Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100053, PR China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing 100053, PR China.
Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100053, PR China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing 100053, PR China; Department of Radiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province 221006, PR China.
Epilepsy Behav. 2021 Oct;123:108272. doi: 10.1016/j.yebeh.2021.108272. Epub 2021 Sep 6.
The aims of this study were to investigate whether the cortical atrophy caused by temporal lobe epilepsy (TLE) was reversible after successful anterior temporal lobectomy (ATL) and to further observe whether possible changes are related to age at surgery and cognitive changes. Twelve patients with unilateral mesial TLE who received ATL and remained seizure free in one year follow-up were included. They underwent two MRI scans few days before and oneyear after surgery. Thirty age- and sex-matched healthy participants were recruited as controls. Group comparisons were used to test the differences in cortical thickness (CTh) between the pre-/postsurgical patients and controls. Longitudinal test was used to directly show postsurgical changes of the patients. Besides, the correlations between regional cortical volume (CVo) changes and age at surgery or cognitive changes were also tested. Compared with controls, the patients with TLE showed dispersed cortical thinning especially in the bilateral frontal lobes before surgery and no significant cortical thinning except for cortices near the resected areas after surgery. The longitudinal analysis showed CTh increment in the ipsilateral precentral and postcentral gyrus, cuneus and widespread in the contralateral cortex. In the volumetric analysis, the CVo changes in the contralateral hemisphere were negatively correlated with age at surgery and positively correlated with MoCA score changes. This study suggests that the cortical atrophy caused by TLE could recover after successful ATL. The recovery ability is greater in younger subjects and is positively related to cognitive recovery. These findings could serve as new clues that patients with TLE can benefit from timely and successful ATL.
本研究旨在探讨颞叶癫痫（TLE）所致皮质萎缩在成功的前颞叶切除术（ATL）后是否可逆，并进一步观察这些可能的变化是否与手术时的年龄和认知变化有关。纳入了 12 例接受单侧内侧 TLE 且在 1 年随访中保持无癫痫发作的患者。他们在手术前几天和手术后一年分别进行了两次 MRI 扫描。招募了 30 名年龄和性别匹配的健康参与者作为对照组。组间比较用于测试术前和术后患者与对照组之间皮质厚度（CTh）的差异。纵向测试用于直接显示患者术后的变化。此外，还测试了区域皮质体积（CVo）变化与手术时年龄或认知变化之间的相关性。与对照组相比，TLE 患者在手术前表现出分散的皮质变薄，特别是双侧额叶，手术后除了切除区域附近的皮质外，没有明显的皮质变薄。纵向分析显示同侧中央前回和中央后回、楔前叶和对侧皮质广泛的 CTh 增加。在体积分析中，对侧半球的 CVo 变化与手术时的年龄呈负相关，与 MoCA 评分变化呈正相关。本研究表明，成功的 ATL 后，TLE 引起的皮质萎缩可以恢复。年轻患者的恢复能力更强，与认知恢复呈正相关。这些发现可以为 TLE 患者从及时和成功的 ATL 中获益提供新的线索。
