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Título: Relationship between environmental factors and gray matter atrophy in refractory MTLE
Autor(es): Yasuda, C.L.
Morita, M.E.
Alessio, A.
Pereira, A.R.
Balthazar, M.L.F.
Saúde, André Vital
Costa, A.L.F.
Costa, A.L.C.
Cardoso, T.A.
Betting, L.E.
Guerreiro, C.A.M.
Damasceno, B.P.
Lopes-Cendes, I.
Tedeschi, H.
Oliveira, E. de
Cendes, F.
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.
URI: http://www.neurology.org/content/74/13/1062.short
http://repositorio.ufla.br/jspui/handle/1/12281
Idioma: en_US
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