海马硬化型内侧颞叶癫痫患者脑灰质不对称性的基于体素形态学测量分析
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摘要
目的探讨海马硬化型内侧颞叶癫痫(MTLE-HS)患者脑灰质体积(GMV)不对称性的特点。方法搜集25例MTLE-HS患者(左侧13例,右侧12例)及25名正常志愿者的三维容积成像数据,采用基于体素的形态学测量分析(VBM),计算不对称系数(AI),分析不同侧别MTLE-HS患者GMV不对称性的差异。结果与正常对照组(HC)相比,MTLE-HS组GMV的不对称性范围缩小,右侧MTLE-HS组缩小更明显。三组间颞叶及部分颞叶外脑区包括丘脑、小脑等的GMV不对称性存在统计学差异。结论 MTLE-HS患者颞叶及颞叶外脑区GMV的不对称性发生改变,且致痫灶起源侧不同对该不对称性的影响不同,可能与两组患者颞叶与颞叶外脑区之间结构连接的强度不同、病情差异或两组之间具有不同发病机制有关,尚待进一步研究。
Objective To investigate gray matter volume(GMV) asymmetry in patients with mesial temporal lobe epilepsy with hippocampal sclerosis(MTLE-HS).Methods 25 MTLE-HS patients(13 with left-sided and 12 with right-sided hippocampal sclerosis) and 25 healthy adults were enrolled.Using voxel-based morphometry(VBM),the asymmetry indexes(AI) of GMV were calculated to analyze the GMV asymmetry of MTLE-HS patients and compare the differences of GMV asymmetry among the three groups.Results Compared to healthy control(HC),there was a significant reduction of GMV asymmetry in MTLE-HS patients,which was more obvious in right MTLE-HS(RMTLE-HS) patients.Besides,the differences of AI among the three groups were observed in mesiotemporal structures as well as extratemporal regions such as thalamus and cerebellum.Conclusion The GMV asymmetry in MTLE-HS patients is altered,affecting both temporal lobes and extratemporal regions.The differences of asymmetry characteristics between LMTLE-HS and RMTLE-HS groups may be related to the different structural connectivity,different clinical features or the probably different pathogenesis that needs further verification.
Objective To investigate gray matter volume(GMV) asymmetry in patients with mesial temporal lobe epilepsy with hippocampal sclerosis(MTLE-HS).Methods 25 MTLE-HS patients(13 with left-sided and 12 with right-sided hippocampal sclerosis) and 25 healthy adults were enrolled.Using voxel-based morphometry(VBM),the asymmetry indexes(AI) of GMV were calculated to analyze the GMV asymmetry of MTLE-HS patients and compare the differences of GMV asymmetry among the three groups.Results Compared to healthy control(HC),there was a significant reduction of GMV asymmetry in MTLE-HS patients,which was more obvious in right MTLE-HS(RMTLE-HS) patients.Besides,the differences of AI among the three groups were observed in mesiotemporal structures as well as extratemporal regions such as thalamus and cerebellum.Conclusion The GMV asymmetry in MTLE-HS patients is altered,affecting both temporal lobes and extratemporal regions.The differences of asymmetry characteristics between LMTLE-HS and RMTLE-HS groups may be related to the different structural connectivity,different clinical features or the probably different pathogenesis that needs further verification.
引文
1 Takao H,Hayashi N,Ohtomo K.White matter asymmetry in healthy individuals:a diffusion tensor imaging study using tract-based spatial statistics[J].Neuroscience,2011,193:291-299.
2 Toga AW,Thompson PM.Mapping brain asymmetry[J].Nat Rev Neurosci,2003,4:37-48.
3 Park HY,Hwang JY,Jung WH,et al.Altered asymmetry of the anterior cingulate cortex in subjects at genetic high risk for psychosis[J].Schizophr Res,2013,150:512-518.
4 Li W,Li J,Xian J,et al.Alterations of grey matter asymmetries in adolescents with prelingual deafness:a combined VBM and cortical thickness analysis[J].Restor Neurol Neurosci,2013,31:1-17.
5吴晟,孔祥闯,余建明,等.基于体素灰质不对称性方法的单侧突发感音神经性耳聋研究[J].临床放射学杂志,2017,36:1579-1583.
6 Zhao X,Zhou Z,Zhu W,et al.Role of conventional magnetic resonance imaging in the screening of epilepsy with structural abnormalities:a pictorial essay[J].Am J Nucl Med Mol Imaging,2017,7:126-137.
7 Pustina D,Avants B,Sperling M,et al.Predicting the laterality of temporal lobe epilepsy from PET,MRI,and DTI:A multimodal study[J].NeuroImage Clinical,2015,9:20-31.
8 Keller SS,Roberts N.Voxel-based morphometry of temporal lobe epilepsy:an introduction and review of the literature[J].Epilepsia,2008,49:741-757.
9 Kurth F,Gaser C,Luders E.A 12-step user guide for analyzing voxel-wise gray matter asymmetries in statistical parametric mapping(SPM)[J].Nat Protoc,2015,10:293-304.
10 Scanlon C,Mueller SG,Cheong I,et al.Grey and white matter abnormalities in temporal lobe epilepsy with and without mesial temporal sclerosis[J].J Neurol,2013,260:2320-2329.
11 Hagemann G,Lemieux L,Free SL,et al.Cerebellar volumes in newly diagnosed and chronic epilepsy[J].J Neurol,2002,249:1651-1658.
12 Ashburner J,Friston KJ.Voxel-based morphometry-the methods[J].Neuroimage,2000,11:805-821.
13 Li J,Zhang Z,Shang H.A meta-analysis of voxel-based morphometry studies on unilateral refractory temporal lobe epilepsy[J].Epilepsy Res,2012,98:97-103.
14 Malmgren K,Thom M.Hippocampal sclerosis-origins and imaging[J].Epilepsia,2012,53:19-33.
15 Besson P,Dinkelacker V,Valabregue R,et al.Structural connectivity differences in left and right temporal lobe epilepsy[J].Neuroimage,2014,100:135-144.
16 Jang SH,Yeo SS.Thalamocortical tract between anterior thalamic nuclei and cingulate gyrus in the human brain:diffusion tensor tractography study[J].Brain Imaging Behav,2013,7:236-241.
17 Bonilha L,Rorden C,Castellano G,et al.Voxel-based morphometry of the thalamus in patients with refractory medial temporal lobe epilepsy[J].Neuroimage,2005,25:1016-1021.
18 Kim JS,Koo DL,Joo EY,et al.Asymmetric Gray Matter Volume Changes Associated with Epilepsy Duration and Seizure Frequency in TemporalLobeEpilepsy Patients with Favorable Surgical Outcome[J].J Clin Neurol,2016,12:323-331.
19 Pail M,Brazdil M,Merecek R,et al.An optimized voxel-based morphometric study of gray matter changes in patients with left-sided and right-sided mesial temporal lobe epilepsy and hippocampal sclerosis(MTLE/HS)[J].Epilepsia,2010,51:511-518.
20 Liu M,Bernhardt BC,Bernasconi A,et al.Gray matter structural compromise is equally distributed in left and right temporal lobe epilepsy[J].Hum Brain Mapp,2016,37:515-524.
2 Toga AW,Thompson PM.Mapping brain asymmetry[J].Nat Rev Neurosci,2003,4:37-48.
3 Park HY,Hwang JY,Jung WH,et al.Altered asymmetry of the anterior cingulate cortex in subjects at genetic high risk for psychosis[J].Schizophr Res,2013,150:512-518.
4 Li W,Li J,Xian J,et al.Alterations of grey matter asymmetries in adolescents with prelingual deafness:a combined VBM and cortical thickness analysis[J].Restor Neurol Neurosci,2013,31:1-17.
5吴晟,孔祥闯,余建明,等.基于体素灰质不对称性方法的单侧突发感音神经性耳聋研究[J].临床放射学杂志,2017,36:1579-1583.
6 Zhao X,Zhou Z,Zhu W,et al.Role of conventional magnetic resonance imaging in the screening of epilepsy with structural abnormalities:a pictorial essay[J].Am J Nucl Med Mol Imaging,2017,7:126-137.
7 Pustina D,Avants B,Sperling M,et al.Predicting the laterality of temporal lobe epilepsy from PET,MRI,and DTI:A multimodal study[J].NeuroImage Clinical,2015,9:20-31.
8 Keller SS,Roberts N.Voxel-based morphometry of temporal lobe epilepsy:an introduction and review of the literature[J].Epilepsia,2008,49:741-757.
9 Kurth F,Gaser C,Luders E.A 12-step user guide for analyzing voxel-wise gray matter asymmetries in statistical parametric mapping(SPM)[J].Nat Protoc,2015,10:293-304.
10 Scanlon C,Mueller SG,Cheong I,et al.Grey and white matter abnormalities in temporal lobe epilepsy with and without mesial temporal sclerosis[J].J Neurol,2013,260:2320-2329.
11 Hagemann G,Lemieux L,Free SL,et al.Cerebellar volumes in newly diagnosed and chronic epilepsy[J].J Neurol,2002,249:1651-1658.
12 Ashburner J,Friston KJ.Voxel-based morphometry-the methods[J].Neuroimage,2000,11:805-821.
13 Li J,Zhang Z,Shang H.A meta-analysis of voxel-based morphometry studies on unilateral refractory temporal lobe epilepsy[J].Epilepsy Res,2012,98:97-103.
14 Malmgren K,Thom M.Hippocampal sclerosis-origins and imaging[J].Epilepsia,2012,53:19-33.
15 Besson P,Dinkelacker V,Valabregue R,et al.Structural connectivity differences in left and right temporal lobe epilepsy[J].Neuroimage,2014,100:135-144.
16 Jang SH,Yeo SS.Thalamocortical tract between anterior thalamic nuclei and cingulate gyrus in the human brain:diffusion tensor tractography study[J].Brain Imaging Behav,2013,7:236-241.
17 Bonilha L,Rorden C,Castellano G,et al.Voxel-based morphometry of the thalamus in patients with refractory medial temporal lobe epilepsy[J].Neuroimage,2005,25:1016-1021.
18 Kim JS,Koo DL,Joo EY,et al.Asymmetric Gray Matter Volume Changes Associated with Epilepsy Duration and Seizure Frequency in TemporalLobeEpilepsy Patients with Favorable Surgical Outcome[J].J Clin Neurol,2016,12:323-331.
19 Pail M,Brazdil M,Merecek R,et al.An optimized voxel-based morphometric study of gray matter changes in patients with left-sided and right-sided mesial temporal lobe epilepsy and hippocampal sclerosis(MTLE/HS)[J].Epilepsia,2010,51:511-518.
20 Liu M,Bernhardt BC,Bernasconi A,et al.Gray matter structural compromise is equally distributed in left and right temporal lobe epilepsy[J].Hum Brain Mapp,2016,37:515-524.