颞叶癫痫患者糖脂代谢系统功能障碍的不对称性：一项 DTI-ALPS 研究。
The asymmetry of glymphatic system dysfunction in patients with temporal lobe epilepsy: A DTI-ALPS study.
机构信息
Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
出版信息
J Neuroradiol. 2023 Nov;50(6):562-567. doi: 10.1016/j.neurad.2023.05.009. Epub 2023 Jun 8.
BACKGROUND AND PURPOSE
While the occurrence of glymphatic system dysfunction has been observed in temporal lobe epilepsy (TLE), the potential asymmetry of this system has yet to be investigated in the TLE context. We aimed to investigate the glymphatic system function in both hemispheres and to analyze asymmetric features of the glymphatic system in TLE patients using diffusion tensor image analysis along the perivascular space (DTI-ALPS) method.
MATERIALS AND METHODS
43 patients (left TLE (LTLE), n = 20; right TLE (RTLE), n = 23) and 39 healthy controls (HC) were enrolled in this study. The DTI-ALPS index was calculated for the left (left ALPS index) and right (right ALPS index) hemispheres respectively. An asymmetry index (AI) was calculated by AI = (Right - Left)/ [(Right + Left)/2] to represent the asymmetric pattern. Independent two sample t-test, two-sample paired t-test or one-way ANOVA with Bonferroni correction were conducted to compare the differences in ALPS indices and AI among the groups.
RESULTS
Both left ALPS index (p = 0.040) and right ALPS index (p = 0.001) of RTLE patients were significantly decreased, while only left ALPS index of LTLE patients (p = 0.005) was reduced. Compared to contralateral ALPS index, the ipsilateral ALPS index was significantly decreased in TLE (p = 0.008) and RTLE (p = 0.009) patients. Leftward asymmetry of the glymphatic system was found in HC (p = 0.045) and RTLE (p = 0.009) patients. The LTLE patients presented reduced asymmetric traits when compared to RTLE patients (p = 0.029).
CONCLUSION
The TLE patients exhibited altered ALPS indices, which could be triggered by glymphatic system dysfunction. Altered ALPS indices were more severe in ipsilateral than in the contralateral hemisphere. Moreover, LTLE and RTLE patients exhibited different change patterns of the glymphatic system. In addition, glymphatic system function presented asymmetric patterns in both normal adult brain and RTLE patients.
背景与目的
虽然在颞叶癫痫（TLE）中已经观察到糖质系统功能障碍的发生，但在 TLE 背景下，尚未对该系统的潜在不对称性进行研究。我们旨在使用血管周围空间弥散张量成像分析（DTI-ALPS）方法，分别在两个半球中研究糖质系统功能，并分析 TLE 患者的糖质系统不对称特征。
材料与方法
本研究纳入了 43 名患者（左颞叶癫痫（LTLE），n=20；右颞叶癫痫（RTLE），n=23）和 39 名健康对照者（HC）。分别计算左（左 ALPS 指数）和右（右 ALPS 指数）半球的 DTI-ALPS 指数。通过 AI=（右侧-左侧）/[（右侧+左侧）/2]计算不对称指数（AI），以表示不对称模式。采用独立样本 t 检验、两样本配对 t 检验或单因素方差分析（ANOVA），并用 Bonferroni 校正比较各组间 ALPS 指数和 AI 的差异。
结果
RTLE 患者的左 ALPS 指数（p=0.040）和右 ALPS 指数（p=0.001）均显著降低，而仅 LTLE 患者的左 ALPS 指数（p=0.005）降低。与对侧 ALPS 指数相比，TLE（p=0.008）和 RTLE（p=0.009）患者的同侧 ALPS 指数显著降低。在 HC（p=0.045）和 RTLE（p=0.009）患者中发现糖质系统的左侧不对称。与 RTLE 患者相比，LTLE 患者表现出减少的不对称特征（p=0.029）。
结论
TLE 患者表现出改变的 ALPS 指数，这可能是由糖质系统功能障碍引起的。在同侧半球，改变的 ALPS 指数比在对侧半球更严重。此外，LTLE 和 RTLE 患者的糖质系统表现出不同的变化模式。此外，在正常成人脑和 RTLE 患者中，糖质系统功能均呈现不对称模式。
Zotero 插件