Background Diffusion tensor imaging （DTI） is a noninvasive imaging technique for the assessment of the integrity of cerebral tissues. This study was undertaken to assess the changes of diffusion indices of hippocamp...Background Diffusion tensor imaging （DTI） is a noninvasive imaging technique for the assessment of the integrity of cerebral tissues. This study was undertaken to assess the changes of diffusion indices of hippocampal formation （HF） in patients with medial temporal lobe epilepsy （MTLE）. Methods Fourteen patients with MTLE and 14 healthy subjects were evaluated. Mean diffusivity （MD） and fractional anisotropy （FA） from the symmetrical-voxel sampling regions of the anterior HF were calculated in all subjects. The MD and FA values were compared across the groups. Results No significant differences of MD and FA values were noted between right and left HF in the controls. In the patient group, MD significantly increased in the HF ipsilateral to the lesioned side [（9.27±1.09）×10^-4 mm^2/s], compared with the values in the contralateral HF [（8.20±0.59）×10^-4 min^2]s] （t = 4.479, P = 0.001） and healthy subjects [（7.58±0.51）×10^-4 mm^2/s] （P 〈 0.001）, but no significant differences were found in FA. When compared with the controls, patients had a significantly higher MD in the contralateral HF （P 〈 0.05）, but the difference in FA was not statistically significant. Conclusions DTI could detect hippocampal abnormality in patients with MTLE. This technique may be helpful for preoperative evaluation of such patients.展开更多
Temporal lobe epilepsy is the most common form of focal epilepsy in adults,accounting for one third of all diagnosed epileptic patients,with seizures originating from or involving mesial temporal structures such as th...Temporal lobe epilepsy is the most common form of focal epilepsy in adults,accounting for one third of all diagnosed epileptic patients,with seizures originating from or involving mesial temporal structures such as the hippocampus,and many of these patients being refractory to treatment with anti-epileptic drugs.Temporal lobe epilepsy is the most common childhood neurological disorder and,compared with adults,the symptoms are greatly affected by age and brain development.Diagnosis of temporal lobe epilepsy relies on clinical examination,patient history,electroencephalographic recordings,and brain imaging.Misdiagnosis or delay in diagnosis is common.A molecular biomarker that could distinguish epilepsy from healthy subjects and other neurological conditions would allow for an earlier and more accurate diagnosis and appropriate treatment to be initiated.Among possible biomarkers of pathological changes as well as potential therapeutic targets in the epileptic brain are micro RNAs.Most of the recent studies had performed micro RNA profiling in body fluids such as blood plasma and blood serum and brain tissues such as temporal cortex tissue and hippocampal tissue.A large number of micro RNAs were dysregulated when compared to healthy controls and with some overlap between individual studies that could serve as potential biomarkers.For example,in adults with temporal lobe epilepsy,possible biomarkers are miR-199a-3p in blood plasma and miR-142-5p in blood plasma and blood serum.In adults with mesial temporal lobe epilepsy,possible biomarkers are miR-153 in blood plasma and miR-145-3p in blood serum.However,in many of the studies involving patients who receive one or several anti-epileptic drugs,the influence of these on micro RNA expression in body fluids and brain tissues is largely unknown.Further studies are warranted with children with temporal lobe epilepsy and consideration should be given to utilizing mouse or rat and non-human primate models of temporal lobe epilepsy.The animal models could be used to confirm 展开更多
目的：探究颞叶难治性癫痫患者致痫灶脑组织中高迁移率族蛋白 B1（HMGB1）及Toll样受体蛋白（TLR4）的表达及意义。方法：选取2011年1月1日至2012年1月1日于郑州大学第五附属医院行“致痫灶切除术”的颞叶难治性癫痫患者85例为实验组，...目的：探究颞叶难治性癫痫患者致痫灶脑组织中高迁移率族蛋白 B1（HMGB1）及Toll样受体蛋白（TLR4）的表达及意义。方法：选取2011年1月1日至2012年1月1日于郑州大学第五附属医院行“致痫灶切除术”的颞叶难治性癫痫患者85例为实验组，术中留取致痫灶脑组织标本；选取同期于该院神经外科行“颅内减压术”的患者20例为对照组，术中留取正常脑组织标本。利用免疫组织化学法检测实验组患者致痫灶脑组织及对照组正常脑组织中HMGB1及其受体TLR4的表达，统计分析患者癫痫发作与致痫灶组织中HMGB1及TLR4表达的关系。结果：实验组患者致痫灶脑组织中HMGB1（χ2＝74．375， P ＝0．000）、TLR4（χ2＝57．495， P ＝0．000）阳性表达率均明显高于正常脑组织；实验组患者致痫灶脑组织中 HMGB1、TLR4表达水平与患者癫痫病程（χ2＝25．798， P ＝0．000）、（χ2＝10．548， P ＝0．001），术前癫痫平均发作时间（χ2＝8．403， P ＝0．004）、（χ2＝10．564， P ＝0．001），术前癫痫发作频率（χ2＝4．912， P ＝0．027）、（χ2＝5．567， P ＝0．018）密切相关。结论：HMGB1-TLR4轴可能成为难治性癫痫发病机制、诊疗研究的新方向。展开更多
Background:Recent studies have shown a possible coexistence of absence seizures with other forms of epilepsy.The purpose of this study was to ascertain the possible contemporary or subsequent presence of childhood abs...Background:Recent studies have shown a possible coexistence of absence seizures with other forms of epilepsy.The purpose of this study was to ascertain the possible contemporary or subsequent presence of childhood absence epilepsy (CAE) and benign epilepsy with centro-temporal spikes (BECTS) in pediatric epileptic patients.Data sources:A PubMed systematic search indexed for MEDLINE,PubMed and EMBASE was undertaken to identify studies in children including articles written between 1996 and 2015.Retrospective studies,meta-analysis and case reports were included.The list of references of all the relevant articles was also studied.The date of our last search was December 2015.Results:Review of the literature revealed 19 cases,8 females and 11 males,reporting a consecutive or contemporary coexistence of CAE and BECTS within the same patients.Patient's age ranged between 4 and 12 years.Three out of 19 patients presented concomitant features of both syndromes,whereas 16 patients experienced the two syndromes at different times.Conclusions:BECTS and CAE may be pathophysiologically related,and the two epileptic phenotypes may indicate a neurobiological continuum.Further studies are needed to elucidate a probable genetic or functional link between partial and primarily generalized electro-clinical patterns in idiopathic childhood epilepsies.展开更多
Objective To explore the ability of interictal diffusion-weighted imaging(DWI)to localize the temporal lobe of seizure origin and to predict postoperative seizure control in patients with temporal lobe epilepsy(TLE).M...Objective To explore the ability of interictal diffusion-weighted imaging(DWI)to localize the temporal lobe of seizure origin and to predict postoperative seizure control in patients with temporal lobe epilepsy(TLE).Methods Twenty-seven patients with intractable TLE considered for surgery and 19 healthy volunteers were studied with conventional magnetic resonance imaging(MRI)and DWI.Apparent diffusion coefficients(ADCs)of bilateral hippocampi in both TLE patients and control subjects were obtained.Lateralization to either temporal lobe with hippocampal ADC was based on the threshold values derived from ±1SD of right/left ratios in normal subjects.And the postoperative pathology was reviewed.Results Hippocampal ADCs were higher on the side of surgery compared with those on the contralateral side as well as the ipsilateral side in control subjects [resected side(109.8±7.3)×10-5 cm2/s,contralateral side(91.7±4.7)×10-5 cm2/s,control subjects(81.6±5.2)×10-5 cm2/s,all P<0.01].Right/left hippocampal ADC ratio and conventional MRI lateralized to the operated temporal lobe in 21 of 27(77.8%)and in 18 of 27(66.7%)patients.Lateralization to the surgical side was not associated with postoperative seizure control with right/left hippocampal ADC ratio(P>0.05).Conclusions Conventional MRI is a sensitive method to detect hippocampal sclerosis.Accuracy of the right/left hippocampal ADC ratio for lateralizing to the side of surgery is very high,but it isn't a better predictor of surgical outcome.展开更多
BACKGROUND： Kainic acid can be used to induce a model of epilepsy by systemic injection, such as intraperitoneal or subcutaneous injection. Individual rats have different responses to kainic acid, therefore high dose...BACKGROUND： Kainic acid can be used to induce a model of epilepsy by systemic injection, such as intraperitoneal or subcutaneous injection. Individual rats have different responses to kainic acid, therefore high doses of drug are required and the success rate of model induction is low. It is necessary to develop an improved method to establish a temporal lobe epilepsy （TLE） animal model. OBJECTIVE： To explore an economic, stable and efficient method of establishing a TLE animal model. DESIGN, TIME AND SETTING： A completely randomized, controlled study. The experiments were performed in the Cellular Function Laboratory of the Physiology Department, Anhui Medical University from March to July 2007. MATERIALS： Twenty adult male Wistar rats, weighing 230-260 g, were provided by the Experimental Animal Centre of Nanjing Medical University. Kainic acid was purchased from Sigma in USA. Type SN-2 stereotaxic apparatus was made by Narishge in Japan. METHODS： Wistar rats were randomly divided into a kainic acid （KA） group （n = 12） and a normal saline （NS） group （n = 8）. For intrahippocampal microinjection, a burr hole was drilled in the skull at the following stereotaxic coordinates： anteroposterior （AP） 4.1 mm caudal to bregma; lateral （ML） 4.2 mm right lateral to the midline. Rats in the KA group were injected with 2.5 μL KA （0.4 g/L） into the center of the CA3 region, while in the NS group the same volume of NS was injected into the same site. MAIN OUTCOME MEASURES： Both groups were monitored under a video capture system for 12 weeks to record spontaneous seizures. Intracranial eletroencepholograph （IEEG） recordings in vivo were performed after the behavioral observations. After the IEEG recordings, hippocampi were processed into coronal sections. Nissl and Timm stainings were then performed to observe and confirm pathology. RESULTS： Twenty rats were involved in the final analysis. Behavioral observations： the eadiest spontaneous onset of epilepsy appeared 2 weeks a展开更多
文摘Background Diffusion tensor imaging （DTI） is a noninvasive imaging technique for the assessment of the integrity of cerebral tissues. This study was undertaken to assess the changes of diffusion indices of hippocampal formation （HF） in patients with medial temporal lobe epilepsy （MTLE）. Methods Fourteen patients with MTLE and 14 healthy subjects were evaluated. Mean diffusivity （MD） and fractional anisotropy （FA） from the symmetrical-voxel sampling regions of the anterior HF were calculated in all subjects. The MD and FA values were compared across the groups. Results No significant differences of MD and FA values were noted between right and left HF in the controls. In the patient group, MD significantly increased in the HF ipsilateral to the lesioned side [（9.27±1.09）×10^-4 mm^2/s], compared with the values in the contralateral HF [（8.20±0.59）×10^-4 min^2]s] （t = 4.479, P = 0.001） and healthy subjects [（7.58±0.51）×10^-4 mm^2/s] （P 〈 0.001）, but no significant differences were found in FA. When compared with the controls, patients had a significantly higher MD in the contralateral HF （P 〈 0.05）, but the difference in FA was not statistically significant. Conclusions DTI could detect hippocampal abnormality in patients with MTLE. This technique may be helpful for preoperative evaluation of such patients.
文摘Temporal lobe epilepsy is the most common form of focal epilepsy in adults,accounting for one third of all diagnosed epileptic patients,with seizures originating from or involving mesial temporal structures such as the hippocampus,and many of these patients being refractory to treatment with anti-epileptic drugs.Temporal lobe epilepsy is the most common childhood neurological disorder and,compared with adults,the symptoms are greatly affected by age and brain development.Diagnosis of temporal lobe epilepsy relies on clinical examination,patient history,electroencephalographic recordings,and brain imaging.Misdiagnosis or delay in diagnosis is common.A molecular biomarker that could distinguish epilepsy from healthy subjects and other neurological conditions would allow for an earlier and more accurate diagnosis and appropriate treatment to be initiated.Among possible biomarkers of pathological changes as well as potential therapeutic targets in the epileptic brain are micro RNAs.Most of the recent studies had performed micro RNA profiling in body fluids such as blood plasma and blood serum and brain tissues such as temporal cortex tissue and hippocampal tissue.A large number of micro RNAs were dysregulated when compared to healthy controls and with some overlap between individual studies that could serve as potential biomarkers.For example,in adults with temporal lobe epilepsy,possible biomarkers are miR-199a-3p in blood plasma and miR-142-5p in blood plasma and blood serum.In adults with mesial temporal lobe epilepsy,possible biomarkers are miR-153 in blood plasma and miR-145-3p in blood serum.However,in many of the studies involving patients who receive one or several anti-epileptic drugs,the influence of these on micro RNA expression in body fluids and brain tissues is largely unknown.Further studies are warranted with children with temporal lobe epilepsy and consideration should be given to utilizing mouse or rat and non-human primate models of temporal lobe epilepsy.The animal models could be used to confirm
文摘目的：探究颞叶难治性癫痫患者致痫灶脑组织中高迁移率族蛋白 B1（HMGB1）及Toll样受体蛋白（TLR4）的表达及意义。方法：选取2011年1月1日至2012年1月1日于郑州大学第五附属医院行“致痫灶切除术”的颞叶难治性癫痫患者85例为实验组，术中留取致痫灶脑组织标本；选取同期于该院神经外科行“颅内减压术”的患者20例为对照组，术中留取正常脑组织标本。利用免疫组织化学法检测实验组患者致痫灶脑组织及对照组正常脑组织中HMGB1及其受体TLR4的表达，统计分析患者癫痫发作与致痫灶组织中HMGB1及TLR4表达的关系。结果：实验组患者致痫灶脑组织中HMGB1（χ2＝74．375， P ＝0．000）、TLR4（χ2＝57．495， P ＝0．000）阳性表达率均明显高于正常脑组织；实验组患者致痫灶脑组织中 HMGB1、TLR4表达水平与患者癫痫病程（χ2＝25．798， P ＝0．000）、（χ2＝10．548， P ＝0．001），术前癫痫平均发作时间（χ2＝8．403， P ＝0．004）、（χ2＝10．564， P ＝0．001），术前癫痫发作频率（χ2＝4．912， P ＝0．027）、（χ2＝5．567， P ＝0．018）密切相关。结论：HMGB1-TLR4轴可能成为难治性癫痫发病机制、诊疗研究的新方向。
文摘Background:Recent studies have shown a possible coexistence of absence seizures with other forms of epilepsy.The purpose of this study was to ascertain the possible contemporary or subsequent presence of childhood absence epilepsy (CAE) and benign epilepsy with centro-temporal spikes (BECTS) in pediatric epileptic patients.Data sources:A PubMed systematic search indexed for MEDLINE,PubMed and EMBASE was undertaken to identify studies in children including articles written between 1996 and 2015.Retrospective studies,meta-analysis and case reports were included.The list of references of all the relevant articles was also studied.The date of our last search was December 2015.Results:Review of the literature revealed 19 cases,8 females and 11 males,reporting a consecutive or contemporary coexistence of CAE and BECTS within the same patients.Patient's age ranged between 4 and 12 years.Three out of 19 patients presented concomitant features of both syndromes,whereas 16 patients experienced the two syndromes at different times.Conclusions:BECTS and CAE may be pathophysiologically related,and the two epileptic phenotypes may indicate a neurobiological continuum.Further studies are needed to elucidate a probable genetic or functional link between partial and primarily generalized electro-clinical patterns in idiopathic childhood epilepsies.
文摘Objective To explore the ability of interictal diffusion-weighted imaging(DWI)to localize the temporal lobe of seizure origin and to predict postoperative seizure control in patients with temporal lobe epilepsy(TLE).Methods Twenty-seven patients with intractable TLE considered for surgery and 19 healthy volunteers were studied with conventional magnetic resonance imaging(MRI)and DWI.Apparent diffusion coefficients(ADCs)of bilateral hippocampi in both TLE patients and control subjects were obtained.Lateralization to either temporal lobe with hippocampal ADC was based on the threshold values derived from ±1SD of right/left ratios in normal subjects.And the postoperative pathology was reviewed.Results Hippocampal ADCs were higher on the side of surgery compared with those on the contralateral side as well as the ipsilateral side in control subjects [resected side(109.8±7.3)×10-5 cm2/s,contralateral side(91.7±4.7)×10-5 cm2/s,control subjects(81.6±5.2)×10-5 cm2/s,all P<0.01].Right/left hippocampal ADC ratio and conventional MRI lateralized to the operated temporal lobe in 21 of 27(77.8%)and in 18 of 27(66.7%)patients.Lateralization to the surgical side was not associated with postoperative seizure control with right/left hippocampal ADC ratio(P>0.05).Conclusions Conventional MRI is a sensitive method to detect hippocampal sclerosis.Accuracy of the right/left hippocampal ADC ratio for lateralizing to the side of surgery is very high,but it isn't a better predictor of surgical outcome.
基金Funds for the Excellent Talent of Anhui Province of China, No.06043090National Century Excellent Talents in University of China, No.NCET-06-0557Natural Science Foundation of Anhui Province Department of Education, No. KJ2007A028
文摘BACKGROUND： Kainic acid can be used to induce a model of epilepsy by systemic injection, such as intraperitoneal or subcutaneous injection. Individual rats have different responses to kainic acid, therefore high doses of drug are required and the success rate of model induction is low. It is necessary to develop an improved method to establish a temporal lobe epilepsy （TLE） animal model. OBJECTIVE： To explore an economic, stable and efficient method of establishing a TLE animal model. DESIGN, TIME AND SETTING： A completely randomized, controlled study. The experiments were performed in the Cellular Function Laboratory of the Physiology Department, Anhui Medical University from March to July 2007. MATERIALS： Twenty adult male Wistar rats, weighing 230-260 g, were provided by the Experimental Animal Centre of Nanjing Medical University. Kainic acid was purchased from Sigma in USA. Type SN-2 stereotaxic apparatus was made by Narishge in Japan. METHODS： Wistar rats were randomly divided into a kainic acid （KA） group （n = 12） and a normal saline （NS） group （n = 8）. For intrahippocampal microinjection, a burr hole was drilled in the skull at the following stereotaxic coordinates： anteroposterior （AP） 4.1 mm caudal to bregma; lateral （ML） 4.2 mm right lateral to the midline. Rats in the KA group were injected with 2.5 μL KA （0.4 g/L） into the center of the CA3 region, while in the NS group the same volume of NS was injected into the same site. MAIN OUTCOME MEASURES： Both groups were monitored under a video capture system for 12 weeks to record spontaneous seizures. Intracranial eletroencepholograph （IEEG） recordings in vivo were performed after the behavioral observations. After the IEEG recordings, hippocampi were processed into coronal sections. Nissl and Timm stainings were then performed to observe and confirm pathology. RESULTS： Twenty rats were involved in the final analysis. Behavioral observations： the eadiest spontaneous onset of epilepsy appeared 2 weeks a
