Clinical Features And Grey Matter Volume Analysis Of Temporal Lobe Epilepsy With Amygdala Enlargement

Background:Temporal lobe epilepsy（TLE）with amygdala enlargement（AE）is considered to be a possible new subtype of TLE,which has unique clinical characteristics,electroencephalogram（EEG）,metabolism,and other characteristics.However,the current reports on the clinical characteristics of TLE patients with AE are inconsistent,and most studies have small sample sizes.Some studies have incomplete control groups.As a result,it is necessary to further improve the experimental design and explore the unique clinical characteristics of TLE patients with AE.Purpose:To explore the clinical features of TLE patients with AE,and to analyze their grey matter volume by voxel-based morphometric measurement（VBM）to provide more evidence and guidance for the clinical diagnosis and treatment of TLE patients.Methods:The study included 24 patients who attended the Epilepsy Center of the First Hospital of Jilin University and were diagnosed with TLE patients with AE from January 2020 to December 2021,and the followup time was at least 6 months.Collect patients’ basic demographic characteristics,clinical characteristics,medication usage,general laboratory examinations,imaging,and long-term EEG data.The control group consisted of 30 patients of TLE with negative MRI and no enlarged amygdala and 40 healthy control groups matched with gender and age.All enrolled persons underwent 3.0 T MRI scan and 3D-T1 scan.The method of VBM was used to analyze the differences in brain tissue.The clinical features and grey matter volume changes of TLE patients with AE were compared and summarized.Results:（1）Compared with MRI-negative TLE patients without AE,the incidence of anxiety and depression in the comorbidities of TLE patients with AE was higher（P=0.019,P=0.033）.There were no significant differences in clinical characteristics such as past history,epileptic seizures,drug control,and EEG between the two groups（P>0.05）.（2）The results of VBM analysis showed that compared with MRI-negative TLE patients without AE,the left amygdala,left ipsilateral hippocampus,lefe ipsilateral parahippocampal gyrus,and right inferior temporal gyrus gray matter volume increased in TLE patients with AE.Compared with HC,the left inferior frontal gyrus of orbit,left inferior frontal gyrus of deltoid,and right precentral gyrus of TLE patients with AE decreased the gray matter volume（P<0.005,cluster size>30）Conclusion:Compared with MRI-negative TLE patients without AE,TLE patients with AE had a higher incidence of anxiety and depression in comorbidities,and there was no significant difference in other clinical characteristics.In TLE patients with AE,the volume of gray matter in the amygdala,hippocampus,parahippocampal gyrus and contralateral inferior temporal gyrus increased in the AE side,and the gray matter volume in the left inferior frontal gyrus and right precentral gyrus decreased,which may be related to speech,cognition,and movement.