一项关于成人全生命周期癫痫相关灰质和白质损伤的全球谜题研究。
A WORLDWIDE ENIGMA STUDY ON EPILEPSY-RELATED GRAY AND WHITE MATTER COMPROMISE ACROSS THE ADULT LIFESPAN.
作者信息
Chen Judy, Ngo Alexander, Rodríguez-Cruces Raúl, Royer Jessica, Caligiuri Maria Eugenia, Gambardella Antonio, Concha Luis, Keller Simon S, Cendes Fernando, Yasuda Clarissa L, Alvim Marina K M, Bonilha Leonardo, Gleichgerrcht Ezequiel, Focke Niels K, Kreilkamp Barbara, Domin Martin, von Podewils Felix, Langner Soenke, Rummel Christian, Wiest Roland, Martin Pascal, Kotikalapudi Raviteja, Bender Benjamin, O'Brien Terence J, Sinclair Benjamin, Vivash Lucy, Kwan Patrick, Desmond Patricia M, Lui Elaine, Duma Gian Marco, Bonanni Paolo, Ballerini Alice, Vaudano Anna Elisabetta, Meletti Stefano, Tondelli Manuela, Alhusaini Saud, Doherty Colin P, Cavalleri Gianpiero L, Delanty Norman, Kälviäinen Reetta, Jackson Graeme D, Kowalczyk Magdalena, Mascalchi Mario, Semmelroch Mira, Thomas Rhys H, Soltanian-Zadeh Hamid, Davoodi-Bojd Esmaeil, Zhang Junsong, Lenge Matteo, Guerrini Renzo, Bartolini Emanuele, Hamandi Khalid, Foley Sonya, Rüber Theodor, Bauer Tobias, Weber Bernd, Caldairou Benoit, Depondt Chantal, Absil Julie, Carr Sarah J A, Abela Eugenio, Richardson Mark P, Devinsky Orrin, Pardoe Heath, Severino Mariasavina, Striano Pasquale, Tortora Domenico, Kaestner Erik, Hatton Sean N, Arienzo Donatello, Vos Sjoerd B, Ryten Mina, Taylor Peter N, Duncan John S, Whelan Christopher D, Galovic Marian, Winston Gavin P, Thomopoulos Sophia I, Thompson Paul M, Sisodiya Sanjay M, Labate Angelo, McDonald Carrie R, Caciagli Lorenzo, Bernasconi Neda, Bernasconi Andrea, Larivière Sara, Schrader Dewi, Bernhardt Boris C
机构信息
Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada.
Neuroscience Research Center, University Magna Græcia, Catanzaro, CZ, Italy.
出版信息
bioRxiv. 2024 Mar 6:2024.03.02.583073. doi: 10.1101/2024.03.02.583073.
OBJECTIVES
Temporal lobe epilepsy (TLE) is commonly associated with mesiotemporal pathology and widespread alterations of grey and white matter structures. Evidence supports a progressive condition although the temporal evolution of TLE is poorly defined. This ENIGMA-Epilepsy study utilized multimodal magnetic resonance imaging (MRI) data to investigate structural alterations in TLE patients across the adult lifespan. We charted both grey and white matter changes and explored the covariance of age-related alterations in both compartments.
METHODS
We studied 769 TLE patients and 885 healthy controls across an age range of 17-73 years, from multiple international sites. To assess potentially non-linear lifespan changes in TLE, we harmonized data and combined median split assessments with cross-sectional sliding window analyses of grey and white matter age-related changes. Covariance analyses examined the coupling of grey and white matter lifespan curves.
RESULTS
In TLE, age was associated with a robust grey matter thickness/volume decline across a broad cortico-subcortical territory, extending beyond the mesiotemporal disease epicentre. White matter changes were also widespread across multiple tracts with peak effects in temporo-limbic fibers. While changes spanned the adult time window, changes accelerated in cortical thickness, subcortical volume, and fractional anisotropy (all decreased), and mean diffusivity (increased) after age 55 years. Covariance analyses revealed strong limbic associations between white matter tracts and subcortical structures with cortical regions.
CONCLUSIONS
This study highlights the profound impact of TLE on lifespan changes in grey and white matter structures, with an acceleration of aging-related processes in later decades of life. Our findings motivate future longitudinal studies across the lifespan and emphasize the importance of prompt diagnosis as well as intervention in patients.
目的
颞叶癫痫（TLE）通常与内侧颞叶病变以及灰质和白质结构的广泛改变相关。有证据支持这是一种进行性疾病，尽管TLE的时间演变尚不清楚。这项ENIGMA - 癫痫研究利用多模态磁共振成像（MRI）数据来研究成年期TLE患者的结构改变。我们绘制了灰质和白质的变化情况，并探讨了两个脑区中与年龄相关改变的协方差。
方法
我们研究了来自多个国际地点的769例TLE患者和885例健康对照，年龄范围在17 - 73岁。为了评估TLE中潜在的非线性寿命变化，我们对数据进行了统一处理，并将中位数分割评估与灰质和白质年龄相关变化的横断面滑动窗口分析相结合。协方差分析检查了灰质和白质寿命曲线的耦合情况。
结果
在TLE中，年龄与广泛的皮质 - 皮质下区域灰质厚度/体积的显著下降相关，范围超出内侧颞叶疾病的中心部位。白质变化也广泛分布于多个神经束，在颞 - 边缘纤维中影响最为明显。虽然变化贯穿成年期，但在55岁以后，皮质厚度、皮质下体积和分数各向异性（均下降）以及平均扩散率（增加）的变化加速。协方差分析揭示了白质神经束与皮质下结构和皮质区域之间存在强烈的边缘关联。
结论
本研究强调了TLE对灰质和白质结构寿命变化的深远影响，在生命的后几十年中与衰老相关的过程加速。我们的研究结果促使未来开展贯穿整个寿命期的纵向研究，并强调对患者进行及时诊断和干预的重要性。
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