Li Wei, Jiang Yuchao, Li Xiuli, Huang Huan, Lei Du, Li Jinmei, Zhang Heng, Yao Dezhong, Luo Cheng, Gong Qiyong, Zhou Dong, An Dongmei
Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China; National Clinical Research Center for Geriatrics, Department of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China.
The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, Center for Information in Medicine, School of life Science and technology, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.
Seizure. 2023 Oct;111:130-137. doi: 10.1016/j.seizure.2023.08.003. Epub 2023 Aug 7.
To explore clinical and structural differences between mesial temporal lobe epilepsy (mTLE) patients with different hippocampal sclerosis (HS) subtypes.
High-resolution T1-weighted MRI and diffusion tensor imaging data were obtained in 41 refractory mTLE patients and 52 age- and sex-matched healthy controls. Postoperative histopathological examination confirmed HS type 1 in 30 patients and HS type 2 in eleven patients. Clinical features, postoperative seizure outcomes, hippocampal subfields volumes, fractional anisotropy (FA) values of white matter regions and graph theory parameters were explored and compared between the HS type 1 and HS type 2 groups.
No significant differences in clinical features and postsurgical seizure outcomes were found between the HS type 1 and type 2 groups. However, the HS type 1 group showed extra atrophy in ipsilateral parasubiculum than healthy controls and more severe atrophy in contralateral hippocampal fissure than the HS type 2 group. More extensive FA decrease were also observed in the HS type 1 group, involving ipsilateral optic radiation, superior fronto-occipital fasciculus, contralateral uncinate fasciculus, tapetum, bilateral hippocampal cingulum, corona radiata, etc. Furthermore, in spite of similar impairments in characteristic path length, global efficiency and local efficiency in two HS groups, the HS type 1 group showed additional decrease of clustering coefficient than healthy controls.
HS type 1 and 2 groups had similar clinical characteristics and postoperative seizure outcomes. More widespread neuronal cell loss in the HS type 1 group contributed to more extensive structural damage and connectivity abnormality. These results shed new light on the imaging correlates of different HS pathology.
探讨不同海马硬化（HS）亚型的内侧颞叶癫痫（mTLE）患者之间的临床和结构差异。
对41例难治性mTLE患者和52例年龄及性别匹配的健康对照者进行高分辨率T1加权磁共振成像（MRI）和扩散张量成像（DTI）数据采集。术后组织病理学检查证实30例患者为1型HS，11例患者为2型HS。对1型HS组和2型HS组的临床特征、术后癫痫发作结果、海马亚区体积、白质区域的分数各向异性（FA）值及图论参数进行探索和比较。
1型HS组和2型HS组在临床特征和术后癫痫发作结果方面未发现显著差异。然而，1型HS组同侧副下托的萎缩程度比健康对照者更严重，对侧海马裂的萎缩程度比2型HS组更严重。1型HS组还观察到更广泛的FA降低，涉及同侧视辐射、额枕上束、对侧钩束、毯部、双侧海马扣带、放射冠等。此外，尽管两个HS组在特征路径长度、全局效率和局部效率方面有相似的损伤，但1型HS组的聚类系数比健康对照者进一步降低。
1型HS组和2型HS组具有相似的临床特征和术后癫痫发作结果。1型HS组更广泛的神经元细胞丢失导致了更广泛的结构损伤和连接异常。这些结果为不同HS病理的影像学相关性提供了新的见解。
