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1.
Entorhinal-Hippocampal Interactions in Medial Temporal Lobe Epilepsy   总被引:17,自引:17,他引:4  
Summary: Experimental studies suggest important interactions between hippocampus and entorhinal cerebral cortex in generation of temporal lobe seizure activity. We studied electrical expression of spontaneous temporallobe ictal activity in hippocampus and entorhinal cortex in 9 medically refractory epileptic patients who had intracranial depth and subdural electrodes implanted during surgical evaluation. All 9 patients subsequently under-went anteromedial temporal lobectomy with hippocam-pectomy, all had >50% decrease in neuronal cell density in hippocampal CA1 and CA3, and all had good to excellent seizure outcome after operation. Two to 10 spontaneous seizures were analyzed per patient (total 41 seizures). Nine patients had variable onset of seizure activity recorded in hippocampus, entorhinal cortex, or both simultaneously. Low-voltage fast activity was observed in either location and varied among seizures in an individual patient. Periodic preictal spikes, when present, were often synchronous in both locations, but were noted independently only in hippocampus. Our data suggest that preictal spikes and low-voltage fast seizure discharges have anatomically distinct origins, and that some syndromes of medial temporal lobe epilepsy involve interactions between entorhinal and hippocampal regions that act together to produce and propagate the seizures in such patients.  相似文献
2.
MRI-Based Hippocampal Volume Measurements in Epilepsy   总被引:14,自引:14,他引:6  
3.
Cortical and Hippocampal Volume Deficits in Temporal Lobe Epilepsy   总被引:13,自引:13,他引:9  
Summary: Purpose : To use quantitative magnetic resonance imaging (MRI) methods to examine the extent of volume abnormalities in the hippocampus and in extrahippocampal brain regions in localization-related epilepsy of temporal lobe origin (TLE).
Methods : Hippocampal, temporal lobe, and extratemporal lobe volumes were examined with 3–mm spin-echo coronal MRI scans in patients with unilateral TLE who were candidates for temporal lobe resection. Measures were adjusted for normal variation due to intracranial volume and age based on 72 healthy male controls. Group differences between 14 male TLE [7 left TLE (LTLE), 7 right TLE (RTLE)] patients and a subset of 49 age range-matched controls were examined with analysis of variance (ANOVA).
Results : As compared with controls, patients with TLE had smaller temporal lobe and frontoparietal region gray matter volumes, bilaterally, smaller temporal lobe white matter volumes bilaterally, and larger ventricular volumes. In contrast to these bilateral tissue volume deficits, hippocampal volume deficits in TLE were ipsilateral to the epileptogenic temporal lobe.
Conclusions : Extrahippocampal volume abnormalities were bilateral and occurred in both temporal and extra-temporal cortical regions in TLE, whereas hippocampal deficits were related to the side of the epileptogenic focus. These data suggest that brain abnormalities in TLE are not limited to the epileptogenic region.  相似文献
4.
Eleven patients had seizures with unilateral temporal lobe onset recorded with simultaneous bilateral medial temporal depth electrodes and neocortical (subdural) electrodes at least on the side of seizure onset. Of a total of 55 seizures, four had simultaneous onset in neocortex and hippocampus, and 51 had onset in unilateral hippocampus. None originated solely in temporal neocortex. Three reproducible patterns of seizure spread from hippocampus were defined in which seizures spread initially to ipsilateral neocortex (32 seizures), spread first to contralateral hippocampus (13 seizures), or spread simultaneously to ipsilateral neocortex and contralateral hippocampus. Although the region of hippocampus in which seizures arose was constant, patterns of spread sometimes varied in the same patient. When contralateral neocortical involvement occurred, it was after or with contralateral hippocampus but never before. These results suggest the existence of an operational hippocampal commissure in humans.  相似文献
5.
Epilepsy and Neuron Loss in the Hippocampus   总被引:10,自引:10,他引:5  
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Using quantitative receptor autoradiography, we assessed binding site densities and distribution patterns of glutamate, GABA(A), acetylcholine (ACh), and monoamine receptors in the hippocampus of 32-month-old Fischer 344/Brown Norway rats. Prior to autoradiography, the rats were divided into two groups according to their retention performance in a water maze reference memory task, which was assessed 1 week after 8 days of daily maze training. The animals of the inferior group showed less long-term retention of the hidden-platform task but did not differ from superior rats in their navigation performance during place training and cued trials. The decreased retention performance in the group of inferior learners was primarily accompanied by increased alpha(1)-adrenoceptors in all hippocampal subregions under inspection (CA1-CA4 and dentate gyrus), while elevated alpha(2)-adrenoceptor binding was observed in the CA1 region and DG. Furthermore, inferior learners had higher NMDA binding in the CA2 and CA4 and increased 5-HT(1A) binding sites in the CA2, CA3, and CA4 region. No significant differences between inferior and superior learners were evident with regard to AMPA, kainate, GABA(A), muscarinergic M(1), dopamine D(1), and 5-HT(2) binding densities in any hippocampal region analyzed. These results show that increased NMDA, 5-HT(1A), and alpha-adrenoceptor binding in the hippocampus is associated with a decline in spatial memory. The increased receptor binding observed in the group of old rats with inferior maze performance might be the result of neural adaptation triggered by age-related changes in synaptic connectivity and/or synaptic activity.  相似文献
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9.
Cajal was probably the first neurobiologist to suggest that plasticity of nerve cells almost completely disappeared during aging. However, we know today that neural plasticity is still present in the brain during aging. In this review we suggest that aging is a physiological process that occurs asynchronously in different areas of the brain and that the rate of that process is modulated by environmental factors and related to the neuronal-synaptic-molecular substrates of each area. We review here some of the most recent results on aging of the brain in relation to the plastic changes that occur in young and aged animals as a result of living in an enriched environment. We highlight the results from our own laboratory on the dynamics of neurotransmitters in different areas of the brain. Specifically we review first the effects of aging on neurons, dendrites, synapses, and also on molecular and functional plasticity. Second, the effects of environmental enrichment on the brain of young and aged animals. And third the effects of an enriched environment on the age-related changes in neurogenesis and in the extracellular concentrations of glutamate and GABA in hippocampus, and on dopamine, acetylcholine, glutamate and GABA under a situation of acute mild stress in the prefrontal cortex.  相似文献
10.
Duration of Sodium Amytal Effect: Behavioral and EEG Measures   总被引:7,自引:7,他引:0  
Summary: In performance of an intracarotid sodium amytal test duration of action is a critical factor since measurements obtained after cessation of action are invalid. Duration of action is often monitored by measuring handstrength contralateral to injection or by visual inspection of amytal-induced EEG slow waves ipsilateral to injection. We describe new objective methods of monitoring drug effect: quantified EEG and sensory discrimination. In a first study of patients with scalp electrodes, the two traditional and the two new measures were compared in 40 injections. Results indicated that the two EEG measures did not differ significantly and estimated a shorter drug effect than the two behavioral measures, which were also not significantly different. The two new measures had a smaller SD, indicating that they may be less erratic. In a second study of 14 patients, using intracerebral electrodes, we showed that slow waves in the frontocentral region lasted as long as the motor and sensory effects, but also that slow waves in the medial temporal region dissipated earlier than the motor and sensory deficits. Our results suggest that motor and sensory measures may overestimate the time in which valid testing can occur if hippocampal function is at issue.  相似文献
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