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Cortico-thalamic connections and temporal lobe epilepsy: An evolving story

机译：皮质-丘脑联系和颞叶癫痫：不断发展的故事

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OBJECTIVE: Although experimental work has provided evidence that the thalamus is a crucial relay structure in temporal lobe epilepsy (TLE), the relation of the thalamus to neocortical pathology remains unclear. To assess thalamo-cortical network pathology in TLE, we mapped pointwise patterns of thalamic atrophy and statistically related them to neocortical thinning. METHODS: We studied cross-sectionally 36 patients with drug-resistant TLE and 19 age- and sex-matched healthy control subjects using high-resolution MRI. To localize thalamic pathology, we converted manual labels into surface meshes using the spherical harmonic description and calculated local deformations relative to a template. In addition, we measured cortical thickness by means of the constrained Laplacian anatomic segmentation using proximity algorithm. RESULTS: Compared with control subjects, patients with TLE showed ipsilateral thalamic atrophy that was located along the medial surface, encompassing anterior, medial, and posterior divisions. Unbiased analysis correlating the degree of medial thalamic atrophy with cortical thickness measurements mapped bilateral frontocentral, lateral temporal, and mesiotemporal cortices. These areas overlapped with those of cortical thinning found when patients were compared with control subjects. Thalamic atrophy intensified with a longer duration of epilepsy and was more severe in patients with a history of febrile convulsions. CONCLUSION: The degree and distribution of thalamic pathology relates to the topography and extent of neocortical atrophy, lending support to the concept that the thalamus is an important hub in the pathologic network of TLE.
机译：目的：尽管实验工作已证明丘脑是颞叶癫痫（TLE）的重要中继结构，但丘脑与新皮层病理的关系尚不清楚。为了评估TLE中的丘脑皮质网络病理，我们绘制了丘脑萎缩的逐点分布图，并将它们与新皮质变薄进行了统计相关。方法：我们采用高分辨率MRI横断面研究了36例耐药TLE患者和19例年龄和性别匹配的健康对照者。为了定位丘脑病理，我们使用球谐函数描述将手动标签转换为表面网格，并计算相对于模板的局部变形。另外，我们通过使用邻近算法的受限拉普拉斯解剖分割来测量皮质厚度。结果：与对照组相比，TLE患者的同侧丘脑萎缩位于内侧表面，包括前，内侧和后分区。无偏见的分析将内侧丘脑萎缩程度与皮层厚度测量值相关联，绘制了双侧额中，外侧颞叶和颞颞皮层。这些区域与将患者与对照组比较时发现的皮质变薄区域重叠。伴有高热惊厥史的患者，丘脑萎缩程度随着癫痫持续时间的延长而加剧。结论：丘脑病理的程度和分布与新皮层萎缩的地形和程度有关，这为丘脑是TLE病理网络的重要枢纽提供了支持。

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