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Han Y, Hao G, Wang Z, Wang C, Qi X, Liang G, Li X. Association between serum apolipoprotein E and cognitive function in Chinese patients with temporal lobe epilepsy. Epilepsy Behav 2024; 154:109750. [PMID: 38552413 DOI: 10.1016/j.yebeh.2024.109750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 03/14/2024] [Accepted: 03/21/2024] [Indexed: 05/06/2024]
Abstract
OBJECTIVE To investigate the effect of serum apolipoprotein E (APOE) levels on cognitive function in patients with temporal lobe epilepsy (TLE). METHODS Clinical data were collected from 190 subjects including 110 TLE patients and 80 healthy people. Cognitive function was assessed using the Addenbrooke's Cognitive Examination Revised (ACE-R) scale. Serum levels of APOE were measured using ELISA kits. Genotyping of APOE in peripheral blood was detected by microarray hybridization. RESULTS Patients with TLE had significantly lower ACE-R total score, memory and verbal fluency scores compared to the healthy group. Serum levels of APOE were significantly higher in TLE patients than in the healthy subjects. Serum APOE levels were significantly negatively correlated with ACE-R total score, memory and verbal fluency scores. The cognitive function score of TLE with APOE ε4 allele was lower than that of TLE without APOE ε4 allele. SIGNIFICANCE Our study showed that serum APOE levels were higher in TLE patients than in the healthy population. And serum APOE levels were associated with cognitive dysfunction in TLE patients. APOE ε4 allele carriers have poor cognitive function in TLE patients.
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Affiliation(s)
- Yuwei Han
- Department of Neurology, General Hospital of Northern Theater Command, Shenyang, Liaoning, 110016, China
| | - Guangzhi Hao
- Department of Neurology, General Hospital of Northern Theater Command, Shenyang, Liaoning, 110016, China
| | - Zhen Wang
- Department of Neurology, General Hospital of Northern Theater Command, Shenyang, Liaoning, 110016, China
| | - Chenchen Wang
- Department of Neurology, General Hospital of Northern Theater Command, Shenyang, Liaoning, 110016, China
| | - Xin Qi
- Department of Neurology, General Hospital of Northern Theater Command, Shenyang, Liaoning, 110016, China
| | - Guobiao Liang
- Department of Neurology, General Hospital of Northern Theater Command, Shenyang, Liaoning, 110016, China
| | - Xiaoming Li
- Department of Neurology, General Hospital of Northern Theater Command, Shenyang, Liaoning, 110016, China.
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Manmatharayan A, Kogan M, Matias C, Syed M, Shelley I, Chinni A, Kang K, Talekar K, Faro SH, Mohamed FB, Sharan A, Wu C, Alizadeh M. Automated subfield volumetric analysis of amygdala, hippocampus, and thalamic nuclei in mesial temporal lobe epilepsy. World Neurosurg X 2023; 19:100212. [PMID: 37304157 PMCID: PMC10250154 DOI: 10.1016/j.wnsx.2023.100212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 05/03/2023] [Accepted: 05/08/2023] [Indexed: 06/13/2023] Open
Abstract
Purpose Identifying relationships between clinical features and quantitative characteristics of the amygdala-hippocampal and thalamic subregions in mesial temporal lobe epilepsy (mTLE) may offer insights into pathophysiology and the basis for imaging prognostic markers of treatment outcome. Our aim was to ascertain different patterns of atrophy or hypertrophy in mesial temporal sclerosis (MTS) patients and their associations with post-surgical seizure outcomes. To assess this aim, this study is designed in 2 folds: (1) hemispheric changes within MTS group and (2) association with postsurgical seizure outcomes. Methods and materials 27 mTLE subjects with mesial temporal sclerosis (MTS) were scanned for conventional 3D T1w MPRAGE images and T2w scans. With respect to 12 months post-surgical seizure outcomes, 15 subjects reported being seizure free (SF) and 12 reported continued seizures. Quantitative automated segmentation and cortical parcellation were performed using Freesurfer. Automatic labeling and volume estimation of hippocampal subfields, amygdala, and thalamic subnuclei were also performed. The volume ratio (VR) for each label was computed and compared between (1) between contralateral and ipsilateral MTS using Wilcoxon rank-sum test and (2) SF and not seizure free (NSF) groups using linear regression analysis. False Discovery rate (FDR) with significant level of 0.05 were used in both analyses to correct for multiple comparisons. Results Amygdala: The medial nucleus of the amygdala was the most significantly reduced in patients with continued seizures when compared to patients who remained seizure free. Hippocampus: Comparison of ipsilateral and contralateral volumes with seizure outcomes showed volume loss was most evident in the mesial hippocampal regions such as CA4 and hippocampal fissure. Volume loss was also most explicit in the presubiculum body in patients with continued seizures at the time of their follow-up. Ipsilateral MTS compared to contralateral MTS analysis showed the heads of the ipsilateral subiculum, presubiculum, parasubiculum, dentate gyrus, CA4, and CA3 were more significantly affected than their respective bodies. Volume loss was most noted in mesial hippocampal regions. Thalamus: VPL and PuL were the most significantly reduced thalamic nuclei in NSF patients. In all statistically significant areas, volume reduction was observed in the NSF group. No significant volume reductions were noted in the thalamus and amygdala when comparing ipsilateral to contralateral sides in mTLE subjects. Conclusions Varying degrees of volume loss were demonstrated in the hippocampus, thalamus, and amygdala subregions of MTS, especially between patients who remained seizure-free and those who did not. The results obtained can be used to further understand mTLE pathophysiology. Clinical relevance/application In the future, we hope these results can be used to deepen the understanding of mTLE pathophysiology, leading to improved patient outcomes and treatments.
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Affiliation(s)
- Arichena Manmatharayan
- Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, 909 Walnut St, Philadelphia, PA, 19107, USA
| | - Michael Kogan
- Department of Neurosurgery, University of New Mexico, Albuquerque, NM, 87131-0001, USA
| | - Caio Matias
- Department of Neurosurgery, Thomas Jefferson University, 909 Walnut Street, 2nd Floor, Philadelphia, PA, 19107, USA
| | - Mashaal Syed
- Department of Neurosurgery, Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, 909 Walnut St, Philadelphia, PA, 19107, USA
| | - India Shelley
- Department of Neurosurgery, Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, 909 Walnut St, Philadelphia, PA, 19107, USA
| | - Amar Chinni
- Department of Neurosurgery, Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, 909 Walnut St, Philadelphia, PA, 19107, USA
| | - Kichang Kang
- Department of Neurosurgery, Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, 909 Walnut St, Philadelphia, PA, 19107, USA
| | - Kiran Talekar
- Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, 909 Walnut St, Philadelphia, PA, 19107, USA
| | - Scott H. Faro
- Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, 909 Walnut St, Philadelphia, PA, 19107, USA
| | - Feroze B. Mohamed
- Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, 909 Walnut St, Philadelphia, PA, 19107, USA
| | - Ashwini Sharan
- Department of Neurosurgery, Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, 909 Walnut St, Philadelphia, PA, 19107, USA
| | - Chengyuan Wu
- Department of Neurosurgery, Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, 909 Walnut St, Philadelphia, PA, 19107, USA
| | - Mahdi Alizadeh
- Department of Neurosurgery, Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, 909 Walnut St, Philadelphia, PA, 19107, USA
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Hermann BP, Struck AF, Busch RM, Reyes A, Kaestner E, McDonald CR. Neurobehavioural comorbidities of epilepsy: towards a network-based precision taxonomy. Nat Rev Neurol 2021; 17:731-746. [PMID: 34552218 PMCID: PMC8900353 DOI: 10.1038/s41582-021-00555-z] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2021] [Indexed: 02/06/2023]
Abstract
Cognitive and behavioural comorbidities are prevalent in childhood and adult epilepsies and impose a substantial human and economic burden. Over the past century, the classic approach to understanding the aetiology and course of these comorbidities has been through the prism of the medical taxonomy of epilepsy, including its causes, course, characteristics and syndromes. Although this 'lesion model' has long served as the organizing paradigm for the field, substantial challenges to this model have accumulated from diverse sources, including neuroimaging, neuropathology, neuropsychology and network science. Advances in patient stratification and phenotyping point towards a new taxonomy for the cognitive and behavioural comorbidities of epilepsy, which reflects the heterogeneity of their clinical presentation and raises the possibility of a precision medicine approach. As we discuss in this Review, these advances are informing the development of a revised aetiological paradigm that incorporates sophisticated neurobiological measures, genomics, comorbid disease, diversity and adversity, and resilience factors. We describe modifiable risk factors that could guide early identification, treatment and, ultimately, prevention of cognitive and broader neurobehavioural comorbidities in epilepsy and propose a road map to guide future research.
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Affiliation(s)
- Bruce P. Hermann
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,
| | - Aaron F. Struck
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,William S. Middleton Veterans Administration Hospital, Madison, WI, USA
| | - Robyn M. Busch
- Epilepsy Center and Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.,Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Anny Reyes
- Department of Psychiatry and Center for Multimodal Imaging and Genetics, University of California, San Diego, San Diego, CA, USA
| | - Erik Kaestner
- Department of Psychiatry and Center for Multimodal Imaging and Genetics, University of California, San Diego, San Diego, CA, USA
| | - Carrie R. McDonald
- Department of Psychiatry and Center for Multimodal Imaging and Genetics, University of California, San Diego, San Diego, CA, USA
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Roggenhofer E, Muller S, Santarnecchi E, Melie-Garcia L, Wiest R, Kherif F, Draganski B. Remodeling of brain morphology in temporal lobe epilepsy. Brain Behav 2020; 10:e01825. [PMID: 32945137 PMCID: PMC7667340 DOI: 10.1002/brb3.1825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 08/10/2020] [Accepted: 08/14/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Mesial temporal lobe epilepsy (TLE) is one of the most widespread neurological network disorders. Computational anatomy MRI studies demonstrate a robust pattern of cortical volume loss. Most statistical analyses provide information about localization of significant focal differences in a segregationist way. Multivariate Bayesian modeling provides a framework allowing inferences about inter-regional dependencies. We adopt this approach to answer following questions: Which structures within a pattern of dynamic epilepsy-associated brain anatomy reorganization best predict TLE pathology. Do these structures differ between TLE subtypes? METHODS We acquire clinical and MRI data from TLE patients with and without hippocampus sclerosis (n = 128) additional to healthy volunteers (n = 120). MRI data were analyzed in the computational anatomy framework of SPM12 using classical mass-univariate analysis followed by multivariate Bayesian modeling. RESULTS After obtaining TLE-associated brain anatomy pattern, we estimate predictive power for disease and TLE subtypes using Bayesian model selection and comparison. We show that ipsilateral para-/hippocampal regions contribute most to disease-related differences between TLE and healthy controls independent of TLE laterality and subtype. Prefrontal cortical changes are more discriminative for left-sided TLE, whereas thalamus and temporal pole for right-sided TLE. The presence of hippocampus sclerosis was linked to stronger involvement of thalamus and temporal lobe regions; frontoparietal involvement was predominant in absence of sclerosis. CONCLUSIONS Our topology inferences on brain anatomy demonstrate a differential contribution of structures within limbic and extralimbic circuits linked to main effects of TLE and hippocampal sclerosis. We interpret our results as evidence for TLE-related spatial modulation of anatomical networks.
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Affiliation(s)
- Elisabeth Roggenhofer
- Neurology Department, Department of Clinical Neuroscience, HUG, University Hospitals and Faculty of Medicine Geneva, Geneva, Switzerland.,Department of Clinical Neurosciences, LREN, CHUV, University of Lausanne, Lausanne, Switzerland
| | - Sandrine Muller
- Department of Clinical Neurosciences, LREN, CHUV, University of Lausanne, Lausanne, Switzerland
| | - Emiliano Santarnecchi
- Berenson-Allen Center for Non-Invasive Brain Stimulation, Cognitive Neurology Department, Beth Israel Medical Center, Harvard Medical School, Boston, MA, USA.,Siena Brain Investigation and Neuromodulation Lab, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Lester Melie-Garcia
- Department of Clinical Neurosciences, LREN, CHUV, University of Lausanne, Lausanne, Switzerland.,Applied Signal Processing Group, Swiss Federal Institute of Technology Lausanne (EPFL), Lausanne, Switzerland
| | - Roland Wiest
- Support Center for Advanced Neuroimaging, Institute for Diagnostic and Interventional Neuroradiology, University Hospital Inselspital, University of Bern, Bern, Switzerland
| | - Ferath Kherif
- Department of Clinical Neurosciences, LREN, CHUV, University of Lausanne, Lausanne, Switzerland
| | - Bogdan Draganski
- Department of Clinical Neurosciences, LREN, CHUV, University of Lausanne, Lausanne, Switzerland.,Department of Neurology, Max-Planck-Institute for Human Cognitive and Brain Sciences, Max Planck Society, Leipzig, Germany
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5
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Long L, Galovic M, Chen Y, Postma T, Vos SB, Xiao F, Wu W, Song Y, Huang S, Koepp M, Xiao B. Shared hippocampal abnormalities in sporadic temporal lobe epilepsy patients and their siblings. Epilepsia 2020; 61:735-746. [PMID: 32196657 DOI: 10.1111/epi.16477] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 02/21/2020] [Accepted: 02/21/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To examine the shared familial contribution to hippocampal and extrahippocampal morphological abnormalities in patients with sporadic temporal lobe epilepsy (TLE) and their unaffected siblings. METHODS We collected clinical, electrophysiological, and T1-weighted magnetic resonance imaging (MRI) data of 18 sporadic patients with TLE without lesions other than hippocampal sclerosis (12 right, 6 left), their 18 unaffected full siblings, and 18 matched healthy volunteers. We compared between-group differences in cortical thickness and volumes of five subcortical areas (hippocampus, amygdala, thalamus, putamen, and pallidum). We determined the subregional extent of hippocampal abnormalities using surface shape analysis. All our imaging results were corrected for multiple comparisons using random field theory. RESULTS We detected smaller hippocampal volumes in patients (right TLE: median right hippocampus 1.92 mL, interquartile range [IQR] 1.39-2.62, P < .001; left TLE: left hippocampus 2.05 mL, IQR 1.99-2.33, P = .01) and their unaffected siblings (right hippocampus 2.65 mL, IQR 2.32-2.80, P < .001; left hippocampus 2.39 mL, IQR 2.18-2.53, P < .001) compared to healthy controls (right hippocampus 2.94 mL, IQR 2.77-3.24; left hippocampus 2.71 mL, IQR 2.37-2.89). Surface shape analysis showed that patients with TLE had bilateral subregional atrophy in both hippocampi (right > left). Similar but less-pronounced subregional atrophy was detected in the right hippocampus of unaffected siblings. Patients with TLE had reduced cortical thickness in bilateral premotor/prefrontal cortices and the right precentral gyrus. Siblings did not show abnormalities in cortical or subcortical areas other than the hippocampus. SIGNIFICANCE Our results demonstrate a shared vulnerability of the hippocampus in both patients with TLE and their unaffected siblings, pointing to a contribution of familial factors to hippocampal atrophy. This neuroimaging trait could represent an endophenotype of TLE, which might precede the onset of epilepsy in some individuals.
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Affiliation(s)
- Lili Long
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China.,Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
| | - Marian Galovic
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK.,MRI Unit, Chalfont Centre for Epilepsy, Chalfont St Peter, UK.,Department of Neurology, University Hospital Zurich, Zurich, Switzerland
| | - Yayu Chen
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Tjardo Postma
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
| | - Sjoerd B Vos
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK.,MRI Unit, Chalfont Centre for Epilepsy, Chalfont St Peter, UK.,Centre for Medical Image Computing, University College London, London, UK
| | - Fenglai Xiao
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK.,MRI Unit, Chalfont Centre for Epilepsy, Chalfont St Peter, UK
| | - Wenyue Wu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Yanmin Song
- Department of Emergency, Xiangya Hospital, Central South University, Changsha, China
| | - Sha Huang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Matthias Koepp
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK.,MRI Unit, Chalfont Centre for Epilepsy, Chalfont St Peter, UK
| | - Bo Xiao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
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Pagnozzi AM, Fripp J, Rose SE. Quantifying deep grey matter atrophy using automated segmentation approaches: A systematic review of structural MRI studies. Neuroimage 2019; 201:116018. [PMID: 31319182 DOI: 10.1016/j.neuroimage.2019.116018] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 07/01/2019] [Accepted: 07/12/2019] [Indexed: 12/13/2022] Open
Abstract
The deep grey matter (DGM) nuclei of the brain play a crucial role in learning, behaviour, cognition, movement and memory. Although automated segmentation strategies can provide insight into the impact of multiple neurological conditions affecting these structures, such as Multiple Sclerosis (MS), Huntington's disease (HD), Alzheimer's disease (AD), Parkinson's disease (PD) and Cerebral Palsy (CP), there are a number of technical challenges limiting an accurate automated segmentation of the DGM. Namely, the insufficient contrast of T1 sequences to completely identify the boundaries of these structures, as well as the presence of iso-intense white matter lesions or extensive tissue loss caused by brain injury. Therefore in this systematic review, 269 eligible studies were analysed and compared to determine the optimal approaches for addressing these technical challenges. The automated approaches used among the reviewed studies fall into three broad categories, atlas-based approaches focusing on the accurate alignment of atlas priors, algorithmic approaches which utilise intensity information to a greater extent, and learning-based approaches that require an annotated training set. Studies that utilise freely available software packages such as FIRST, FreeSurfer and LesionTOADS were also eligible, and their performance compared. Overall, deep learning approaches achieved the best overall performance, however these strategies are currently hampered by the lack of large-scale annotated data. Improving model generalisability to new datasets could be achieved in future studies with data augmentation and transfer learning. Multi-atlas approaches provided the second-best performance overall, and may be utilised to construct a "silver standard" annotated training set for deep learning. To address the technical challenges, providing robustness to injury can be improved by using multiple channels, highly elastic diffeomorphic transformations such as LDDMM, and by following atlas-based approaches with an intensity driven refinement of the segmentation, which has been done with the Expectation Maximisation (EM) and level sets methods. Accounting for potential lesions should be achieved with a separate lesion segmentation approach, as in LesionTOADS. Finally, to address the issue of limited contrast, R2*, T2* and QSM sequences could be used to better highlight the DGM due to its higher iron content. Future studies could look to additionally acquire these sequences by retaining the phase information from standard structural scans, or alternatively acquiring these sequences for only a training set, allowing models to learn the "improved" segmentation from T1-sequences alone.
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Affiliation(s)
- Alex M Pagnozzi
- CSIRO Health and Biosecurity, The Australian e-Health Research Centre, Brisbane, Australia.
| | - Jurgen Fripp
- CSIRO Health and Biosecurity, The Australian e-Health Research Centre, Brisbane, Australia
| | - Stephen E Rose
- CSIRO Health and Biosecurity, The Australian e-Health Research Centre, Brisbane, Australia
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Yaakub SN, Barker GJ, Carr SJ, Abela E, Koutroumanidis M, Elwes RDC, Richardson MP. Abnormal temporal lobe morphology in asymptomatic relatives of patients with hippocampal sclerosis: A replication study. Epilepsia 2019; 60:e1-e5. [PMID: 30324623 PMCID: PMC6334277 DOI: 10.1111/epi.14575] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 09/11/2018] [Accepted: 09/11/2018] [Indexed: 12/25/2022]
Abstract
We investigated gray and white matter morphology in patients with mesial temporal lobe epilepsy with hippocampal sclerosis (mTLE+HS) and first-degree asymptomatic relatives of patients with mTLE+HS. Using T1-weighted magnetic resonance imaging (MRI), we sought to replicate previously reported findings of structural surface abnormalities of the anterior temporal lobe in asymptomatic relatives of patients with mTLE+HS in an independent cohort. We performed whole-brain MRI in 19 patients with mTLE+HS, 14 first-degree asymptomatic relatives of mTLE+HS patients, and 32 healthy control participants. Structural alterations in patients and relatives compared to controls were assessed using automated hippocampal volumetry and cortical surface-based morphometry. We replicated previously reported cortical surface area contractions in the ipsilateral anterior temporal lobe in both patients and relatives compared to healthy controls, with asymptomatic relatives showing similar but less extensive changes than patients. These findings suggest morphologic abnormality in asymptomatic relatives of mTLE+HS patients, suggesting an inherited brain structure endophenotype.
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Affiliation(s)
- Siti Nurbaya Yaakub
- Department of Basic & Clinical NeuroscienceInstitute of Psychiatry, Psychology & NeuroscienceKing’s College LondonLondonUK
| | - Gareth J. Barker
- Department of NeuroimagingInstitute of Psychiatry, Psychology & NeuroscienceKing’s College LondonLondonUK
| | - Sarah J. Carr
- Department of Basic & Clinical NeuroscienceInstitute of Psychiatry, Psychology & NeuroscienceKing’s College LondonLondonUK
| | - Eugenio Abela
- Department of Basic & Clinical NeuroscienceInstitute of Psychiatry, Psychology & NeuroscienceKing’s College LondonLondonUK
| | - Michalis Koutroumanidis
- Department of Clinical Neurophysiology and EpilepsiesGuy’s and St. Thomas’ NHS Foundation TrustLondonUK
| | | | - Mark P. Richardson
- Department of Basic & Clinical NeuroscienceInstitute of Psychiatry, Psychology & NeuroscienceKing’s College LondonLondonUK
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Alhusaini S, Kowalczyk MA, Yasuda CL, Semmelroch MK, Katsurayama M, Zabin M, Zanão T, Nogueira MH, Alvim MK, Ferraz VR, Tsai MH, Fitzsimons M, Lopes-Cendes I, Doherty CP, Cavalleri GL, Cendes F, Jackson GD, Delanty N. Normal cerebral cortical thickness in first-degree relatives of temporal lobe epilepsy patients. Neurology 2018; 92:e351-e358. [DOI: 10.1212/wnl.0000000000006834] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 09/20/2018] [Indexed: 11/15/2022] Open
Abstract
ObjectiveTo examine cerebral cortex thickness in asymptomatic first-degree relatives of patients with mesial temporal lobe epilepsy (MTLE).MethodsWe investigated 127 asymptomatic first-degree relatives of patients with MTLE due to hippocampal sclerosis (HS) (mean age ± SD = 39.4 ± 13 years) and 203 healthy control individuals (mean age ± SD = 36.0 ± 11 years). Participants underwent a comprehensive clinical evaluation and structural brain MRI at 3 study sites. Images were processed simultaneously at each site using a surface-based morphometry method to quantify global brain measures, hippocampal volumes, and cerebral cortical thickness. Differences in brain measures between relatives of patients and controls were examined using generalized models, while controlling for relevant covariates, including age and sex.ResultsNone of the asymptomatic first-degree relatives of MTLE + HS patients showed evidence of HS on qualitative image assessments. Compared to the healthy controls, the asymptomatic relatives of patients displayed no significant differences in intracranial volume, average hemispheric surface area, or hippocampal volume. Similarly, no significant cerebral cortical thinning was identified in the relatives of patients. This was consistent across the 3 cohorts.ConclusionLack of cortical thickness changes in the asymptomatic relatives of patients indicates that the previously characterized MTLE + HS-related cortical thinning is not heritable, and is likely driven by disease-related factors. This finding therefore argues for early and aggressive intervention in patients with medically intractable epilepsy.
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9
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Almane DN, Zhao Q, Rathouz PJ, Hanson M, Jackson DC, Hsu DA, Stafstrom CE, Jones JE, Seidenberg M, Koehn M, Hermann BP. Contribution of Family Relatedness to Neurobehavioral Comorbidities in Idiopathic Childhood Epilepsies. J Int Neuropsychol Soc 2018; 24:653-661. [PMID: 29745359 PMCID: PMC6988642 DOI: 10.1017/s1355617718000243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Rates of cognitive, academic and behavioral comorbidities are elevated in children with epilepsy. The contribution of environmental and genetic influences to comorbidity risk is not fully understood. This study investigated children with epilepsy, their unaffected siblings, and controls to determine the presence and extent of risk associated with family relatedness across a range of epilepsy comorbidities. METHODS Participants were 346 children (8-18 years), n=180 with recent-onset epilepsy, their unaffected siblings (n=67), and healthy first-degree cousin controls (n=99). Assessments included: (1) Child Behavior Checklist/6-18 (CBCL), (2) Behavior Rating Inventory of Executive Function (BRIEF), (3) history of education and academic services, and (4) lifetime attention deficit hyperactivity disorder (ADHD) diagnosis. Analyses consisted of linear mixed effect models for continuous variables, and logistic mixed models for binary variables. RESULTS Differences were detected between the three groups of children across all measures (p<.001). For ADHD, academic problems, and executive dysfunction, children with epilepsy exhibited significantly more problems than unaffected siblings and controls; siblings and controls did not differ statistically significantly from each other. For social competence, children with epilepsy and their unaffected siblings displayed more abnormality compared with controls, with no statistically significant difference between children with epilepsy and unaffected siblings. For behavioral problems, children with epilepsy had more abnormality than siblings and controls, but unaffected siblings also exhibited more abnormalities than controls. CONCLUSIONS The contribution of epilepsy and family relatedness varies across specific neurobehavioral comorbidities. Family relatedness was not significantly associated with rates of ADHD, academic problems and executive dysfunction, but was associated with competence and behavioral problems. (JINS, 2018, 24, 653-661).
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Affiliation(s)
- Dace N Almane
- 1Department of Neurology,University of Wisconsin School of Medicine and Public Health,Madison,Wisconsin
| | - Qianqian Zhao
- 2Department of Biostatistics and Medical Informatics,University of Wisconsin School of Medicine and Public Health,Madison,Wisconsin
| | - Paul J Rathouz
- 2Department of Biostatistics and Medical Informatics,University of Wisconsin School of Medicine and Public Health,Madison,Wisconsin
| | - Melissa Hanson
- 1Department of Neurology,University of Wisconsin School of Medicine and Public Health,Madison,Wisconsin
| | - Daren C Jackson
- 1Department of Neurology,University of Wisconsin School of Medicine and Public Health,Madison,Wisconsin
| | - David A Hsu
- 1Department of Neurology,University of Wisconsin School of Medicine and Public Health,Madison,Wisconsin
| | - Carl E Stafstrom
- 3Department of Neurology,Johns Hopkins University School of Medicine,Baltimore,Maryland
| | - Jana E Jones
- 1Department of Neurology,University of Wisconsin School of Medicine and Public Health,Madison,Wisconsin
| | - Michael Seidenberg
- 4Department of Psychology,Rosalind Franklin University of Medicine and Science,North Chicago,Illinois
| | - Monica Koehn
- 5Marshfield Clinic Neurosciences,Marshfield Clinic,Marshfield,Wisconsin
| | - Bruce P Hermann
- 1Department of Neurology,University of Wisconsin School of Medicine and Public Health,Madison,Wisconsin
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Alhusaini S, Whelan CD, Sisodiya SM, Thompson PM. Quantitative magnetic resonance imaging traits as endophenotypes for genetic mapping in epilepsy. NEUROIMAGE-CLINICAL 2016; 12:526-534. [PMID: 27672556 PMCID: PMC5030372 DOI: 10.1016/j.nicl.2016.09.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 07/21/2016] [Accepted: 09/05/2016] [Indexed: 12/18/2022]
Abstract
Over the last decade, the field of imaging genomics has combined high-throughput genotype data with quantitative magnetic resonance imaging (QMRI) measures to identify genes associated with brain structure, cognition, and several brain-related disorders. Despite its successful application in different psychiatric and neurological disorders, the field has yet to be advanced in epilepsy. In this article we examine the relevance of imaging genomics for future genetic studies in epilepsy from three perspectives. First, we discuss prior genome-wide genetic mapping efforts in epilepsy, considering the possibility that some studies may have been constrained by inherent theoretical and methodological limitations of the genome-wide association study (GWAS) method. Second, we offer a brief overview of the imaging genomics paradigm, from its original inception, to its role in the discovery of important risk genes in a number of brain-related disorders, and its successful application in large-scale multinational research networks. Third, we provide a comprehensive review of past studies that have explored the eligibility of brain QMRI traits as endophenotypes for epilepsy. While the breadth of studies exploring QMRI-derived endophenotypes in epilepsy remains narrow, robust syndrome-specific neuroanatomical QMRI traits have the potential to serve as accessible and relevant intermediate phenotypes for future genetic mapping efforts in epilepsy. QMRI traits have the potential to serve as robust intermediate phenotypes for brain-related disorders. Hippocampal volume is the most promising neuroimaging endophenotype for MTLE + HS. Imaging genomics holds great promise in advancing epilepsy genetic research. Studies are encouraged to explore the validity of QMRI traits as endophenotypes for epilepsy.
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Affiliation(s)
- Saud Alhusaini
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Christopher D Whelan
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - Sanjay M Sisodiya
- Department of Clinical and Experimental Epilepsy, University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, London, UK
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
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Sone D, Sato N, Maikusa N, Ota M, Sumida K, Yokoyama K, Kimura Y, Imabayashi E, Watanabe Y, Watanabe M, Okazaki M, Onuma T, Matsuda H. Automated subfield volumetric analysis of hippocampus in temporal lobe epilepsy using high-resolution T2-weighed MR imaging. NEUROIMAGE-CLINICAL 2016; 12:57-64. [PMID: 27489767 PMCID: PMC4960104 DOI: 10.1016/j.nicl.2016.06.008] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 06/07/2016] [Accepted: 06/11/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Automated subfield volumetry of hippocampus is desirable for use in temporal lobe epilepsy (TLE), but its utility has not been established. Automatic segmentation of hippocampal subfields (ASHS) and the new version of FreeSurfer software (ver.6.0) using high-resolution T2-weighted MR imaging are candidates for this volumetry. The aim of this study was to evaluate hippocampal subfields in TLE patients using ASHS as well as the old and new versions of FreeSurfer. MATERIALS AND METHODS We recruited 50 consecutive unilateral TLE patients including 25 with hippocampal sclerosis (TLE-HS) and 25 without obvious etiology (TLE-nonHS). All patients and 45 healthy controls underwent high-resolution T2-weighted and 3D-volume T1-weighted MRI scanning. We analyzed all of their MR images by FreeSurfer ver.5.3, ver.6.0 and ASHS. For each subfield, normalized z-scores were calculated and compared among groups. RESULTS In TLE-HS groups, ASHS and FreeSurfer ver.6.0 revealed maximal z-scores in ipsilateral cornu ammonis (CA) 1, CA4 and dentate gyrus (DG), whereas in FreeSurfer ver.5.3 ipsilateral subiculum showed maximal z-scores. In TLE-nonHS group, there was no significant volume reduction by either ASHS or FreeSurfer. CONCLUSIONS ASHS and the new version of FreeSurfer may have an advantage in compatibility with existing histopathological knowledge in TLE patients with HS compared to the old version of FreeSurfer (ver.5.3), although further investigations with pathological findings and/or surgical outcomes are desirable.
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Affiliation(s)
- Daichi Sone
- Department of Radiology, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8551, Japan; Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo, Tokyo 113-8654, Japan
| | - Noriko Sato
- Department of Radiology, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8551, Japan
| | - Norihide Maikusa
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8551, Japan
| | - Miho Ota
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8551, Japan
| | - Kaoru Sumida
- Department of Radiology, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8551, Japan
| | - Kota Yokoyama
- Department of Radiology, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8551, Japan
| | - Yukio Kimura
- Department of Radiology, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8551, Japan
| | - Etsuko Imabayashi
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8551, Japan
| | - Yutaka Watanabe
- Department of Psychiatry, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8551, Japan
| | - Masako Watanabe
- Department of Psychiatry, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8551, Japan
| | - Mitsutoshi Okazaki
- Department of Psychiatry, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8551, Japan
| | - Teiichi Onuma
- Musashino-Kokubunji Clinic, 4-1-9-3, Honcho, Kokubunji, Tokyo 185-0012, Japan
| | - Hiroshi Matsuda
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8551, Japan
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Whelan CD, Alhusaini S, O'Hanlon E, Cheung M, Iyer PM, Meaney JF, Fagan AJ, Boyle G, Delanty N, Doherty CP, Cavalleri GL. White matter alterations in patients with MRI-negative temporal lobe epilepsy and their asymptomatic siblings. Epilepsia 2015; 56:1551-61. [DOI: 10.1111/epi.13103] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2015] [Indexed: 12/27/2022]
Affiliation(s)
- Christopher D. Whelan
- Molecular and Cellular Therapeutics Department; Royal College of Surgeons in Ireland; Dublin Ireland
- Imaging Genetics Center; Mark and Mary Stevens Neuroimaging and Informatics Institute; University of Southern California; Los Angeles California U.S.A
| | - Saud Alhusaini
- Molecular and Cellular Therapeutics Department; Royal College of Surgeons in Ireland; Dublin Ireland
| | - Erik O'Hanlon
- Department of Psychiatry; Royal College of Surgeons in Ireland; Dublin 2 Ireland
| | - Maria Cheung
- Molecular and Cellular Therapeutics Department; Royal College of Surgeons in Ireland; Dublin Ireland
| | | | - James F. Meaney
- Centre for Advanced Medical Imaging (CAMI); St. James's Hospital; Dublin Ireland
| | - Andrew J. Fagan
- Centre for Advanced Medical Imaging (CAMI); St. James's Hospital; Dublin Ireland
| | - Gerard Boyle
- Centre for Advanced Medical Imaging (CAMI); St. James's Hospital; Dublin Ireland
| | - Norman Delanty
- Molecular and Cellular Therapeutics Department; Royal College of Surgeons in Ireland; Dublin Ireland
- Division of Neurology; Beaumont Hospital; Dublin Ireland
| | | | - Gianpiero L. Cavalleri
- Molecular and Cellular Therapeutics Department; Royal College of Surgeons in Ireland; Dublin Ireland
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Peng B, Wu L, Zhang L, Chen Y. Volumetric changes in amygdala and entorhinal cortex and their relation to memory impairment in patients with medial temporal lobe epilepsy with visually normal MR imaging findings. Epilepsy Res 2015; 114:66-72. [PMID: 26088887 DOI: 10.1016/j.eplepsyres.2015.04.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 04/18/2015] [Accepted: 04/23/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To explore the relation between parahippocampal structures, such as the amygdala and the entorhinal cortex (EC), with verbal and nonverbal memory in patients with medial temporal lobe epilepsy (MTLE) with visually normal MR imaging findings by volumetric measurements using magnetic resonance imaging (MRI). METHODS Thirty-six consecutive patients with MTLE presenting a non-sclerotic hippocampus though visual inspection were assessed by MRI to measure the volumes of the hippocampus, amygdale and EC, and by using the clinical memory scale (CMS), a test battery for verbal and nonverbal memory, where summation of all CMS subscale scores equals the memory quotient (MQ). The correlations between MRI volumetric data (Z scores or asymmetry indexes (AI; (L-R)/(L+R)), "L" and "R" refer to the left and right volumes of each structure, respectively), clinical variables and memory scale scores were analyzed using a principal component regression model. RESULTS Volumetric MRI revealed significant differences between the volumes of the hippocampus, EC, and right amygdala, but no differences in the volume of the left amygdala between the controls and the patients group. The patients group performed significantly worse in MQ (p < 0.01), the associate memory test (p < 0.01), directed memory test (p < 0.05), and the nonsense graphical recognition test (p < 0.05) compared to the control group. The asymmetry of the amygdala negatively correlated to verbal paired associates' recall and nonsense graphical recognition. The direct memory was positively related to the volume of the EC. CONCLUSION The volumetric asymmetry of the amygdala contributes to either verbal or nonverbal memory impairment in MTLE patients. Verbal memory may correlate with the volume of the EC.
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Affiliation(s)
- Bingwei Peng
- Department of Neurology, Guang Zhou Women and Children's Medical Center, China.
| | - Liwen Wu
- Department of Neurology, Peking Union Medical College Hospital, China.
| | - Lihua Zhang
- Department of Neurology, Peking Union Medical College Hospital, China.
| | - Yan Chen
- Department of Neurology, Peking Union Medical College Hospital, China.
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14
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Alhusaini S, Whelan CD, Doherty CP, Delanty N, Fitzsimons M, Cavalleri GL. Temporal Cortex Morphology in Mesial Temporal Lobe Epilepsy Patients and Their Asymptomatic Siblings. Cereb Cortex 2015; 26:1234-41. [PMID: 25576532 DOI: 10.1093/cercor/bhu315] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Temporal cortex abnormalities are common in patients with mesial temporal lobe epilepsy due to hippocampal sclerosis (MTLE+HS) and believed to be relevant to the underlying mechanisms. In the present study, we set out to determine the familiarity of temporal cortex morphologic alterations in a cohort of MTLE+HS patients and their asymptomatic siblings. A surface-based morphometry (SBM) method was applied to process MRI data acquired from 140 individuals (50 patients with unilateral MTLE+HS, 50 asymptomatic siblings of patients, and 40 healthy controls). Using a region-of-interest approach, alterations in temporal cortex morphology were determined in patients and their asymptomatic siblings by comparing with the controls. Alterations in temporal cortex morphology were identified in MTLE+HS patients ipsilaterally within the anterio-medial regions, including the entorhinal cortex, parahippocampal gyrus, and temporal pole. Subtle but similar pattern of morphology changes with a medium effect size were also noted in the asymptomatic siblings. These localized alterations were related to volume loss that appeared driven by shared contractions in cerebral cortex surface area. These findings indicate that temporal cortex morphologic alterations are common to patients and their asymptomatic siblings and suggest that such localized traits are possibly heritable.
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Affiliation(s)
- Saud Alhusaini
- Molecular and Cellular Therapeutics Department, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Christopher D Whelan
- Molecular and Cellular Therapeutics Department, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland
| | | | - Norman Delanty
- Molecular and Cellular Therapeutics Department, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland Neurology Division
| | - Mary Fitzsimons
- Brain Morphomerty Laboratory, Epilepsy Programme, Beaumont Hospital, Dublin, Ireland
| | - Gianpiero L Cavalleri
- Molecular and Cellular Therapeutics Department, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland
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15
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Morgan VL, Conrad BN, Abou-Khalil B, Rogers BP, Kang H. Increasing structural atrophy and functional isolation of the temporal lobe with duration of disease in temporal lobe epilepsy. Epilepsy Res 2014; 110:171-8. [PMID: 25616470 DOI: 10.1016/j.eplepsyres.2014.12.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 11/21/2014] [Accepted: 12/04/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Due to pharmacoresistant seizures and the underutilization of surgical treatments, a large number of temporal lobe epilepsy (TLE) patients experience seizures for years or decades. The goal of this study was to generate a predictive model of duration of disease with the least number of parameters possible in order to identify and quantify the significant volumetric and functional indicators of TLE progression. METHODS Two cohorts of subjects including 12 left TLE, 21 right TLE and 20 healthy controls (duration = 0) were imaged on a 3T MRI scanner using high resolution T1-weighted structural MRI and 20 min of resting functional MRI scanning. Multivariate linear regression methods were used to compute a predictive model of duration of disease using 49 predictors including functional connectivity and gray matter volumes computed from these images. RESULTS No model developed from the full set of data accurately predicted the duration of disease across the entire range from 3 to 50 years. We then performed the regression on 35 subjects with durations of disease in the range 10 to 35 years. The resulting predictive model showed that longer durations were associated with reductions in functional connectivity from the ipsilateral temporal lobe to the contralateral temporal lobe, precuneus and mid cingulate, and with decreases in volume of the ipsilateral hippocampus and pallidum. CONCLUSIONS Functional and volumetric parameters accurately predicted duration of disease in TLE. The findings suggest that TLE is associated with a gradual functional isolation and significant progressive structural atrophy of the ipsilateral temporal lobe over years of duration in the range of 10-35 years. Furthermore, these changes can also be detected in the contralateral hemisphere in these patients, but to a lesser degree.
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Affiliation(s)
- Victoria L Morgan
- Vanderbilt University Institute of Imaging Science, Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, USA.
| | - Benjamin N Conrad
- Vanderbilt University Institute of Imaging Science, Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, USA
| | | | - Baxter P Rogers
- Vanderbilt University Institute of Imaging Science, Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, USA
| | - Hakmook Kang
- Department of Biostatistics, Vanderbilt University, Nashville, TN, USA
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Peng B, Wu L, Zhang L, Chen Y. The relationship between hippocampal volumes and nonverbal memory in patients with medial temporal lobe epilepsy. Epilepsy Res 2014; 108:1839-44. [PMID: 25443451 DOI: 10.1016/j.eplepsyres.2014.09.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 09/03/2014] [Accepted: 09/06/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To explore the involvement of medial temporal lobe structures such as the hippocampus, amygdala, and entorhinal cortex (EC) in memory consolidation by volumetric magnetic resonance imaging (MRI). METHODS Sixty-two consecutive patients with medial temporal lobe epilepsy (MMTLE) were assessed using the Clinical Memory Scale (CMS) and MRI to measure the volumes of the hippocampus, amygdala, and EC. Participants were grouped according to MRI findings into 3 groups: left MRI-positive (abnormal hippocampal formation on the left side; n=17), right MRI-positive (abnormal hippocampal formation on the left side; n=9), and MRI-negative (normal hippocampal formation; n=36). One-way analysis of variance (ANOVA) was used to assess group differences for all volumetric data (Z scores or asymmetry indexes (AI)), memory scale scores, and clinical parameters. Post hoc analyses were done with Fisher's least significant difference (LSD) tests. AI=100×(L-R)/(L+R). "L" and "R" refer to the left and right volumes of each structure, respectively. RESULTS The nonsense graphical recognition tests and the facial memory tests were significantly different between the three groups. Post hoc analyses showed that the right MRI-positive group performed significantly worse than the MRI-negative group on nonsense graphical recognition tests (P=0.008) and the left MRI-positive group had significantly lower scores than the MRI-negative group on facial memory tests (P=0.023). CONCLUSIONS Nonverbal memory was correlated with the status of the right hippocampus.
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Affiliation(s)
- Bingwei Peng
- Department of Neurology, Guang Zhou Women and Children's Medical Center, China(1).
| | - Liwen Wu
- Department of Neurology, Peking Union Medical College Hospital, China.
| | - Lihua Zhang
- Department of Neurology, Peking Union Medical College Hospital, China.
| | - Yan Chen
- Department of Neurology, Peking Union Medical College Hospital, China
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