Mo Jiajie, Wang Yao, Zhang Jianguo, Cai Lixin, Liu Qingzhu, Hu Wenhan, Sang Lin, Zhang Chao, Wang Xiu, Shao Xiaoqiu, Zhang Kai
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Department of Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
EJNMMI Res. 2022 Jun 3;12(1):32. doi: 10.1186/s13550-022-00902-1.
Hand automatisms (HA) are common clinical manifestations in mesial temporal lobe epilepsy. However, the location of the symptomatogenic zone (EZ) in HA as well as the networks involved, are still unclear. To have a better understanding of HA underlying mechanisms, we analyzed images from interictal [F] fluorodeoxyglucose-positron emission tomography (FDG-PET) in patients with mesial temporal lobe epilepsy (mTLE).
We retrospectively recruited 79 mTLE patients and 18 healthy people that substituted the control group for the analysis. All patients underwent anterior temporal lobectomy and were seizure-free. Based on the semiology of the HA occurrence, the patients were divided into three subgroups: patients with unilateral HA (Uni-HA), with bilateral HA (Bil-HA) and without HA (None-HA). We performed the intergroup comparison analysis of the interictal FDG-PET images and compared the functional connectivity within metabolic communities.
Our analysis showed that the metabolic patterns varied among the different groups. The Uni-HA subgroup had significant differences in the extratemporal lobe brain areas, mostly in the ipsilateral supplementary motor area (SMA) and middle cingulate cortex (MCC) when compared to the healthy control group. The Bil-HA subgroup demonstrated that the bilateral SMA and MCC areas were differentially affected, whereas in the None-HA subgroup the differences were evident in limited brain areas. The metabolic network involving HA showed a constrained network embedding the SMA and MCC brain regions. Furthermore, the increased metabolic synchronization between SMA and MCC was significantly correlated with HA.
The metabolic pattern of HA was most conspicuous in SMA and MCC brain regions. Increased metabolic synchronization within SMA and MCC was considered as the major EZ of HA.
手部自动症（HA）是内侧颞叶癫痫常见的临床表现。然而，HA中症状起始区（EZ）的位置以及所涉及的神经网络仍不清楚。为了更好地理解HA的潜在机制，我们分析了内侧颞叶癫痫（mTLE）患者发作间期[F]氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）图像。
我们回顾性招募了79例mTLE患者和18名健康人作为对照组进行分析。所有患者均接受了前颞叶切除术且术后无癫痫发作。根据HA发作的症状学，将患者分为三个亚组：单侧HA（Uni-HA）患者、双侧HA（Bil-HA）患者和无HA（None-HA）患者。我们对发作间期FDG-PET图像进行组间比较分析，并比较代谢群落内的功能连接性。
我们的分析表明，不同组之间的代谢模式有所不同。与健康对照组相比，Uni-HA亚组在颞叶外脑区存在显著差异，主要位于同侧辅助运动区（SMA）和中扣带回皮质（MCC）。Bil-HA亚组显示双侧SMA和MCC区域受到不同程度的影响，而在None-HA亚组中，差异仅在有限的脑区明显。涉及HA的代谢网络显示出一个包含SMA和MCC脑区的受限网络。此外，SMA和MCC之间代谢同步性的增加与HA显著相关。
HA的代谢模式在SMA和MCC脑区最为明显。SMA和MCC内代谢同步性的增加被认为是HA的主要EZ。
