Mathern G W, Kuhlman P A, Mendoza D, Pretorius J K
Division of Neurosurgery, School of Medicine, University of California, Los Angeles 90095-1769, USA.
J Neuropathol Exp Neurol. 1997 Feb;56(2):199-212. doi: 10.1097/00005072-199702000-00011.
This study determined fascia dentata anatomy and hippocampal neuron densities in patients with different epileptic syndromes. Based on presurgical data, patients were classified into: (a) pediatric patients (n=19); (b) temporal mass lesion cases (n=14); and (c) hippocampal sclerosis patients (n=31). Surgically removed hippocampi and autopsies (n=34) were studied for: (a) hippocampal neuron densities; (b) stratum granulosum (SG) widths and lengths; and (c) hilar areas. The number of granule cells and hilar neurons per tissue section were estimated from the neuron densities and fascia dentata area measurements. Results showed that compared with autopsies (p<0.05): (a) pediatric patients had similar SG and hilar areas; granule cell density was lower (but not hilar neuron density); and the estimated number of granule cells was lower (but not the number of hilar neurons); (b) the widths of SG and hilar areas were greater in mass lesion cases; the density of granule cells and hilar neurons was lower; and the total estimated numbers of granule cells and hilar neurons were similar to those of the autopsies; and (c) hippocampal sclerosis patients had wider, yet shorter SG; hilar areas were smaller; granule cell and hilar densities were lower; and the total estimated numbers of granule cells and hilar neurons were lower than those of the autopsy cases. The duration of the seizures did not correlate with lower fascia dentata neuron densities or estimates of total granule cell and hilar neurons. Furthermore, greater SG widths correlated with lower hilar and CA4 neuron densities, but not with age at first seizure or duration of epilepsy. These results indicate that the size of the fascia dentata SG and hilus along with hippocampal neuron densities differ between surgical patients with different epileptic syndromes, and a wider SG was associated with a lower density of end folium neurons. These findings support the hypothesis that hippocampal sclerosis and granule cell dispersion are not the consequence of repetitive seizures beginning at an early developmental age, but seem to differ depending on the type of epileptic syndrome.
本研究确定了不同癫痫综合征患者的齿状回解剖结构和海马神经元密度。根据术前数据，将患者分为：(a) 儿科患者（n = 19）；(b) 颞叶占位性病变病例（n = 14）；以及 (c) 海马硬化患者（n = 31）。对手术切除的海马体和尸检样本（n = 34）进行了以下研究：(a) 海马神经元密度；(b) 颗粒层（SG）的宽度和长度；以及 (c) 门区。根据神经元密度和齿状回面积测量值估算每个组织切片中的颗粒细胞和门区神经元数量。结果显示，与尸检样本相比（p < 0.05）：(a) 儿科患者的SG和门区相似；颗粒细胞密度较低（但门区神经元密度无差异）；颗粒细胞的估算数量较低（但门区神经元数量无差异）；(b) 占位性病变病例的SG和门区宽度更大；颗粒细胞和门区神经元密度较低；颗粒细胞和门区神经元的总估算数量与尸检样本相似；(c) 海马硬化患者的SG更宽但更短；门区更小；颗粒细胞和门区密度较低；颗粒细胞和门区神经元的总估算数量低于尸检病例。癫痫发作持续时间与较低的齿状回神经元密度或颗粒细胞和门区神经元总数的估算值无关。此外，SG宽度越大，与较低的门区和CA4神经元密度相关，但与首次发作年龄或癫痫持续时间无关。这些结果表明，不同癫痫综合征手术患者的齿状回SG和门区大小以及海马神经元密度存在差异，SG较宽与终叶神经元密度较低有关。这些发现支持了以下假设：海马硬化和颗粒细胞弥散不是早期发育阶段开始的重复性癫痫发作的结果，而是似乎因癫痫综合征类型而异。
