Tung Hsin, Pan Szu-Yen, Lan Tsuo-Hung, Lin Yung-Yang, Peng Syu-Jyun
Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Center of Faculty Development, Taichung Veterans General Hospital, Taichung, Taiwan.
Front Neurol. 2022 Feb 10;12:810186. doi: 10.3389/fneur.2021.810186. eCollection 2021.
Brain cortico-subcortical connectivity has been investigated in epilepsy using the functional MRI (MRI). Although structural images cannot demonstrate dynamic changes, they provide higher spatial resolution, which allows exploration of the organization of brain in greater detail.
We used high-resolution brain MRI to study the hippocampal-thalamic-cortical networks in temporal lobe epilepsy (TLE) using a volume-based morphometric method. We enrolled 22 right-TLE, 33 left-TLE, and 28 age/gender-matched controls retrospectively. FreeSurfer software was used for the thalamus segmentation.
Among the 50 subfields, ipsilateral anterior, lateral, and parts of the intralaminar and medial nuclei, as well as the contralateral parts of lateral nuclei had significant volume loss in both TLE. The anteroventral nucleus was most vulnerable. Most thalamic subfields were susceptible to seizure burden, especially the left-TLE. SPM12 was used to conduct an analysis of the gray matter density (GMD) maps. Decreased extratemporal GMD occurred bilaterally. Both TLE demonstrated significant GMD loss over the ipsilateral inferior frontal gyrus, precentral gyrus, and medial orbital cortices.
Thalamic subfield atrophy was related to the ipsilateral inferior frontal GMD changes, which presented positively in left-TLE and negatively in right-TLE. These findings suggest prefrontal-thalamo-hippocampal network disruption in TLE.
利用功能磁共振成像（fMRI）对癫痫患者的脑皮质-皮质下连接进行了研究。虽然结构图像无法显示动态变化，但它们提供了更高的空间分辨率，从而能够更详细地探索大脑的组织结构。
我们使用高分辨率脑MRI，采用基于体积的形态测量方法研究颞叶癫痫（TLE）患者的海马-丘脑-皮质网络。我们回顾性纳入了22例右侧TLE患者、33例左侧TLE患者以及28例年龄/性别匹配的对照者。使用FreeSurfer软件进行丘脑分割。
在50个亚区中，双侧TLE患者的同侧前核、外侧核以及部分板内核和内侧核，以及外侧核的对侧部分均有显著体积减小。前腹核最为脆弱。大多数丘脑亚区易受发作负担影响，尤其是左侧TLE患者。使用SPM12对灰质密度（GMD）图进行分析。双侧颞外GMD降低。双侧TLE患者在同侧额下回、中央前回和眶内侧皮质均有显著的GMD损失。
丘脑亚区萎缩与同侧额下回GMD变化有关，在左侧TLE中呈正相关，在右侧TLE中呈负相关。这些发现提示TLE患者存在前额叶-丘脑-海马网络破坏。
