Wang Ge, Liu Xianghe, Zhang Min, Wang Kangrun, Liu Chaorong, Chen Yayu, Wu Wenyue, Zhao Haiting, Xiao Bo, Wan Lily, Long Lili
Department of Neurology, Xiangya Hospital, Central South University, Changsha, China.
National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
Front Neurol. 2023 Aug 3;14:1213224. doi: 10.3389/fneur.2023.1213224. eCollection 2023.
This study aimed to comprehensively explore the cerebellar structural and functional changes in temporal lobe epilepsy (TLE) and its association with clinical information.
The SUIT toolbox was utilized to perform cerebellar volume and diffusion analysis. In addition, we extracted the average diffusion values of cerebellar peduncle tracts to investigate microstructure alterations. Seed-based whole-brain analysis was used to investigate cerebellar-cerebral functional connectivity (FC). Subgroup analyses were performed to identify the cerebellar participation in TLE with/without hippocampal sclerosis (HS)/focal-to-bilateral tonic-clonic seizure (FBTCS) and TLE with different lateralization.
TLE showed widespread gray matter atrophy in bilateral crusII, VIIb, VIIIb, left crusI, and left VIIIa. Both voxel and tract analysis observed diffusion abnormalities in cerebellar afferent peduncles. Reduced FC between the right crus II and the left parahippocampal cortex was found in TLE. Additionally, TLE showed increased FCs between left lobules VI-VIII and cortical nodes of the dorsal attention and visual networks. Across all patients, decreased FC was associated with poorer cognitive function, while increased FCs appeared to reflect compensatory effects. The cerebellar structural changes were mainly observed in HS and FBTCS subgroups and were regardless of seizure lateralization, while cerebellar-cerebral FC alterations were similar in all subgroups.
TLE exhibited microstructural changes in the cerebellum, mainly related to HS and FBTCS. In addition, altered cerebellar-cerebral functional connectivity is associated with common cognitive alterations in TLE.
本研究旨在全面探索颞叶癫痫（TLE）患者小脑的结构和功能变化及其与临床信息的关联。
使用SUIT工具包进行小脑体积和扩散分析。此外，我们提取了小脑脚束的平均扩散值以研究微观结构改变。基于种子点的全脑分析用于研究小脑-大脑功能连接（FC）。进行亚组分析以确定小脑在伴/不伴海马硬化（HS）/局灶性至双侧强直阵挛发作（FBTCS）的TLE以及不同侧化的TLE中的参与情况。
TLE患者双侧小脑 CrusII、VIIb、VIIIb、左侧 CrusI 和左侧 VIIIa 出现广泛灰质萎缩。体素和束分析均观察到小脑传入脚的扩散异常。TLE患者右侧 Crus II与左侧海马旁皮质之间的FC降低。此外，TLE患者左侧小叶VI-VIII与背侧注意和视觉网络的皮质节点之间的FC增加。在所有患者中，FC降低与较差的认知功能相关，而FC增加似乎反映了代偿作用。小脑结构变化主要在HS和FBTCS亚组中观察到，且与发作侧化无关，而小脑-大脑FC改变在所有亚组中相似。
TLE患者小脑存在微观结构变化，主要与HS和FBTCS有关。此外，小脑-大脑功能连接改变与TLE常见的认知改变相关。
