural changes, including hippocampal atrophy and temporal pole blurring, are present in both MRI-positive and MRI-negative HS patients, suggesting the potential usefulness of incorporating quantitative analyses into clinical practice. HS is characterized by increased intra-hippocampal EEG synchronization and decreased coupling between the hippocampus and amygdala.
在相当一部分内侧颞叶癫痫（mTLE）患者中，海马硬化（HS）的磁共振成像（MRI）变化可能很细微。在本研究中，我们旨在记录HS患者海马体和杏仁核的结构及功能变化。
从66例mTLE患者和28例对照的结构MRI数据中提取海马体和杏仁核的定量特征。使用杏仁核和海马体的体积数据进行结构协方差分析。对22例HS患者和16例非HS疾病对照进行静息颅内脑电图（EEG）测量功能连接性（FC）分析。
MRI阳性和MRI阴性HS组均存在海马萎缩（曼-惠特尼检验：7.61，P<0.01；曼-惠特尼检验：6.51，P<0.01）。患者组杏仁核体积减小（曼-惠特尼检验：2.92，P<0.05），尤其是MRI阴性HS患者（曼-惠特尼检验：2.75，P<0.05）。结构协方差分析显示，在对照和HS患者中，杏仁核和海马体的标准化体积紧密相关（ρ =0.72，P<0.01）。FC分析表明，HS患者海马体内连接性显著增加（学生t检验：2.58，P=0.03），但海马体与杏仁核之间的连接性降低（学生t检验：3.33，P=0.01），特别是MRI阴性HS患者。
MRI阳性和MRI阴性HS患者均存在包括海马萎缩和颞极模糊在内的定量结构变化，提示将定量分析纳入临床实践可能有用。HS的特征是海马内脑电图同步增加，海马体与杏仁核之间的耦合减少。
