Progressive brain atrophy and cortical reorganization related to surgery in temporal lobe epilepsy

IF 4.4 2区医学 Q1 CLINICAL NEUROLOGY

Annals of Clinical and Translational Neurology Pub Date : 2024-12-21 DOI:10.1002/acn3.52285

Wei Li, Yingjie Qin, Xiuli Li, Heng Zhang, Qiyong Gong, Dong Zhou, Dongmei An

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Abstract

Objective

Epilepsy is associated with progressive cortical atrophy exceeding normal aging. We aimed to explore longitudinal cortical alterations in patients with temporal lobe epilepsy (TLE) and distinct surgery outcomes.

Methods

We obtained longitudinal T1-weighted MRI data in a well-designed cohort, including 53 operative TLE patients, 23 nonoperative TLE patients, and 23 healthy controls. According to seizure outcomes at 24 months after surgery, operative patients were divided into seizure-free (SF) and nonseizure-free (NSF) group. Operative patients were scanned before and after surgery, while nonoperative patients and healthy controls were rescanned with similar interval times. We measured gray matter volume (GMV) in all participants and compared longitudinal cortical alterations among groups.

Results

In nonoperative group, statistically significant GMV decrease was observed in ipsilateral median cingulate and paracingulate gyri and cerebellum crus I when compared with healthy controls. In operative group, postoperative GMV increase was discovered in many regions involving bilateral hemispheres, especially in the frontal lobe, without differences between SF and NSF group. Postoperative GMV decrease was found in ipsilateral inferior frontal gyrus, putamen, thalamus, and insula. GMV decrease in ipsilateral inferior frontal gyrus, putamen, and insula was more significant in SF group.

Interpretation

Progressive cortical atrophy existed in nonoperative TLE patients. Cortical remodeling indicated by postoperative GMV increase may arise mostly from the surgery itself, rather than postsurgical seizure outcomes. More significant GMV decrease in ipsilateral inferior frontal gyrus, putamen, and insula may imply their closer connections with resected regions in seizure-free patients.

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进行性脑萎缩和皮层重组与颞叶癫痫手术有关。

目的：癫痫与进行性皮质萎缩相关，超过正常衰老。我们的目的是探讨颞叶癫痫（TLE）患者的纵向皮质改变和不同的手术结果。方法：我们在设计良好的队列中获得纵向t1加权MRI数据，其中包括53例手术性TLE患者，23例非手术性TLE患者和23例健康对照。根据术后24个月癫痫发作情况将手术患者分为无癫痫发作组（SF）和非无癫痫发作组（NSF）。手术患者在手术前和手术后进行扫描，而非手术患者和健康对照者以相似的间隔时间重新扫描。我们测量了所有参与者的灰质体积（GMV），并比较了各组之间的纵向皮质变化。结果：与健康对照组相比，非手术组同侧扣带中回、副扣带回及小腿小脑GMV下降有统计学意义。手术组术后GMV增加的区域多累及双侧半球，尤其是额叶，SF组与NSF组无差异。术后同侧额下回、壳核、丘脑和脑岛GMV均下降。SF组同侧额下回、壳核和脑岛GMV下降更为明显。解释：非手术性TLE患者存在进行性皮质萎缩。术后GMV增加所显示的皮质重塑可能主要是由手术本身引起的，而不是术后癫痫发作的结果。同侧额下回、壳核和脑岛的GMV下降更明显，这可能意味着它们与非癫痫患者切除区域的联系更紧密。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Clinical and Translational Neurology Medicine-Neurology (clinical)

CiteScore

9.10

自引率

1.90%

发文量

218

审稿时长

8 weeks

期刊介绍： Annals of Clinical and Translational Neurology is a peer-reviewed journal for rapid dissemination of high-quality research related to all areas of neurology. The journal publishes original research and scholarly reviews focused on the mechanisms and treatments of diseases of the nervous system; high-impact topics in neurologic education; and other topics of interest to the clinical neuroscience community.