단측성 내측두엽 간질의 국소 뇌혈류 분포：발작기 및 발작간기 스펙트의 SPM 분석
Regional Cerebral Blood Flow Patterns in Unilateral Mesial Temporal Lobe Epilepsy：Statistical Parametric Mapping of Ictal and Interictal SPECT
태우석, 주은연, 김지현, 서대원, 홍성철, 이문향, 김명희, 홍승봉,
소속 상세정보
태우석 ( Tae Woo-Suk )
성균관대학교 의과대학 삼성서울병원 신경과학교실
주은연 ( Joo Eun-Yeon )
성균관대학교 의과대학 삼성서울병원 신경과학교실
김지현 ( Kim Jee-Hyun )
성균관대학교 의과대학 삼성서울병원 신경과학교실
서대원 ( Seo Dae-Won )
성균관대학교 의과대학 삼성서울병원 신경과
홍성철 ( Hong Seung-Chyul )
성균관대학교 의과대학 삼성서울병원 신경외과학교실
이문향 ( Lee Mun-Hyang )
성균관대학교 의과대학 삼성서울병원 소아과학교실
김명희 ( Kim Myoung-Hee )
이화여자대학교 컴퓨터학과
홍승봉 ( Hong Seung-Bong )
성균관대학교 의과대학 삼성서울병원 신경과학교실
KMID : 0877220030070010016
Abstract
Purpose：To investigate the regional cerebral blood flow of pati-ents with mesial temporal lobe epilepsy (mTLE), we performed the statistical parametric mapping (SPM) analysis in patients with mTLE.
Methods：Nineteen normal subjects and 38 with mTLE (22 left, 16 right) underwent brain SPECT. For SPM analysis, all SPECT images were spatially normalized and then smoothed. The left and right mTLE groups were statistically compared with normal sub-jects, and the paired t-test was performed between ictal and inte-rictal SPECTs. The positive and negative contrasts displayed the regions of hypo- or hyper-perfusion, respectively. The significance level was set to false discovery rate corrected p<0.05.
Results：In the interictal state, the ipsilateral hippocampus, both thalami, pericentral gyri, left insula, and both medial frontal lobes showed hypoperfusion, whereas both posterior lateral temporal ar-eas showed hyperperfusion. In the ictal state, the rCBF of ipsilateral temporal lobe to the epileptic focus and both prefrontal white ma-tters increased, while both medial frontal lobes showed hypoper-fusion. In the right mTLE, the left hippocampus and insula showed hypoperfusion during the interictal state. In the paired t-test, ipsila-teral temporal lobe, hippocampus, thalamus, putamen, insula, and both precentral gyri showed hyperperfusion.
Conclusions：Surprisingly, the hypoperfusion and hyperperfu-sion patterns of patients with mTLE were similar both in the interictal and ictal states. These findings indicate that the occurrence and propagation of epileptic discharges happen not only in the ictal state but also during the interictal period. The hypoperfusion pat-terns suggest that the cortico-thalamo-hippocampal-insula circuit was impaired during the interictal state while temporal and pre-frontal regions showed hypofunction during the ictal period.
키워드
Mesial temporal lobe epilepsy;SPECT·Hyper-perfusion;Hypoperfusion;Statistical parametric mapping
원문 및 링크아웃 정보
등재저널 정보