颞叶癫痫的嗅觉功能障碍和边缘低激活。

IF 3.5 2区 医学 Q1 NEUROIMAGING
Markus Schmidt, Tobias Bauer, Marcel Kehl, Anna Minarik, Lennart Walger, Johannes Schultz, Martin S. Otte, Peter Trautner, Christian Hoppe, Tobias Baumgartner, Louisa Specht-Riemenschneider, Florian Mormann, Alexander Radbruch, Rainer Surges, Theodor Rüber
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引用次数: 0

摘要

颞叶癫痫(TLE)的致痫网络包括初级和次级嗅皮层结构,如梨状皮层和内嗅皮层、杏仁核和海马。嗅觉光环和嗅觉功能障碍是 TLE 的相关症状。本研究旨在通过嗅觉测试和嗅觉功能磁共振成像(fMRI)来描述TLE患者的嗅觉功能。我们前瞻性地招募了 20 名单侧 TLE 患者(年龄 45 ± 20 岁 [平均 ± SD],65% 女性,90% 右撇子)和 20 名健康人(年龄 33 ± 15 岁 [平均 ± SD],35% 女性,90% 右撇子)。在TLE组中,75%的患者推测发作起始区为左侧;45%的TLE患者推测病因为边缘脑炎;15%的TLE患者报告有嗅觉光环。在预评估期间,嗅觉功能通过筛查嗅棒测试(Burkhart,Wedel,德国)进行评估。在预测试期间,所有患者都被要求对五种不同气味(丁香酚、香兰素、苯乙醇、癸酸、戊酸)和一种对照溶液的强度、价值、熟悉程度和相关记忆进行评分。在 fMRI 实验中,所有实验者都反复嗅闻丁香酚(阳性气味)、戊酸(阴性气味)和对照溶液,并被要求用李克特五点量表对气味强度进行评分。我们采集了功能性 EPI 序列和结构图像(T1、T2、FLAIR)。与健康人相比,TLE 患者对所呈现气味的中性评价更高(双侧 Mann-Whitney U 检验,FDR-p
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Olfactory Dysfunction and Limbic Hypoactivation in Temporal Lobe Epilepsy

Olfactory Dysfunction and Limbic Hypoactivation in Temporal Lobe Epilepsy

The epileptogenic network in temporal lobe epilepsy (TLE) contains structures of the primary and secondary olfactory cortex such as the piriform and entorhinal cortex, the amygdala, and the hippocampus. Olfactory auras and olfactory dysfunction are relevant symptoms of TLE. This study aims to characterize olfactory function in TLE using olfactory testing and olfactory functional magnetic resonance imaging (fMRI). We prospectively enrolled 20 individuals with unilateral TLE (age 45 ± 20 years [mean ± SD], 65% female, 90% right-handed) and 20 healthy individuals (age 33 ± 15 years [mean ± SD], 35% female, 90% right-handed). In the TLE group, the presumed seizure onset zone was left-sided in 75%; in 45% of the individuals with TLE limbic encephalitis was the presumed etiology; and 15% of the individuals with TLE reported olfactory auras. Olfactory function was assessed with a Screening Sniffin’ Sticks Test (Burkhart, Wedel, Germany) during a pre-assessment. During a pre-testing, all individuals were asked to rate the intensity, valence, familiarity, and associated memory of five different odors (eugenol, vanillin, phenethyl alcohol, decanoic acid, valeric acid) and a control solution. During the fMRI experiment, all individuals repeatedly smelled eugenol (positively valenced odor), valeric acid (negatively valenced odor), and the control solution and were asked to rate odor intensity on a five-point Likert scale. We acquired functional EPI sequences and structural images (T1, T2, FLAIR). Compared to healthy individuals, individuals with TLE rated the presented odors as more neutral (two-sided Mann–Whitney U tests, FDR-p < 0.05) and less familiar (two-sided Mann–Whitney U tests, FDR-p < 0.05). fMRI data analysis revealed a reduced response contrast in secondary olfactory areas (e.g., hippocampus) connected to the limbic system when comparing eugenol and valeric acid in individuals with TLE when compared with healthy individuals. However, no lateralization effect was obtained when calculating a lateralization index by the number of activated voxels in the olfactory system (two-sided Mann–Whitney U test; U = 176.0; p = 0.525). TLE is characterized by olfactory dysfunction and associated with hypoactivation of secondary olfactory structures connected to the limbic system. These findings contribute to our understanding of the pathophysiology of TLE. This study was preregistered on OSF Registries (www.osf.io).

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来源期刊
Human Brain Mapping
Human Brain Mapping 医学-核医学
CiteScore
8.30
自引率
6.20%
发文量
401
审稿时长
3-6 weeks
期刊介绍: Human Brain Mapping publishes peer-reviewed basic, clinical, technical, and theoretical research in the interdisciplinary and rapidly expanding field of human brain mapping. The journal features research derived from non-invasive brain imaging modalities used to explore the spatial and temporal organization of the neural systems supporting human behavior. Imaging modalities of interest include positron emission tomography, event-related potentials, electro-and magnetoencephalography, magnetic resonance imaging, and single-photon emission tomography. Brain mapping research in both normal and clinical populations is encouraged. Article formats include Research Articles, Review Articles, Clinical Case Studies, and Technique, as well as Technological Developments, Theoretical Articles, and Synthetic Reviews. Technical advances, such as novel brain imaging methods, analyses for detecting or localizing neural activity, synergistic uses of multiple imaging modalities, and strategies for the design of behavioral paradigms and neural-systems modeling are of particular interest. The journal endorses the propagation of methodological standards and encourages database development in the field of human brain mapping.
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