ABSTRACT

Objectives: To detect and compare the features of interictal perfusion and volume asymmetry between temporal lobe epilepsy (TLE) patients with and without hippocampal sclerosis (HS).

Methods: Sixty-one TLE patients (mean age 28.4 ± 9.3 years; 28 female/33 male) with unilateral signs of HS (TLE-HS+) and 25 TLE patients (mean age 29.8 ± 8.0 years; 17 female/8 male) without HS (TLE-HS-) were included. Thirty healthy volunteers served as controls (mean age 26.0 ± 8.7 years; 22 female/8 male). Brain segmentation and volume calculation were performed. Quantitative cerebral blood flow (CBF) values were measured based on arterial spin labeling (ASL). The asymmetry indices (AIs) of volume and perfusion were calculated.

Results: TLE-HS+ (adjusted P = 0.001) and TLE-HS- patients (adjusted P = 0.006) had significantly higher hippocampal perfusion AIs than controls. TLE-HS+ and TLE-HS- had similar hippocampal perfusion AIs (adjusted P = 1.00). TLE-HS+ had higher hippocampal volume AIs than TLE-HS- and controls (adjusted P < 0.001). TLE-HS- and controls had similar hippocampal volume AIs (adjusted P = 1.00). All (100%) TLE-HS+ patients had positive hippocampal perfusion or volume AIs. No significant correlation between the AIs of hippocampal perfusion and volume was found in both TLE-HS+(P = 0.894) and TLE-HS- (P = 0.106) patients. TLE-HS+ patients demonstrated more extensive whole-brain asymmetry of both perfusion and volume than TLE-HS- patients.

Conclusion: TLE-HS+ and TLE-HS- patients have different patterns of whole-brain perfusion and volume asymmetry. Hippocampal perfusion asymmetry was revealed in both TLE-HS+ and TLE-HS- patients.

摘要

目的：检测和比较伴和不伴海马硬化（HS）的颞叶癫痫（TLE）患者发作间期灌注和容量不对称的特征。

方法：61 名 TLE 患者（平均年龄 28.4 ± 9.3 岁；28 名女性/33 名男性）有单侧 HS 体征（TLE-HS+）和 25 名 TLE 患者（平均年龄 29.8 ± 8.0 岁；17 名女性/8 名男性）没有HS (TLE-HS-) 被包括在内。30 名健康志愿者作为对照（平均年龄 26.0 ± 8.7 岁；22 名女性/8 名男性）。进行了大脑分割和体积计算。基于动脉自旋标记 (ASL) 测量定量脑血流量 (CBF) 值。计算体积和灌注的不对称指数（AI）。

结果：TLE-HS+（调整后的P = 0.001）和 TLE-HS- 患者（调整后的P = 0.006）的海马灌注 AI 显着高于对照组。TLE-HS+ 和 TLE-HS- 具有相似的海马灌注 AI（调整后的P = 1.00）。TLE-HS+ 的海马体积 AI 高于 TLE-HS- 和对照（调整后的 P < 0.001）。TLE-HS- 和对照具有相似的海马体积 AI（调整后的P = 1.00）。所有 (100%) TLE-HS+ 患者的海马灌注或体积 AI 均呈阳性。TLE-HS+（ P = 0.894）和TLE-HS-（ P= 0.106) 患者。TLE-HS+ 患者表现出比 TLE-HS- 患者更广泛的全脑灌注和容量不对称性。

结论：TLE-HS+ 和 TLE-HS- 患者具有不同的全脑灌注模式和容量不对称。在 TLE-HS+ 和 TLE-HS- 患者中均发现海马灌注不对称。