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The double inversion recovery study on the gray matter abnormalities of MRI negative temporal lobe epilepsy patients

ObjectivesTo study the gray matter (GM) volume of MRI-negative temporal lobe epilepsy (TLE) patients with double inversion recovery (DIR) combining with SPM analysis.MethodsTwenty-four MRI-negative TLE patients and twenty-four healthy controls (HC) with matched sex and age were collected from Zhongshan hospital from 2016 Januany to 2018 December. All the participants underwent DIR scanning and the MRI data were further postprocessed with Statistical Parametric Mapping (SPM).ResultsMRI-negative TLE patients showed reduced GM density in the left superior frontal gyrus (medial orbital), right temporal pole, right para-hippocampal gyrus, right lingual gyrus, and increased GM value in the right superior frontal gyrus (medial) than HC group with statistical significance (P<0 001="" cluster="">50). According to the EEG manifestation, the MRI-negative TLE group was classified into the multiple and single focal discharges group.The multiple focal discharges MRI-negative TLE group demonstrated decreased GM density in the right temporal pole, right superior occipital gyrus, right para-hippocampal gyrus and bilateral superiorfrontal gyrus (medial orbital), but increased GM value in the right superior frontal gyrus (medial) than HC group with statistical significance (P<0 001="" cluster="">50). No statistical differences were found in the single focal discharges MRI-negative TLE group comparing with either the HC or multiple focal discharges group. According to the seizure type with or without secondarily generalizedtonic-clonic seizures, the MRI-negative TLE patients were classified into sGTCS and non-sGTCS group. There existed greater statistical GM density for sGTCS group in the right lingual gyrus, right thalamus, left middle occipital gyrus, left basal ganglia and left cuneus than the non-sGTCS group (P<0 001="" cluster="">50).ConclusionsThere existed wider areas of GM volume changes in the brain regions of MRI negative TLE patients, including both the temporal and extra-temporal areas, with most significant GM alteration in multiple focal discharges and sGTCS TLE group.

囊泡乙酰膽堿轉運體減少與癲癇相關記憶障礙有相關性：一項［18F］VAT 正電子發射斷層掃描腦成像研究

《癲癇發作分類標準更新：國際抗癲癇聯盟立場聲明》中國專家解讀

基于2017版癲癇發作分類框架，國際抗癲癇聯盟（International League Against Epilepsy，ILAE）完成了癲癇發作操作性分類標準的更新。本次修訂由ILAE執行委員會任命的37人工作組共同完成：通過改良Delphi法（共識閾值設定為超過三分之二的多數）公開征求意見后形成修訂方案。該修訂方案在ILAE 官網公示征求意見后，執委會任命7名專家組成修訂小組對反饋意見進行整合，最終更新的分類標準于2025年4月在Epilepsia上發表。更新后的分類標準延續四大主要發作類別：局灶性、全面性、未知是否為局灶性或全面性和無法分類的發作，共包含4個主要類別和21種具體發作類型，并特別注重非英語語種的術語可譯性，旨在為從資源有限地區到高級專科癲癇中心的所有癲癇從業人員建立統一術語體系，并為患者及照護者提供通俗易懂的表述。鑒于癲癇發作分類在癲癇診斷和治療中的重要作用，本文融合中國癲癇領域專家解讀《癲癇發作分類標準更新：國際抗癲癇聯盟立場聲明》并形成共識，旨在推進該分類標準在我國癲癇領域臨床和科研中的應用。