術前の腸内皮質の容量と側頭葉のにおける術後の発作の結果
Samia Elkommos1, Mark P Richardson2, Jan-Christoph Schoene-Bake3
1Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.
Lancet (London, England)
|August 28, 2015
まとめ
腸内皮質の体積の減少は,治癒不可能な側頭葉 (mTLE) の患者に手術の成功を予測するものではありません. エピレプシー手術後の発作結果に影響を与える要因を理解するためにさらなる研究が必要である.
科学分野:
- 神経学
- 神経外科
- エピレプシー 研究
背景:
- メシアル temporal lobe epilepsy (mTLE) の手術は有効ですが,患者の3分の1では失敗しています.
- 腸内皮質の異常は手術に抵抗するmTLEを引き起こすと推測されています.
- 手術前における 腸内皮質の容量を 手術の結果の予測として調べる
研究 の 目的:
- 術前の腸内皮質の容量は,治療不可能なmTLE患者の術後の発作制御を予測するかどうかを判断する.
- 腸内皮質の容量と 外科手術の結果の関連性を調べる
主な方法:
- 78人の治療不可能なmTLE患者と76人の健康な対照群のMRIスキャンを分析した.
- 左側と右側の腸内皮質の量を手動で測定した.
- 術後の結果は,国際病連合 (ILAE) の分類を用いて評価された.
主要な成果:
- mTLE患者では,対照群と比較して,ipsilateral 腸内皮質の体積が減少した.
- 右側mTLEの患者は,逆側頭皮質の体積も減少した.
- 発作のない患者と発作が持続した患者の間で,腸内皮質の体積に有意な差は認められなかった.
結論:
- 腸内皮質の大量縮小は,治療不可能なmTLEにおける術後の結果を予測するものではありません.
- 腸内皮質の接続性と切除の範囲のさらなる調査が必要である.
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