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|Título: ||Relationship between environmental factors and gray matter atrophy in refractory MTLE|
|Autor(es): ||Yasuda, C.L.|
Saúde, André Vital
Oliveira, E. de
|Assunto: ||Epilepsy – Complications|
White matter – Atrophy
Gray matter – Atrophy
Voxel-based morphometry (VBM)
Epilepsia – Complicações
Substância branca – Atrofia
Substância cinzenta – Atrofia
Morfometria baseada em voxel
|Publicador: ||American Academy of Neurology|
|Data de publicação: ||30-Mar-2010|
|Referência: ||YASUDA, C. L. et al. Relationship between environmental factors and gray matter atrophy in refractory MTLE. Neurology, Minneapolis, v. 74, n. 13, p. 1062-1068, Mar. 2010.|
|Abstract: ||Objective: To investigate clinical, neuropsychological, and MRI abnormalities (gray matter atrophy [GMA] and white matter atrophy [WMA]) in surgical mesial temporal lobe epilepsy (MTLE) patients with and without familial antecedent for epilepsy.
Methods: A cohort study including 69 operated patients with unilateral MTLE, divided into a group of 29 patients (mean age 35.8 ± 10.4 years) with a negative family history (FH) of epilepsy and a group of 40 patients (32.8 ± 10 years) with a positive FH. We performed voxel-based morphometry (VBM) on preoperative MRIs and investigated possible clinical and neuropsychological differences between the 2 groups. We also performed VBM and t tests to compare the patients' groups with normal controls.
Results: The negative-FH group had lower IQ scores (p = 0.004), performed poorer on the Boston Naming Test (p = 0.02) and on delayed recall (p = 0.03), and presented a more prominent asymmetry index of hippocampal volume (p = 0.04) and more frequent initial precipitating injuries (p = 0.023). VBM showed a more restricted pattern of GMA in the positive-FH group and a more bilateral and widespread pattern of GMA in the negative-FH group, involving thalami, temporal, frontal, parietal, and occipital lobes. WMA was widespread and bilateral in both groups.
Conclusions: The more widespread structural voxel-based morphometry abnormalities and worse IQ performance identified in the negative–family history (FH) group may result from a stronger environmental influence, including initial precipitating injuries. This is further support for the hypothesis that hippocampal sclerosis in mesial temporal lobe epilepsy with positive FH is determined by a stronger genetic predisposition with less influence of environmental factors compared with patients in the negative-FH group.|
|Aparece nas coleções: ||DCC - Artigos publicados em periódicos|
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