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目的研究伴海马硬化及占位性内侧颞叶癫痫(m TLE)脑灰质形态改变的差异,并探讨不同类型m TLE脑结构损伤特征及潜在的病理生理机制。方法对30例伴海马硬化m TLE(m TLE-HS)、30例颞叶占位性m TLE患者(m TLE-OL)以及30名健康受试者进行全脑扫描,采用磁化准备快速梯度回波成像(MPRAGE)序列获得三维T1结构图像。运用代价函数对图像预处理,应用非线性映射空间变换的基于体素的形态学测量(VBM)进行分析,比较不同病因m TLE颞叶外脑灰质体积(GMV)的改变,并观察m TLE患者GMV改变与病程的相关性。结果相比于正常对照组,两组m TLE均有颞叶外的GMV改变,但变化脑区分布模式不同:m TLE-HS显示更广泛的脑灰质萎缩(P<0.01,Alpha-Sim校正)。m TLE-HS患者局部GMV与病程无明显相关性;m TLE-OL患者对侧顶下叶及患侧基底节区GMV与病程负相关。结论不同类型m TLE脑灰质形态学改变不同,提示两者存在的癫痫网络有所不同,进一步证实了m TLE-HS为一种特异性癫痫综合征。
Objective To investigate the changes of cerebral gray matter in hippocampal sclerosis and space-occupying medial temporal lobe epilepsy (m TLE), and to explore the characteristics of brain damage in different types of m TLE and the underlying pathophysiological mechanisms. Methods Thirty patients (m TLE-HS) with hippocampal sclerosis, m TLE-OL with 30 patients with temporal lobe m TLE and 30 healthy subjects underwent whole-brain scanning. Wave imaging (MPRAGE) sequence to obtain a three-dimensional T1 structure image. The voxel-based morphometric measurement (VBM) of image preprocessing and non-linear mapping space transformation was used to analyze the change of GMV in m TLE with different etiologies and to observe the changes of mTLE patients Correlation of GMV changes with course of disease. Results Compared with the normal control group, both mTLE had temporal lobe GMV changes but the pattern of altered brain regions varied: m TLE-HS showed more extensive gray matter atrophy (P <0.01, Alpha-Sim correction) . There was no significant correlation between the local GMV and the course of disease in patients with TLE-HS. The patients with TLE-OL had a negative correlation with the duration of GMV in the inferior parietal and ipsilateral basal ganglia. Conclusion Different morphological changes of different types of m TLE brain gray matter, suggesting that there is a difference between the two epilepsy network, and further confirmed m TLE-HS as a specific epilepsy syndrome.