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囊泡乙酰胆碱转运体减少与癫痫相关记忆障碍有相关性：一项［18F］VAT 正电子发射断层扫描脑成像研究

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.

《癫痫发作分类标准更新：国际抗癫痫联盟立场声明》中国专家解读

基于2017版癫痫发作分类框架，国际抗癫痫联盟（International League Against Epilepsy，ILAE）完成了癫痫发作操作性分类标准的更新。本次修订由ILAE执行委员会任命的37人工作组共同完成：通过改良Delphi法（共识阈值设定为超过三分之二的多数）公开征求意见后形成修订方案。该修订方案在ILAE 官网公示征求意见后，执委会任命7名专家组成修订小组对反馈意见进行整合，最终更新的分类标准于2025年4月在Epilepsia上发表。更新后的分类标准延续四大主要发作类别：局灶性、全面性、未知是否为局灶性或全面性和无法分类的发作，共包含4个主要类别和21种具体发作类型，并特别注重非英语语种的术语可译性，旨在为从资源有限地区到高级专科癫痫中心的所有癫痫从业人员建立统一术语体系，并为患者及照护者提供通俗易懂的表述。鉴于癫痫发作分类在癫痫诊断和治疗中的重要作用，本文融合中国癫痫领域专家解读《癫痫发作分类标准更新：国际抗癫痫联盟立场声明》并形成共识，旨在推进该分类标准在我国癫痫领域临床和科研中的应用。