Epilepsy Program, Neurology Department, Hospital Clínic de Barcelona, EpiCARE: European Reference Network for Epilepsy, Institut D'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Carrer de Villarroel, 170, 08036, Barcelona, Spain.
Magnetic Resonance Imaging Core Facility, IDIBAPS, Barcelona, Spain.
Sci Rep. 2021 May 13;11(1):10199. doi: 10.1038/s41598-021-89010-z.
Glutamic acid decarboxylase 65 antibodies (anti-GAD65) have been found in patients with late-onset chronic temporal lobe epilepsy (TLE). No prior neuroimaging studies have addressed how they affect hippocampal volume and shape and how they relate to cognitive abnormalities. We aimed to investigate both brain structure and function in patients with isolated TLE and high anti-GAD65 levels (RIA ≥ 2000 U/ml) compared to 8 non-immune mesial TLE (niTLE) and 8 healthy controls (HC). Hippocampal subfield volume properties were correlated with the duration of the disease and cognitive test scores. The affected hippocampus of GAD-TLE patients showed no volume changes to matched HC whereas niTLE volumes were significantly smaller. Epilepsy duration in GAD-TLE patients correlated negatively with volumes in the presubiculum, subiculum, CA1, CA2-3, CA4, molecular layer and granule cell-molecular layer of the dentate nucleus. We found differences by advanced vertex-wise shape analysis in the anterior hippocampus of the left GAD-TLE compared to HC whereas left niTLE showed bilateral posterior hippocampus deformation. Verbal deficits were similar in GAD-TLE and niTLE but did not correlate to volume changes. These data might suggest a distinct expression of hippocampal structural and functional abnormalities based on the immune response.
谷氨酸脱羧酶 65 抗体（抗-GAD65）已在迟发性慢性颞叶癫痫（TLE）患者中发现。以前没有神经影像学研究探讨它们如何影响海马体积和形状，以及它们与认知异常的关系。我们旨在研究孤立性 TLE 患者和高抗-GAD65 水平（RIA≥2000 U/ml）与 8 例非免疫性内侧 TLE（niTLE）和 8 例健康对照组（HC）之间的脑结构和功能。海马亚区体积特性与疾病持续时间和认知测试评分相关。GAD-TLE 患者的受影响海马与匹配的 HC 相比没有体积变化，而 niTLE 体积明显较小。GAD-TLE 患者的癫痫持续时间与 presubiculum、subiculum、CA1、CA2-3、CA4、分子层和齿状核颗粒细胞-分子层的体积呈负相关。我们通过先进的顶点形状分析发现，左 GAD-TLE 患者的前海马存在差异，而左 niTLE 则表现为双侧后海马变形。GAD-TLE 和 niTLE 的语言缺陷相似，但与体积变化无关。这些数据可能表明基于免疫反应的海马结构和功能异常的独特表达。
