In this study, the diffusion tensor imaging along perivascular space analysis (DTI-ALPS) technique was utilized to evaluate the functional changes in the glymphatic system of the bilateral hemispheres in patients with unilateral temporal lobe epilepsy (TLE) accompanied by hippocampal sclerosis (HS). The aim was to gain insights into the alterations in the glymphatic system function in TLE patients. A total of 61 unilateral TLE patients with HS and 53 healthy controls (HCs) from the Department of Neurosurgery at Xiangya Hospital were included in the study. All subjects underwent DTI using the same 3 T MR Scanner, and the DTI-ALPS index was calculated. Differences in the DTI-ALPS index between TLE patients and HCs were evaluated, along with the correlation between the DTI-ALPS index of TLE and clinical features of epilepsy. These features included age, age of onset, seizure duration, and neuropsychological scores. Compared to the bilateral means of the HCs, both the ipsilateral and contralateral DTI-ALPS index of the TLE patients were significantly decreased (TLE ipsilateral 1.41 ± 0.172 vs. HC bilateral mean: 1.49 ± 0.116, = 0.006; TLE contralateral: 1.42 ± 0.158 vs. HC bilateral mean: 1.49 ± 0.116, = 0.015). The ipsilateral DTI-ALPS index in TLE patients showed a significant negative correlation with disease duration (r = -0.352, = 0.005). The present study suggests the presence of bilateral dysfunctions in the glymphatic system and also highlight a laterality feature in these dysfunctions. Additionally, the study found a significant negative correlation between the ipsilateral DTI-ALPS index and disease duration, underscoring the significance of early effective interventions and indicating potential for the development of innovative treatments targeting the glymphatic system.

中文翻译：

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单侧颞叶癫痫伴海马硬化患者双侧类淋巴功能障碍及其与病程的关系

本研究采用血管周围空间弥散张量成像分析（DTI-ALPS）技术评估单侧颞叶癫痫（TLE）伴海马硬化（HS）患者双侧半球类淋巴系统的功能变化。目的是深入了解 TLE 患者类淋巴系统功能的变化。该研究共纳入来自湘雅医院神经外科的 61 例单侧 TLE 伴 HS 患者和 53 例健康对照（HC）。所有受试者均使用相同的 3 T MR 扫描仪接受 DTI，并计算 DTI-ALPS 指数。评估了 TLE 患者和 HC 之间 DTI-ALPS 指数的差异，以及 TLE DTI-ALPS 指数与癫痫临床特征之间的相关性。这些特征包括年龄、发病年龄、癫痫发作持续时间和神经心理学评分。与HC双侧平均值相比，TLE患者的同侧和对侧DTI-ALPS指数均显着降低（TLE同侧1.41±0.172 vs. HC双侧平均值：1.49±0.116，= 0.006；TLE对侧：1.42±0.158与 HC 双侧平均值：1.49 ± 0.116，= 0.015）。 TLE患者同侧DTI-ALPS指数与病程呈显着负相关（r=-0.352，=0.005）。本研究表明类淋巴系统存在双侧功能障碍，并强调了这些功能障碍的偏侧性特征。此外，该研究发现同侧 DTI-ALPS 指数与疾病持续时间之间存在显着负相关，强调了早期有效干预的重要性，并表明开发针对类淋巴系统的创新治疗方法的潜力。