| Background:Mesial Temporal Lobe Epilepsy (MTLE) is the main type of Intractable Epilepsy, and the main pathological change is hippocampus sclerosis. and the pathogenesis mechanism is still not entirely clear now. The microsurgical treatment of MTLE, mainly including selective amygdalehippocampectomy, is considered to be an effective treatment. However, the effect of clinical control of epilepsy of 30% patients is still unsatisfied. Further study of MTLE pathogenesis and screening of more effective and safe therapeutic target is the problem that is urgently needed to solve on neuroscience.High-frequency and long term abnormal discharge of neurons can lead to recurrent seizures, and enhance synaptic transmission, make synaptic events such as exocytosis and endocytosis of synaptic vesicle occur rapidly and high-frequently. Dynamin-1 plays an key role on synaptic vesicle recycle and transport of vesicles in the Golgi. Dynamin-1 plays a key role on the keeping of high-frequency and long term discharge of neurons. The dephosphorylation of Dynamin-1 is the activation state. Dynamin-1 of phosphorylation which is the steady state distributes in the synaptic cytoplasm. Dynamin-1 of dephosphorylation transfers to the presynaptic membrane to mediate endocytosis, and recycle neurotransmitter and vesicles. The research of the expression of Dynamin-1 and Dynamin-1 of phosphorylation in MTLE hippocampus is helpful to exlpore the pathogenesis and the role of synaptic vesicle recycle in MTLE to provide the target for the treatment. Objective:To study the effect of the microsurgery treatment for MTLE; To study the different expression of Dynamin-1 and P-Dynamin-1 in the hippocampus of patients of MTLE and patients without epilepsy.Method:Retrospectively analyze the clinical dates of 40 patients with MTLE with microsurgery treatmentfrom July 2007 to October 2010. and follow-up data was available in all patients and analyze.11 patients underwent Standard Anterior Temporal Lobectomy(SATL), and 29 patients for Selective AmygdaloHippocampectomy(SAH).The expression of Dynamin-1 and P-Dynamin-1 was detected with Western blot and the expression of P-Dynamin-1 was also detected with immunohistochemistry. The results were analyzed using SPSS software, count data using chi-square test, measurement data using T test. P<0.05 was considered statistically significant.Result:The mean followed up was 20.3 months for 40 patients. According to Engel grade:28 cases were Gradeâ… , the rate was 70%; 6 (15%) cases were Gradeâ…¡; 2(5%) cases were Gradeâ…¢; 4(10%) cases were Gradeâ…£. There were no mortality, 16 (40%) cases of patients had visual field defect after surgical operation, 3 cases had obvious symptom of visual field deficit,5 (12.5%) cases experienced memory decreased.The result of Western blot demonstrated that there was no difference between the expressions of total Dynamin-1 in the hippocampus of patients with MTLE and normal controls; compared to the normal control group, the expression of p-Dynamin-lin the MTLE group decreased, the result was considered statistically significant(P<0.05). The result of immunohistochemistry showed that the radio of the positive expression of p-Dynamin-1 was lower than the normal control.ConclusionMicrosurgery was efficient treatment for MTLE. The epilepsy control between SAH and StATL was not different, however, with less effect on temporal stem and temporal lobe.The expression of total Dynamin-lwas not different between MTLE hippocampus and normal control, While, the expression of P-Dynamin-1 in the hippocampus of patients with MTLE decreased obviously,which showed that P- Dynamin-1 was significantly related to the proceed of MTLE. |
PDF Full Text Request