Hamid Celona, Maiworm Michelle, Wagner Marlies, Knake Susanne, Nöth Ulrike, Deichmann Ralf, Gracien René-Maxime, Seiler Alexander
Department of Neurology, Goethe University Hospital, Frankfurt, Germany.
Brain Imaging Center, Goethe University Frankfurt, Frankfurt, Germany.
Front Neurol. 2023 Jul 17;14:1175971. doi: 10.3389/fneur.2023.1175971. eCollection 2023.
In patients with epilepsies of structural origin, brain atrophy and pathological alterations of the tissue microstructure extending beyond the putative epileptogenic lesion have been reported. However, in patients without any evidence of epileptogenic lesions on diagnostic magnetic resonance imaging (MRI), impairment of the brain microstructure has been scarcely elucidated. Using multiparametric quantitative (q) magnetic resonance imaging MRI, we aimed to investigate diffuse impairment of the microstructural tissue integrity in MRI-negative focal epilepsy patients.
27 MRI-negative patients with focal epilepsy (mean age 33.1 ± 14.2 years) and 27 matched healthy control subjects underwent multiparametric qMRI including T1, T2, and PD mapping at 3 T. After tissue segmentation based on synthetic anatomies, mean qMRI parameter values were extracted from the cerebral cortex, the white matter (WM) and the deep gray matter (GM) and compared between patients and control subjects. Apart from calculating mean values for the qMRI parameters across the respective compartments, voxel-wise analyses were performed for each tissue class.
There were no significant differences for mean values of quantitative T1, T2, and PD obtained from the cortex, the WM and the deep GM between the groups. Furthermore, the voxel-wise analyses did not reveal any clusters indicating significant differences between patients and control subjects for the qMRI parameters in the respective compartments.
Based on the employed methodology, no indication for an impairment of the cerebral microstructural tissue integrity in MRI-negative patients with focal epilepsy was found in this study. Further research will be necessary to identify relevant factors and mechanisms contributing to microstructural brain tissue damage in various subgroups of patients with epilepsy.
在结构性起源的癫痫患者中，已报道存在脑萎缩以及超出假定致痫灶的组织微观结构病理改变。然而，在诊断性磁共振成像（MRI）上无任何致痫灶证据的患者中，脑微观结构损害鲜有阐明。我们使用多参数定量（q）磁共振成像，旨在研究MRI阴性局灶性癫痫患者微观结构组织完整性的弥漫性损害。
27例MRI阴性局灶性癫痫患者（平均年龄33.1±14.2岁）和27例匹配的健康对照者接受了3T的多参数qMRI检查，包括T1、T2和质子密度（PD）成像。基于合成解剖结构进行组织分割后，从大脑皮质、白质（WM）和深部灰质（GM）中提取平均qMRI参数值，并在患者和对照者之间进行比较。除了计算各区域qMRI参数的平均值外，还对每个组织类别进行了体素分析。
两组之间从皮质、WM和深部GM获得的定量T1、T2和PD平均值无显著差异。此外，体素分析未发现任何簇显示各区域qMRI参数在患者和对照者之间存在显著差异。
基于所采用的方法，本研究未发现MRI阴性局灶性癫痫患者存在脑微观结构组织完整性受损的迹象。有必要进行进一步研究，以确定导致癫痫患者不同亚组脑微观结构组织损伤的相关因素和机制。
