脑源性神经生长因子对齿状回miR-132表达及抑制性电流的影响

目的:探讨脑源性神经生长因子(BDNF)对海马mi R-132的表达及齿状回颗粒细胞抑制性突触后电流(sIPSCs)的影响,明确BDNF对颞叶内侧癫痫(MTLE)发病机制的作用。方法:选取哈医大一院神经外科2008年4月-2010年10月手术治疗的MTLE患者12例海马组织。RT-pcr技术检测BDNF孵育后mir-132表达,脑片膜片钳技术检测BDNF对sIPSCs的影响。结果:BDNF升高了颞叶癫痫海马mi RNA-132的表达(P0.01),减弱了颗粒细胞sIPSCs的频率和幅度(P0.01)。结论:BDNF升高了海马mir-132的表达,减弱颗粒细胞sIPSCs的频率和幅度,可能对MTLE的发展有促进作用。     

调控RET依赖性GDNF信号通路对大鼠癫痫模型的影响

目的:探究双侧海马CA1区立体定向注射anti-GDNF抗体对匹鲁卡品诱导的大鼠癫痫模型的影响。方法:选择成年雄性SD大鼠60只,并随机分为3组,即假手术组(sham组,n=20)、癫痫模型组(model组,n=20)和GDNF抑制剂组(anti-GDNF组,n=20)。使用氯化锂-匹鲁卡品腹腔注射诱导癫痫模型,sham组只给予氯化锂,anti-GDNF组在造模前2 h给予大鼠双侧海马CA1区立体定向注射anti-GDNF抗体。在造模后1、3、7 d观察大鼠癫痫的发作频率,7 d后采用脑电图监测(EEG)测定脑电波的变化情况,通过免疫组化方法测定海马CA1区域神经元数量变化(Neu N表达水平),造模后1 d时使用western blot方法测定海马CA1区GDNF、RET和P53蛋白的表达。结果:Model组大鼠棘-慢波数量明显高于Sham组,anti-GDNF组以上指标较model组显著减少(P0.05);Model组海马CA1区神经元大量凋亡,但anti-GDNF组凋亡较model组显著减少(P0.05)。与Sham组比较,在癫痫发作后1 d,model组的GDNF、RET表达水平上调,P53表达水平下降(P0.05),而anti-GDNF组大鼠海马CA1区GDNF、RET表达较model组明显下调,P53表达水平显著上降(P0.05)。结论:双侧海马CA1区立体定向注射anti-GDNF抗体能够减少癫痫发作,并对海马神经元起到保护作用,可能与其抑制GDNF/RET/P53信号通路有关。     

孕酮对全脑缺血/再灌注损伤大鼠学习记忆及海马P2X7受体表达的影响

目的:研究孕酮(PROG)对全脑缺血/再灌注(I/R)损伤大鼠学习记忆及海马P2X7受体表达的影响。方法:雄性SD大鼠48只,随机分成4组(n=12):正常组、假手术组、I/R组和I/R+PROG组。采用改良Pulsinelli’s 4血管闭塞法建立全脑缺血/再灌注损伤动物模型,Y-型迷宫检测学习与记忆成绩;免疫荧光法观察海马区P2X7受体蛋白表达;羟胺氧化法测定海马组织中超氧化物歧化酶(SOD)活性;硫代巴比妥酸法测定海马组织中丙二醛(MDA)含量。结果:正常组和假手术组学习记忆成绩、海马区P2X7阳性表达细胞数、海马组织中SOD活性和MDA含量差异无显著性;与假手术组相比,I/R组学习记忆成绩显著降低(P<0.01);与I/R组相比,I/R+PROG组学习记忆成绩显著升高(P<0.05)。与假手术组相比,I/R组海马区P2X7阳性表达细胞数显著增多(P<0.01);与I/R组相比,I/R+PROG组海马区P2X7阳性表达细胞数显著减少(P<0.01)。与假手术组相比,I/R组海马组织中SOD活性显著降低(P<0.01),而MDA含量显著升高(P<0.01);与I/R组相比,I/R+PROG组海马组织中SOD活性显著升高(P<0.05),而MDA含量显著降低(P<0.01)。结论:PROG可明显改善全脑缺血/再灌注损伤大鼠学习与记忆能力,其作用机制可能与下调海马区P2X7受体蛋白表达和清除氧自由基有关。     

局部高频电刺激海马对海人酸致痫大鼠海马细胞外谷氨酸和γ-氨基丁酸释放的影响

目的：通过高频电刺激海人酸癫痫模型大鼠海马,观察海马细胞外谷氨酸（Glu）和γ-氨基丁酸（GABA）的动态变化。方法：将SD大鼠分成4大组（n=10）：①空白组;②海人酸组;③假刺激组：植入刺激电极未予电刺激;④电刺激组：海人酸注射后予130 Hz电刺激。利用微透析技术收集不同时段海马细胞外液,应用高效液相-荧光检测法测定收集液Glu、GABA的浓度。结果：注射海人酸后Glu明显升高,并持续至第14天,电刺激使Glu明显下降;而注射海人酸后GABA呈短暂性升高,后逐渐下降于第4天后保持稍高于正常水平,电刺激并无明显改变GABA的水平。结论：海马细胞外Glu下降在海马电刺激治疗癫痫中起到重要作用;高频电刺激海马选择性地减少谷氨酸能神经元活动,但不影响GABA的释放。     

姜黄素对自发性高血压大鼠海马缺血/再灌注损伤神经元凋亡核通路的影响

目的:探讨自发性高血压大鼠(SHR)脑缺血/再灌注损伤海马神经元凋亡c-Jun氨基末端激酶(JNK)核通路的变化特点,以及姜黄素对其保护作用可能机制。方法:雄性Wistar-Kyoto大鼠(WKY)和SHR,随机分为5组:WKY假手术组(W-Sham组)、缺血/再灌注组(W-I/R组)和SHR假手术组(S-Sham组)、缺血/再灌注组(S-I/R组)、姜黄素100mg/kg预处理组(S-Cur组),上述5个实验组按再灌注时间又分为再灌注2h、6h、1d、3d、7d5个亚组(n=6)。采用四动脉结扎法制备脑缺血/再灌注模型,以TUNEL法检测海马CA1区的细胞凋亡,免疫组化法分析海马CA1区c-jun、c-fos的动态变化。结果:S-Sham组大鼠海马CA1区TUNEL细胞数量和c-jun、c-fos表达高于W-Sham组(P0.05),S-I/R组TUNEL细胞数量和c-jun、c-fos表达高于S-Sham组及W-I/R组(P0.05);S-Cur组TUNEL细胞数量和c-jun、c-fos表达较S-I/R组明显降低(P0.05)。结论:缺血/再灌注更易导致SHR海马神经元凋亡。姜黄素可抑制SHR脑缺血/再灌注损伤海马神经元凋亡,其作用机制可能与抑制c-jun、c-fos蛋白的表达有关。     

迷走神经在缺血后处理减轻大鼠复苏后脑损伤中的作用探究

目的:探讨迷走神经在远隔缺血后处理减轻大鼠心肺复苏后脑损伤中的作用。方法:雄性SD大鼠70只,随机分5组:假手术组(sham组,n=10);模型组(CA组,n=15),远隔缺血后处理组(RIPost组,n=15),远隔缺血后处理+迷走神经切断组(RIPost+VAG组,n=15),迷走神经切断组(VAG组,n=15)。ELISA法检测ROSC 24 h神经元特异性烯醇化酶(NSE)、乙酰胆碱(Ach)、IL-1β和TNF-α浓度;ROSC 24h NSE免疫荧光染色;ROSC 1d及3d神经功能缺损评分(NDS);ROSC 5d Nissl染色计算海马CA1区神经元数目。结果:与sham组相比,各组海马CA1区NSE、IL-1β和TNF-α含量升高,而Ach浓度降低,NDS评分和海马CA1区存活神经元数目降低(P0.05);与CA组相比,RIPost组海马CA1区NSE、IL-1β和TNF-α含量降低,Ach浓度升高,NDS评分和海马CA1区存活神经元数目升高(P0.05),而RIPost+VAG组及VAG组各项指标与其差异无统计学意义(P0.05);与RIPost组相比,RIPost+VAG组海马CA1区NSE、IL-1β和TNF-α含量升高,Ach浓度降低,NDS评分和海马CA1区存活神经元数目降低(P0.05)。结论:迷走神经的完整性在远隔缺血后处理减轻大鼠心肺复苏后脑损伤中具有重要意义。     

黄芪红花配伍对大鼠脑缺血后血管新生及Cav-1/VEGF信号通路的影响

目的:黄芪红花配伍是否通过调节小凹蛋白1(Caveolin-1,Cav-1)/血管内皮生长因子(vascular endothelial growth factor,VEGF)通路促进血管新生保护大鼠脑缺血损伤。方法:60只雄性SD大鼠随机分为5个组:对照组(Sham组,n=12),模型组(MACO组,n=12),黄芪红花40:1组(n=12),20:1组(n=12),5:1(n=12)。大鼠脑缺血再灌注损伤模型采用尼龙线栓法制作,连续给药21d后,评价神经功能学评分,计算脑梗死体积,采用免疫组化法测定皮质区的微血管密度,采用RT-PCR法检测皮质区VEGF m RNA和Cav-1 m RNA表达,采用Western-blotting法测定皮质区VEGF和Cav-1的蛋白表达。结果:连续给药21d后,各组大鼠的神经功能学评分均有所降低,3个不同比例的黄芪红花组的神经功能学评分降低最为明显(P0.01),脑梗死体积较模型组显著减少(P0.05~P0.01),微血管密度、VEGF和Cav-1 m RNA和蛋白表达水平均较模型组明显升高(P0.05~P0.01)。结论:黄芪红花配伍可能通过调节Cav-1/VEGF信号通路促进脑缺血再灌注损伤大鼠脑内的血管新生,从而减轻脑缺血损伤,且最佳的配伍比例为黄芪红花5:1。     

重度OSAS患者前额叶皮质及岛叶1H-MR波谱研究

目的:利用氢质子MRS(1H-MRS)探讨重度阻塞性呼吸睡眠暂停综合症(Severe obstructive sleep apnea syndrome,S-OSAS)患者前额叶皮质及岛叶脑代谢产物特征。方法:选择18例S-OSAS患者(S-OSAS组)和15名健康志愿者(HC组)行左侧前额叶皮质及岛叶1H-MRS检查,测量两组左侧前额叶皮质区及岛叶N-乙酰天冬氨酸/肌酸(NAA/Cr)、胆碱/肌酸(Cho/Cr)值。对患S-OSAS累计时间与前额叶皮质及岛叶NAA/Cr作直线相关分析。结果:与正常对照组相比,S-OSAS患者左侧前额叶皮质、岛叶NAA/Cr比值降低,分别为1.43±0.47、1.34±0.06,对照组分别为1.51±0.65、1.45±0.07;S-OSAS组患者左侧前额叶皮质、岛叶Cho/Cr分别为0.90±0.08、1.19±0.13,对照组分别为0.87±0.07、1.09±0.02,两组差异有统计学意义。前额叶皮质及岛叶代谢物NAA/Cr与患S-OSAS累计时间成负相关性(r值分别为-0.965、-0.955,P<0.01)。结论:1H-MRS显示S-OSAS患者前额叶皮质及岛叶病理生理变化,从该区代谢物的改变反应出S-OSAS患者执行及情感功能的异常,其NAA/Cr改变程度与患S-OSAS累计时间相关。     

灵芝酸对氯化锂-匹鲁卡品致痫大鼠脑的保护作用

目的观察灵芝酸对氯化锂-匹鲁卡品致痫大鼠脑皮质GFAP和FGF-2蛋白表达的影响,探讨灵芝酸抗癫痫作用及其作用机制。方法选取雄性SD大鼠44只,随机分为4组(n=11):正常对照组,癫痫模型组,灵芝酸治疗组,丙戊酸钠治疗组,每组腹腔注射给药后,观察各组大鼠行为学改变,Westernblotting法和免疫荧光法检测各组大鼠皮质区GFAP和FGF-2蛋白表达。结果与正常对照组相比,癫痫组FGF-2的蛋白表达水平显著下降(P0.01);GFAP的蛋白表达水平显著升高(P0.01)。与丙戊酸钠组相比,灵芝酸组FGF-2的蛋白表达水平显著升高(P0.05);GFAP的蛋白表达水平显著降低(P0.05)。结论灵芝酸对癫痫大鼠脑具有一定的保护作用,其抗癫痫机制与灵芝酸能够调节FGF-2和GFAP蛋白的表达水平有关。     

不同术式对颞叶癫痫患者术后认知功能、记忆能力以及生活质量的影响

目的:探讨不同术式对颞叶癫痫患者术后认知功能、记忆能力以及生活质量的影响。方法:选取2014年2月～2018年4月期间我院收治的103例颞叶癫痫患者为研究对象,根据随机数字表法将患者分为单侧前颞叶切除术(ATL)组(n=51,给予ATL治疗)和选择性海马杏仁核切除术(SAH)组(n=52,给予SAH治疗),比较两组患者的手术疗效、术后认知功能、记忆能力、生活质量以及并发症。结果:两组术后6个月临床总有效率比较差异无统计学意义(P0.05)。两组患者术后6个月生活质量量表各项评分均较术前升高(P0.05)。两组患者术后6个月总智商(FIQ)、语言智商(VIQ)评分均较术前升高,且SAH组高于ATL组(P0.05)。两组术后6个月优势半球侧记忆商数(MQ)评分降低,非优势半球侧MQ评分升高(P0.05);SAH组术后6个月非优势半球侧MQ评分高于ATL组(P0.05)。两组患者术后并发症发生率比较无统计学差异(P0.05)。结论:颞叶癫痫患者采用ATL、SAH术式治疗,可获得相似的治疗效果,安全性均较好,但SAH术式在保护患者的认知功能及记忆能力方面更优。     

Limbic Structures Show Altered Glial–Neuronal Metabolism in the Chronic Phase of Kainate Induced Epilepsy

A better understanding is needed of how glutamate metabolism is affected in mesial temporal lobe epilepsy (MTLE). Here we investigated glial–neuronal metabolism in the chronic phase of the kainate (KA) model of MTLE. Thirteen weeks following systemic KA, rats were injected i.p. with [1-¹³C]glucose. Brain extracts from hippocampal formation, entorhinal cortex, and neocortex, were analyzed by ¹³C and ¹H magnetic resonance spectroscopy to quantify ¹³C labeling and concentrations of metabolites, respectively. The amount and ¹³C labeling of glutamate were reduced in the hippocampal formation and entorhinal cortex of epileptic rats. Together with the decreased concentration of NAA, these results indicate neuronal loss. Additionally, mitochondrial dysfunction was detected in surviving glutamatergic neurons in the hippocampal formation. In entorhinal cortex glutamine labeling and concentration were unchanged despite the reduced glutamate content and label, possibly due to decreased oxidative metabolism and conserved flux of glutamate through glutamine synthetase in astrocytes. This mechanism was not operative in the hippocampal formation, where glutamine labeling was decreased. In neocortex labeling and concentration of GABA were increased in epileptic rats, possibly representing a compensatory mechanism. The changes in the hippocampus might be of pathophysiological importance and merit further studies aiming at resolving metabolic causes and consequences of MTLE. Special issue article in honor of Dr. Frode Fonnum.     

GABAergic neurons and GABA(A)-receptors in temporal lobe epilepsy.

Mesial temporal lobe epilepsy (MTLE) is the most prevalent form of epilepsy, characterized by recurrent complex partial seizures and hippocampal sclerosis. The pathophysiology underlying this disorder remains unidentified. While a loss of benzodiazepine binding sites is a key diagnostic feature of MTLE, experimental studies have shown enhanced inhibitory transmission and increased expression of GABA(A)-receptors, suggesting that compensatory mechanisms are operative in epileptic hippocampus. In the present study, changes in the expression and cellular distribution of major GABA(A)-receptor subunits were investigated in the hippocampus of pilocarpine-treated rats during the phase of spontaneous recurrent seizures. A uniform decrease in GABA(A)-receptor subunit-immunoreactivity was observed in regions of extensive neuronal death (i.e. CA1, CA3, hilus). whereas a prominent increase occurred in the dentate gyrus (DG). Most strikingly, the increase was largest for the alpha3- and alpha5-subunits, which are expressed at very low levels in the DG of control rats, suggesting the formation of novel GABA(A)-receptor subtypes in epileptic tissue. Furthermore, an extensive loss of interneurons expressing the alpha1-subunit, representing presumptive basket cells, was seen in the DG. These changes were very similar to those reported in a novel mouse model of MTLE, based on the unilateral injection of kainic acid into the dorsal hippocampus (Bouilleret et al., 1999). This indicates that the regulation of GABA(A)-receptor expression is related to chronic recurrent seizures, and is not due to the extrahippocampal neuronal damage affecting pilocarpine-treated rats. These results allow causal relationships in the induction and maintenance of chronic recurrent seizures to be distinguished. The loss of a critical number of interneurons in the DG is a possible cause of seizure initiation, whereas the long-lasting upregulation of GABA(A)-receptors in granule cells represents a compensatory response to seizure activity.     

Reduction of Hippocampal Collapsin Response Mediated Protein-2 in Patients with Mesial Temporal Lobe Epilepsy

Although the syndrome of mesial temporal lobe epilepsy (MTLE) associated with hippocampal sclerosis has been elaborated in recent years, pathogenesis and pathomechanisms are still elusive. Performing protein hunting in hippocampus of patients with MTLE we detected derangement of collapsin response mediated protein-2 (CRMP-2). Hippocampal tissue from controls and MTLEs was taken and two-dimensional gel electrophoresis with subsequent MALDI-MS-characterisation was applied. The proteomic approach identified 13 spots unambiguously assigned to CRMP-2. Three spots at molecular weight 55 kDa showed a significant decrease in MTLE and other 3 spots at 65 kDa showed deranged in MTLE. Immunoblotting revealed two bands at 65 and 55 kDa in the control group whereas the 55 kDa band was extremely low expressed in MTLE. CRMP-2 is required to induce axonal outgrowth and maintaining neuronal polarity in hippocampal neurons and the significant decrease of this protein may represent or underlie impaired neuronal plasticity, neurodegeneration, wiring of the brain in MTLE and may explain abnormal migration. Therefore, the decrease of CRMP-2 may well contribute to the understanding of the still unclear pathomechanisms involved in MTLE.     

磁共振波谱分析与帕金森病患者Hoehn&Yahr分级的相关性研究

目的:探讨磁共振波谱分析(MRS)与帕金森病(PD)HoehnYahr分级之间的相关性。方法:选择2016年9月-2017年8月我院收治的60例PD患者为研究对象,根据HoehnYahr分级将患者分为早期PD组32例、中期PD组18例、晚期PD组10例,并选择同时期在门诊进行健康体检的20例志愿者作为对照组。对各组研究对象的双侧基底节、双侧额叶、双侧丘脑区进行MRS,并分析PD患者HoehnYahr分级与MRS的关系。结果:晚期PD组双侧基底节、双侧额叶、双侧丘脑区NAA/Cr、NAA/Cho、Cho/Cr比值均低于中期PD组、早期PD组、对照组,且中期PD组低于早期PD组、对照组,早期PD组低于对照组,差异有统计学意义(P0.05)。通过Spearman相关性分析显示,MRS检测出PD患者NAA/Cr、NAA/Cho、Cho/Cr比值与HoehnYahr分级间呈负相关性(P0.05)。结论:MRS与PD患者的HoehnYahr分级具有负相关性,并且可通过MRS预测患者疾病的严重程度,以对其进行相应的治疗以及预后评估。     

左旋组氨酸对匹罗卡品致痫大鼠癫痫发作和海马区神经细胞凋亡的影响

目的:观察左旋组氨酸(L-His)对匹罗卡品(PLO)致痫大鼠皮质脑电图及大鼠海马各区神经细胞凋亡的影响。方法:雄性SD大鼠30只,随机平均分为对照组(匹罗卡品组)、干预组(匹罗卡品+左旋组氨酸组)。各组给予相关干预处理后腹腔注射匹罗卡品建立癫痫模型,行皮质脑电图观察及海马区细胞凋亡染色观察。结果:经皮质脑电图显示,干预组潜伏期延长、痫波频率及大发作次数较对照组明显降低,差异有统计学意义(P<0.05)。凋亡染色显示,对照组的海马各区细胞在各时间点的凋亡数明显高于干预组,差异具有统计学意义(P<0.05)。结论:左旋组氨酸可以延迟匹罗卡品致痫的形成并降低点燃后癫痫发作程度,降低海马各区细胞凋亡数值,提示左旋组氨酸具有抗痫作用。     

Heritability of Subcortical Volumetric Traits in Mesial Temporal Lobe Epilepsy

Objectives

We aimed to 1) determine if subcortical volume deficits are common to mesial temporal lobe epilepsy (MTLE) patients and their unaffected siblings 2) assess the suitability of subcortical volumetric traits as endophenotypes for MTLE.

Methods

MRI-based volume measurements of the hippocampus, amygdala, thalamus, caudate, putamen and pallidium were generated using an automated brain reconstruction method (FreeSurfer) for 101 unrelated ‘sporadic’ MTLE patients [70 with hippocampal sclerosis (MTLE+HS), 31 with MRI-negative TLE], 83 unaffected full siblings of patients and 86 healthy control subjects. Changes in the volume of subcortical structures in patients and their unaffected siblings were determined by comparison with healthy controls. Narrow sense heritability was estimated ipsilateral and contralateral to the side of seizure activity.

Results

MTLE+HS patients displayed significant volume deficits across the hippocampus, amygdala and thalamus ipsilaterally. In addition, volume loss was detected in the putamen bilaterally. These volume deficits were not present in the unaffected siblings of MTLE+HS patients. Ipsilaterally, the heritability estimates were dramatically reduced for the volume of the hippocampus, thalamus and putamen but remained in the expected range for the amygdala. MRI-negative TLE patients and their unaffected siblings showed no significant volume changes across the same structures and heritability estimates were comparable with calculations from a healthy population.

Conclusions

The findings indicate that volume deficits for many subcortical structures in ‘sporadic’ MTLE+HS are not heritable and likely related to acquired factors. Therefore, they do not represent suitable endophenotypes for MTLE+HS. The findings also support the view that, at a neuroanatomical level, MTLE+HS and MRI-negative TLE represent two distinct forms of MTLE.     

Brain development:1H magnetic resonance spectroscopy of rat brain extracts compared with chromatographic methods

We compared in vitro¹H magnetic resonance spectroscopy (MRS) measurements of rat brain extracts (rats: 2–56 days old) with chromatographic measurements and in a further step also with results of in vivo MRS. The following substances can be reliably measured in brain extracts by in vitro MRS: N-acetylaspartate (NAA), total creatine (Cr), phosphorylethanoloamine (PE), taurine (Tau), glutamate (Glu), glutamine (Gln), -aminobutyrate (GABA) and alanine (Ala). Two different methods of MRS data evaluation compared with chromatographic data on Cr and NAA are shown. During development of the rat from day 2–56 brain concentrations of PE, Tau and Ala decrease, those of NAA, Cr, Glu and Gln increase, while GABA does not change. The developmental patterns of these substances are the same, whether measured by in vitro MRS or by chromatographic methods. Quantification of NAA, Cr, Tau, GABA and PE leads to the same results with both methods, while Glu, Gln and Ala concentrations determined by in vitro MRS are apparently lower than those measured chemically. The NAA/Cr ratios of 7 to 35-day-old rats were determined by in vivo¹H MRS. These results correlate with chromatographic and in vitro data. Using appropriate methods in the in vivo and in vitro MR-technique, the obtained data compare well with the chromatographic results.     

磁共振波谱成像结合扩散加权成像在脑胶质瘤及脑转移瘤鉴别诊断中的意义

目的:评估磁共振波谱成像(Proton Magnetic Resonance Spectroscopy,1H-MRS)联合磁共振扩散加权成像(Diffusion Weighted Imaging,DWI)在鉴别脑胶质瘤及孤立的脑转移瘤中的作用。方法:应用3.0T磁共振扫描仪,对临床手术确诊及组织病理学诊断证实的49例脑肿瘤患者(35例多形性胶质母细胞瘤,14例脑转移瘤)进行常规磁共振成像、磁共振波谱成像及磁共振扩散加权成像,并并对获得的数据进一步测量瘤内及瘤周区的代谢比、N-乙酰天门冬氨酸(NAA)、胆碱(Cho)、肌酸(Cr)值以及表观弥散系数(ADC值),分析两肿瘤组之间不同参数的统计学差异。此外,我们研究了感兴趣区域(ROI)的大小对肿瘤区域的病变扩散性能潜在影响。结果:胶质母细胞瘤瘤周N-乙酰天门冬氨酸(NAA)、肌酸(Cr),胆碱(Cho)/Cr,Cho/NAA和r CBV显著高于颅内转移瘤(P0.05);ADC值在两肿瘤组之间无显著差异(P0.05)。结论:在瘤周区1H-MRS有助于鉴别胶质母细胞瘤与单发的脑转移瘤。在瘤内扩散性的定量特性依赖ROI大小的设置。     

Changes in Functional Integration with the Non-Epileptic Temporal Lobe of Patients with Unilateral Mesiotemporal Epilepsy

Purpose

To investigate epilepsy-induced changes in effective connectivity between the non-epileptic amygdalo-hippocampal complex (AHC) and the rest of the brain in patients with unilateral mesiotemporal lobe epilepsy (MTLE) associated with hippocampal sclerosis (HS).

Methods

Thirty-three patients with unilateral MTLE associated with HS (20 females, mean age: 36 years, 19 left HS) and 33 adult controls matched for age and gender underwent ¹⁸F-Fluorodeoxyglucose positron emission tomography (FDG-PET). Right-HS patients'' FDG-PET data were flipped to obtain a left–epileptic–focus–lateralized group of patients. Voxels of interest (VOI) were selected within the cytoarchitectonic probabilistic maps of the non-epileptic AHC (probability level  = 100%, SPM8 Anatomy toolbox v1.7). Patients and controls were compared using VOI metabolic activity as covariate of interest to search for epilepsy-induced changes in the contribution of the non-epileptic AHC to the level of metabolic activity in other brain areas. Age, gender, duration of epilepsy, seizure type and frequency were used as covariates of no-interest for connectivity analyses.

Key findings

Significant decrease in effective connectivity was found between the non-epileptic AHC and ventral prefrontal cortical areas bilaterally, as well as with the temporal pole and the posterior cingulate cortex contralateral to HS. Significant increase in connectivity was found between the non-epileptic AHC and midline structures, such as the anterior cingulate and dorsal medial prefrontal cortices, as well as the temporo-parietal junction bilaterally. Connectivity analyses also revealed a preserved positive connectivity between the non-epileptic and the epileptic AHC in the patients'' group.

Significance

This study evidences epilepsy-induced changes in connectivity between the non-epileptic AHC and some limbic and default mode network areas. These changes in connectivity probably account for emotional, cognitive and decision-making impairments frequently observed in MTLE patients. The preserved neurometabolic connectivity between the non-epileptic and the epileptic AHC in MTLE patients is pivotal to explain the epilepsy-induced changes found in this study.