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Poiret C, Bouyeure A, Patil S, Boniteau C, Duchesnay E, Grigis A, Lemaitre F, Noulhiane M. Attention-gated 3D CapsNet for robust hippocampal segmentation. J Med Imaging (Bellingham) 2024; 11:014003. [PMID: 38173654 PMCID: PMC10760147 DOI: 10.1117/1.jmi.11.1.014003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 11/18/2023] [Accepted: 12/04/2023] [Indexed: 01/05/2024] Open
Abstract
Purpose The hippocampus is organized in subfields (HSF) involved in learning and memory processes and widely implicated in pathologies at different ages of life, from neonatal hypoxia to temporal lobe epilepsy or Alzheimer's disease. Getting a highly accurate and robust delineation of sub-millimetric regions such as HSF to investigate anatomo-functional hypotheses is a challenge. One of the main difficulties encountered by those methodologies is related to the small size and anatomical variability of HSF, resulting in the scarcity of manual data labeling. Recently introduced, capsule networks solve analogous problems in medical imaging, providing deep learning architectures with rotational equivariance. Nonetheless, capsule networks are still two-dimensional and unassessed for the segmentation of HSF. Approach We released a public 3D Capsule Network (3D-AGSCaps, https://github.com/clementpoiret/3D-AGSCaps) and compared it to equivalent architectures using classical convolutions on the automatic segmentation of HSF on small and atypical datasets (incomplete hippocampal inversion, IHI). We tested 3D-AGSCaps on three datasets with manually labeled hippocampi. Results Our main results were: (1) 3D-AGSCaps produced segmentations with a better Dice Coefficient compared to CNNs on rotated hippocampi (p = 0.004 , cohen's d = 0.179 ); (2) on typical subjects, 3D-AGSCaps produced segmentations with a Dice coefficient similar to CNNs while having 15 times fewer parameters (2.285M versus 35.069M). This may greatly facilitate the study of atypical subjects, including healthy and pathological cases like those presenting an IHI. Conclusion We expect our newly introduced 3D-AGSCaps to allow a more accurate and fully automated segmentation on atypical populations, small datasets, as well as on and large cohorts where manual segmentations are nearly intractable.
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Affiliation(s)
- Clement Poiret
- UNIACT, NeuroSpin, Institut Joliot, CEA Paris-Saclay, Gif-sur-Yvette, France
- Université Paris Cité, InDEV team, U1141 NeuroDiderot, Inserm, Paris, France
| | - Antoine Bouyeure
- UNIACT, NeuroSpin, Institut Joliot, CEA Paris-Saclay, Gif-sur-Yvette, France
- Université Paris Cité, InDEV team, U1141 NeuroDiderot, Inserm, Paris, France
| | - Sandesh Patil
- UNIACT, NeuroSpin, Institut Joliot, CEA Paris-Saclay, Gif-sur-Yvette, France
- Université Paris Cité, InDEV team, U1141 NeuroDiderot, Inserm, Paris, France
| | - Cécile Boniteau
- UNIACT, NeuroSpin, Institut Joliot, CEA Paris-Saclay, Gif-sur-Yvette, France
- Université Paris Cité, InDEV team, U1141 NeuroDiderot, Inserm, Paris, France
| | - Edouard Duchesnay
- UNIACT, NeuroSpin, Institut Joliot, CEA Paris-Saclay, Gif-sur-Yvette, France
| | - Antoine Grigis
- UNIACT, NeuroSpin, Institut Joliot, CEA Paris-Saclay, Gif-sur-Yvette, France
| | - Frederic Lemaitre
- Université de Rouen, CETAPS EA 3832, Rouen, France
- CRIOBE, UAR 3278, CNRS-EPHE-UPVD, Mooréa, Polynésie Française
| | - Marion Noulhiane
- UNIACT, NeuroSpin, Institut Joliot, CEA Paris-Saclay, Gif-sur-Yvette, France
- Université Paris Cité, InDEV team, U1141 NeuroDiderot, Inserm, Paris, France
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Nitheesha V, Rao JSM, Reddy M, Nagarajan K, Narayan SK, Kandasamy P, Chandrasekharan V. Clinicoradiological Profile of Incomplete Hippocampal Inversion Diagnosed on MR Neuroimaging. Neurol India 2023; 71:1211-1216. [PMID: 38174460 DOI: 10.4103/0028-3886.391380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Background and Purpose Incomplete hippocampal inversion (IHI) is a developmental failure of normal hippocampal inversion. Previous studies have described IHI in epilepsy and non-epilepsy subjects. IHI has also been reported with malformations of cortical development (MCDs) and corpus callosal agenesis that have association with neuropsychiatric disorders such as autism spectrum disorder (ASD). This study aims to describe the clinical profile of magnetic resonance imaging (MRI)-diagnosed IHI. Materials and Methods We studied patients with IHI who were identified after a retrospective review of the MRI archives of the past 3 years. The MRI findings of partial and total IHI were included. The clinical profiles associated with IHI were classified into epilepsy and non-epilepsy categories. Results A retrospective review of MRI done over 3 years revealed 54 cases of IHI (32 left-sided, 20 bilateral, and 2 isolated right-sided), and out of 74 IHI, 59 were of total type and 15 partial. Thirty-six subjects (61.1%) had epilepsy (9 with neurodevelopmental problems), 17 subjects (31.5%) had ASD, and 4 subjects (7.4%) had only neurodevelopmental disorders. MCDs were seen in 7 (12.9%): polymicrogyria (4), periventricular heterotopia (2), and pachygyria (1). Hippocampal volume loss was seen in 10, and contralateral mesial temporal sclerosis was seen in 2 patients. Conclusion Hippocampal inversion has been reported in MRI scans of patients with epilepsy, ASD, MCDs, and many other related disorders. Further studies are required to know its occurrence among patients who get MRI scans due to many other disorders such as headaches, psychiatric disorders, minor hear trauma, and perinatal insults. If possible, studies among normal populations also need to be done.
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Affiliation(s)
- Vendoti Nitheesha
- Department of Radio-Diagnosis, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
| | - Jamine S Mohan Rao
- Department of Neurology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
| | - Midhusha Reddy
- Department of Radio-Diagnosis, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
| | - Krishnan Nagarajan
- Department of Radio-Diagnosis, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
| | - Sunil K Narayan
- Department of Neurology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
| | - Preeti Kandasamy
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
| | - Venkatesh Chandrasekharan
- Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
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Vaz A, Teixeira BCDA, Bertholdo DB. Incomplete hippocampal inversion: diagnostic criteria and effect on epilepsy, seizure localization and therapeutic outcome in children. Seizure 2022; 100:67-75. [PMID: 35779435 DOI: 10.1016/j.seizure.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/26/2022] [Accepted: 06/12/2022] [Indexed: 10/18/2022] Open
Abstract
PURPOSE Elaborate a simple Magnetic Resonance Imaging (MRI)-based score to define Incomplete Hippocampal Inversion (IHI) in children (Phase 1), and evaluate the relation of IHI with (A) epilepsy, (B) seizure localization and (C) therapeutic response in a paediatric population (Phase 2). METHODS In Phase 1, incompletely inverted hippocampi were matched to completely inverted hippocampi. Multiple qualitative and quantitative hippocampal and extra-hippocampal features were evaluated in coronal-oblique T1-weighted (T1W) and coronal T2-weighted (T2W) images. Multivariate analysis was performed to elaborate the MRI-based score to define IHI. In Phase 2, epilepsy patients were matched to controls, and the T1W and T2W scores were applied. Multivariate analysis was performed to assess the relation of IHI and epilepsy, seizure localization and therapeutic response. RESULTS The hippocampal diameter ratio and parahippocampal angle in the coronal-oblique T1-weighted images, and the hippocampal diameter ratio and collateral sulcus depth in the coronal T2-weighted images predicted IHI in Phase 1. Simple and practical imaging-based scores were developed and are available on the website: https://ihiscore.netlify.app/. The Area Under the Receiver Operating Characteristic Curve of the T1W and T2W scores were, respectively, 0.965 and 0.983. In Phase 2, IHI independently predicted epilepsy (OR = 3.144, 95% CI = 1.981-4.991, p < 0.001), temporal lobe epilepsy (OR = 4.237, 95% CI = 1.586-11.318, p = 0.004), and drug resistant epilepsy (OR = 7.000, 95% CI = 2.800-17.500, p < 0.001). CONCLUSION The association between IHI and temporal lobe epilepsy (and the lack of association with extra-temporal epilepsy) favours the possibility of a relation between IHI and the pathophysiology of seizures in epileptic patients. Furthermore, IHI is a potential prognostic marker for therapeutic response in epilepsy.
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Affiliation(s)
- André Vaz
- Hospital Pequeno Príncipe (Curitiba, Brazil), and Universidade Federal do Paraná (Curitiba, Brazil). Postal address: Centro de Imagem (CEIMA), Rua Desembargador Motta, 1070, 80250-060 Curitiba, Brazil.
| | - Bernardo Corrêa de Almeida Teixeira
- Hospital Pequeno Príncipe (Curitiba, Brazil), and Universidade Federal do Paraná (Curitiba, Brazil). Postal address: Hospital Pequeno Príncipe, Centro de Imagem (CEIMA), Rua Desembargador Motta, 1070, 80250-060 Curitiba, Brazil
| | - Debora Brighente Bertholdo
- Clínica DAPI (Curitiba, Brasil), and Pontifícia Universidade Católica do Paraná (Curitiba, Brazil). Postal address: Hospital Pequeno Príncipe, Centro de Imagem (CEIMA), Rua Brg. Franco, 122, 80430-210 Curitiba, Brazil
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Hainc N, McAndrews MP, Valiante T, Andrade DM, Wennberg R, Krings T. Imaging in medically refractory epilepsy at 3 Tesla: a 13-year tertiary adult epilepsy center experience. Insights Imaging 2022; 13:99. [PMID: 35661273 PMCID: PMC9167324 DOI: 10.1186/s13244-022-01236-1] [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: 02/10/2022] [Accepted: 05/13/2022] [Indexed: 11/25/2022] Open
Abstract
Objectives MRI negative epilepsy has evolved through increased usage of 3 T and insights from surgically correlated studies. The goal of this study is to describe dedicated 3 T epilepsy MRI findings in medically refractory epilepsy (MRE) patients at a tertiary epilepsy center to familiarize radiologists with an updated spectrum and frequency of potential imaging findings in the adult MRE population. Methods Included were all patients with MRE admitted to the epilepsy monitoring unit who were discussed at weekly interdisciplinary imaging conferences at Toronto Western Hospital with MRI studies (3 T with dedicated epilepsy protocol) performed between January 2008 and January 2021. Lesion characterization was performed by two readers based on most likely imaging diagnosis in consensus. Lobes involved per case were recorded. Results A total of 738 patients (386 female; mean age 35 years, range 15–77) were included. A total of 262 patients (35.5%) were MRI negative. The most common imaging finding was mesial temporal sclerosis, seen in 132 patients (17.9%), followed by encephalomalacia and gliosis, either posttraumatic, postoperative, postischemic, or postinfectious in nature, in 79 patients (10.7%). The most common lobar involvement (either partially or uniquely) was temporal (341 cases, 58.6%). MRE patients not candidates for surgical resection were included in the study, as were newly described pathologies from surgically correlated studies revealing findings seen retrospectively on reported MRI negative exams (isolated enlargement of the amygdala, temporal pole white matter abnormality, temporal encephalocele). Conclusion This study provides an updated description of the spectrum of 3 T MRI findings in adult MRE patients from a tertiary epilepsy center.
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Affiliation(s)
- Nicolin Hainc
- Division of Neuroradiology, Joint Department of Medical Imaging, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada. .,Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
| | - Mary Pat McAndrews
- Krembil Brain Institute, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Taufik Valiante
- Krembil Brain Institute, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.,Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Danielle M Andrade
- Krembil Brain Institute, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.,Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Richard Wennberg
- Krembil Brain Institute, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.,Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Timo Krings
- Division of Neuroradiology, Joint Department of Medical Imaging, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.,Krembil Brain Institute, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
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5
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Natsume T, Inaba Y, Osawa Y, Fukuyama T. High Incidence of Hippocampal Abnormalities in Pediatric Patients with Congenital Cytomegalovirus Infection. Neuropediatrics 2022; 53:239-245. [PMID: 35098496 PMCID: PMC9444318 DOI: 10.1055/a-1754-1142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Congenital cytomegalovirus (CMV) infection exhibits polymicrogyria, intracranial calcification, white matter lesions, and several types of intracranial lesions on magnetic resonance imaging (MRI), in addition to various developmental disorders and epilepsies. However, little is known on the presence of hippocampal abnormality in this affliction. The aim of this study is to clarify the incidence of hippocampal abnormality in congenital CMV infection. METHODS Seventeen children diagnosed as having congenital CMV infection along with 17 age-matched pediatric controls were retrospectively evaluated by brain MRI and clinical review. The measurement data were obtained from conventional coronal sections in this retrospective study. Hippocampal malrotation (HIMAL) was defined as a hippocampal diameter ratio (i.e., the ratio of the height and width of the hippocampus) of >0.92. RESULTS Hippocampal diameter ratios were significantly higher in the congenital CMV infection group (0.99 [range: 0.70-1.58] on the right side and 0.85 [range: 0.66-1.39] on the left side) than in controls (0.71 [range: 0.58-0.91] and 0.70 [range: 0.50-1.00], respectively). HIMAL was present in 17 of 34 hippocampi (50%) in the congenital CMV infection group and 1 of 34 hippocampi (2.9%) in controls. No correlations were detected between HIMAL and intelligence quotient/developmental quotient or the occurrences of autism spectrum disorder or epilepsy. CONCLUSION This study is the first to demonstrate the incidence of hippocampal abnormality to be significantly higher in congenital CMV infection patients than in age-matched controls. Further study is necessary to clarify the associations of HIMAL with other clinical and developmental features.
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Affiliation(s)
- Takenori Natsume
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yuji Inaba
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan,Division of Neuropediatrics, Nagano Children's Hospital, Azumino, Japan,Life Science Research Center, Nagano Children's Hospital, Azumino, Japan,Address for correspondence Yuji Inaba, MD, PhD Division of Neuropediatrics, Nagano Children's Hospital3100 Toyoshina, Azumino 399-8288Japan
| | - Yoshihiro Osawa
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan
| | - Tetsuhiro Fukuyama
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan,Tetsuhiro Fukuyama, MD, PhD Department of Pediatrics, Shinshu University School of Medicine3-1-1 Asahi, Matsumoto 390-8621Japan
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6
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He C, Ye L, Chen C, Hu L, Jin B, Ding Y, Li H, Ding M, Wang S, Wang S. Hippocampal Malrotation Could Be Less Significant in Epilepsy Caused by Focal Cortical Dysplasia Type I and Type II. Front Neurol 2022; 13:755022. [PMID: 35237224 PMCID: PMC8882826 DOI: 10.3389/fneur.2022.755022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 01/12/2022] [Indexed: 12/05/2022] Open
Abstract
Objectives Debates over the relationship between hippocampal malrotation (HIMAL) and epilepsy continue without consensus. This study explores the role of HIMAL in a cohort of epilepsy caused by focal cortical dysplasia (FCD). Methods In this study, 90 patients with epilepsy caused by FCD type I and type II and 48 healthy adults underwent a 3 Tesla MRI following a dedicated epilepsy protocol for the analysis of the prevalence and morphologic features of HIMAL. In addition, numerous clinical characteristics and hippocampal volumes were evaluated. Results The cohort included a total of 90 patients (32 were HIMAL, 58 were non-HIMAL). Among these patients, 32 (35.6%) had HIMAL (22 left, four right, and six bilateral), which did not differ from the 48 controls, where 16 (33.3%) had HIMAL (12 left, two right, and two bilateral). Neither the quantitative features of HIMAL (diameter ratio, dominant inferior temporal sulcus height ratio, medial distance ratio, dominant inferior temporal sulcus angle, and parahippocampal angle), nor the accompanying characteristics of HIMAL (vertical dominant inferior temporal sulcus, enlarged temporal horn, and a low position of ipsilateral fornix) showed differences between patients with FCD and controls. No statistical difference in the clinical characteristics between FCD patients with HIMAL and those without was found. Neither the side nor the existence of HIMAL was correlated with the lateralization and location of FCD. As to the hippocampal volume, there was no difference between FCD patients with HIMAL and those without. Conclusion Hippocampal malrotation is a common morphologic variant in healthy controls as well as in patients with epilepsy caused by FCD type I and type II. Hippocampal malrotation could be less significant in epilepsy caused by FCD type I and type II.
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Affiliation(s)
- Chenmin He
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lingqi Ye
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Cong Chen
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lingli Hu
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Bo Jin
- Department of Neurology, Zhejiang Provincial People's Hospital, Hangzhou, China
| | - Yao Ding
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Hong Li
- Epilepsy Center, Department of Radiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Meiping Ding
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Shan Wang
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- *Correspondence: Shan Wang
| | - Shuang Wang
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Shuang Wang
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7
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Roeske MJ, McHugo M, Vandekar S, Blackford JU, Woodward ND, Heckers S. Incomplete hippocampal inversion in schizophrenia: prevalence, severity, and impact on hippocampal structure. Mol Psychiatry 2021; 26:5407-5416. [PMID: 33437006 PMCID: PMC8589684 DOI: 10.1038/s41380-020-01010-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 12/16/2020] [Accepted: 12/17/2020] [Indexed: 11/09/2022]
Abstract
Incomplete hippocampal inversion (IHI) is an anatomical variant of the human brain resulting from an arrest in brain development, especially prevalent in the left hemisphere. We hypothesized that IHI is more common in schizophrenia and contributes to the well-known hippocampal structural differences. We studied 199 schizophrenia patients and 161 healthy control participants with 3 T MRI to establish IHI prevalence and the relationship of IHI with hippocampal volume and asymmetry. IHI was more prevalent (left hemisphere: 15% of healthy control participants, 27% of schizophrenia patients; right hemisphere: 4% of healthy control participants, 10% of schizophrenia patients) and more severe in schizophrenia patients compared to healthy control participants. Severe IHI cases were associated with a higher rate of automated segmentation failure. IHI contributed to smaller hippocampal volume and increased R > L volume asymmetry in schizophrenia. The increased prevalence and severity of IHI supports the neurodevelopmental model of schizophrenia. The impact of this developmental variant deserves further exploration in studies of the hippocampus in schizophrenia.
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Affiliation(s)
- Maxwell J. Roeske
- grid.412807.80000 0004 1936 9916Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN USA
| | - Maureen McHugo
- grid.412807.80000 0004 1936 9916Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN USA
| | - Simon Vandekar
- grid.412807.80000 0004 1936 9916Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN USA
| | - Jennifer Urbano Blackford
- grid.412807.80000 0004 1936 9916Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN USA ,grid.413806.8Research Health Scientist, Research and Development, Veterans Affairs Medical Center, Nashville, TN USA
| | - Neil D. Woodward
- grid.412807.80000 0004 1936 9916Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN USA
| | - Stephan Heckers
- grid.412807.80000 0004 1936 9916Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN USA
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Hassankhani A, Stein JM, Haboosheh AG, Vossough A, Loevner LA, Nabavizadeh SA. Anatomical Variations, Mimics, and Pitfalls in Imaging of Patients with Epilepsy. J Neuroimaging 2020; 31:20-34. [PMID: 33314527 DOI: 10.1111/jon.12809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/22/2020] [Accepted: 10/26/2020] [Indexed: 11/27/2022] Open
Abstract
Epilepsy is among one of the most common neurologic disorders. The role of magnetic resonance imaging (MRI) in the diagnosis and management of patients with epilepsy is well established, and most patients with epilepsy are likely to undergo at least one or more MRI examinations in the course of their disease. Recent advances in high-field MRI have enabled high resolution in vivo visualization of small and intricate anatomic structures that are of great importance in the assessment of seizure disorders. Familiarity with normal anatomic variations is essential in the accurate diagnosis and image interpretation, as these variations may be mistaken for epileptogenic foci, leading to unnecessary follow-up imaging, or worse, unnecessary treatment. After a brief overview of normal imaging anatomy of the mesial temporal lobe, this article will review a few important common and uncommon anatomic variations, mimics, and pitfalls that may be encountered in the imaging evaluation of patients with epilepsy.
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Affiliation(s)
- Alvand Hassankhani
- Division of Neuroradiology, Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Joel M Stein
- Division of Neuroradiology, Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Amit G Haboosheh
- Department of Radiology, Hadassah Ein Karem Hospital, Jerusalem, Israel
| | - Arastoo Vossough
- Division of Neuroradiology, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Laurie A Loevner
- Division of Neuroradiology, Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Seyed Ali Nabavizadeh
- Division of Neuroradiology, Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
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9
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Cachia A, Cury C, Brunelin J, Plaze M, Delmaire C, Oppenheim C, Medjkane F, Thomas P, Jardri R. Deviations in early hippocampus development contribute to visual hallucinations in schizophrenia. Transl Psychiatry 2020; 10:102. [PMID: 32214096 PMCID: PMC7096500 DOI: 10.1038/s41398-020-0779-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 02/17/2020] [Accepted: 02/26/2020] [Indexed: 01/06/2023] Open
Abstract
Auditory hallucinations (AHs) are certainly the most emblematic experiences in schizophrenia, but visual hallucinations (VHs) are also commonly observed in this developmental psychiatric disorder. Notably, several studies have suggested a possible relationship between the clinical variability in hallucinations' phenomenology and differences in brain development/maturation. In schizophrenia, impairments of the hippocampus, a medial temporal structure involved in mnesic and neuroplastic processes, have been repeatedly associated with hallucinations, particularly in the visual modality. However, the possible neurodevelopmental origin of hippocampal impairments in VHs has never been directly investigated. A classic marker of early atypical hippocampal development is incomplete hippocampal inversion (IHI). In this study, we compared IHI patterns in healthy volunteers, and two subgroups of carefully selected schizophrenia patients experiencing frequent hallucinations: (a) those with pure AHs and (b) those with audio-visual hallucinations (A+VH). We found that VHs were associated with a specific IHI pattern. Schizophrenia patients with A+VH exhibited flatter left hippocampi than patients with pure AHs or healthy controls. This result first confirms that the greater clinical impairment observed in A+VH patients may relate to an increased neurodevelopmental weight in this subpopulation. More importantly, these findings bring crucial hints to better specify the sensitivity period of A+VH-related IHI during early brain development.
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Affiliation(s)
- Arnaud Cachia
- Université de Paris, Institut de Psychiatrie et Neurosciences de Paris, INSERM, GHU Paris psychiatrie & neurosciences, F-75005, Paris, France. .,Université de Paris, Laboratoire de Psychologie du développement et de l'Education de l'Enfant, CNRS, F-75005, Paris, France. .,Institut Universitaire de France, Paris, France.
| | - Claire Cury
- grid.83440.3b0000000121901201Department of Medical Physics and Biomedical Engineering, University College, London, UK ,grid.410368.80000 0001 2191 9284Univ Rennes, CNRS, Inria, Inserm, IRISA UMR 6074, EMPENN — ERL U 1228, F-35000 Rennes, France
| | - Jérôme Brunelin
- grid.25697.3f0000 0001 2172 4233INSERM U 1028, CNRS UMR-5292, Lyon Neuroscience Research Center, PSYR2 Team, Université de Lyon, CH le Vinatier, Lyon, France
| | - Marion Plaze
- Université de Paris, Institut de Psychiatrie et Neurosciences de Paris, INSERM, GHU Paris psychiatrie & neurosciences, F-75005 Paris, France
| | - Christine Delmaire
- grid.410463.40000 0004 0471 8845CHU Lille, Salengro Hospital, Neuroradiology dpt, 59000 Lille, France
| | - Catherine Oppenheim
- Université de Paris, Institut de Psychiatrie et Neurosciences de Paris, INSERM, GHU Paris psychiatrie & neurosciences, F-75005 Paris, France
| | - François Medjkane
- grid.410463.40000 0004 0471 8845CHU Lille, Hôpital Fontan, Plateforme CIC - CURE, 59000 Lille, France ,Univ Lille, INSERM U-1172, CHU Lille, Lille Neuroscience & Cognition Centre (LiNC), Plasticity & SubjectivitY (PSY) team, 59000 Lille, France
| | - Pierre Thomas
- grid.410463.40000 0004 0471 8845CHU Lille, Hôpital Fontan, Plateforme CIC - CURE, 59000 Lille, France ,Univ Lille, INSERM U-1172, CHU Lille, Lille Neuroscience & Cognition Centre (LiNC), Plasticity & SubjectivitY (PSY) team, 59000 Lille, France
| | - Renaud Jardri
- grid.410463.40000 0004 0471 8845CHU Lille, Hôpital Fontan, Plateforme CIC - CURE, 59000 Lille, France ,Univ Lille, INSERM U-1172, CHU Lille, Lille Neuroscience & Cognition Centre (LiNC), Plasticity & SubjectivitY (PSY) team, 59000 Lille, France
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Beker Acay M, Köken R, Ünlü E, Kaçar E, Balçık Ç. Evaluation of hippocampal infolding angle and incomplete hippocampal inversion in pediatric patients with epilepsy and febrile seizures. Diagn Interv Radiol 2018; 23:326-330. [PMID: 28509667 DOI: 10.5152/dir.2017.160077] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE We aimed to investigate the frequency of incomplete hippocampal inversion (IHI) and the hippocampal infolding angle (HIA) in pediatric patients with no additional abnormal findings in the brain. METHODS Pediatric brain magnetic resonance imaging (MRI) examinations conducted between September 2012 and February 2015 were screened and 83 patients with epilepsy, 49 patients with febrile convulsion, and 74 control patients were included in this retrospective study. Presence of IHI was evaluated and HIA was measured on MRI. RESULTS IHI was found in 23 patients in the epilepsy group (27.7%), 15 patients in the febrile convulsion group (30.6%), and 14 patients in the control group (19.0%), with no significant difference between the groups (P = 0.27). Compared with the epilepsy and febrile convulsion groups, HIA was significantly larger in the control group in sections of the right cerebral pedincule, the left cerebral pedincule, and the right superior cerebellar pedincule. No correlation was found between the laterality of the epileptogenic focus in the epilepsy group and existence of IHI, nor between age and HIA values among the groups. CONCLUSION Although IHI is not an uncommon abnormality in the normal pediatric population, decreased HIA is more frequently found in patients with epilepsy or febrile convulsions.
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Affiliation(s)
- Mehtap Beker Acay
- Department of Radiology, Afyon Kocatepe University School of Medicine, Afyonkarahisar, Turkey.
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11
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McClelland AC, Gomes WA, Shinnar S, Hesdorffer DC, Bagiella E, Lewis DV, Bello JA, Chan S, MacFall J, Chen M, Pellock JM, Nordli DR, Frank LM, Moshé SL, Shinnar RC, Sun S. Quantitative Evaluation of Medial Temporal Lobe Morphology in Children with Febrile Status Epilepticus: Results of the FEBSTAT Study. AJNR Am J Neuroradiol 2016; 37:2356-2362. [PMID: 27633809 DOI: 10.3174/ajnr.a4919] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 07/04/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The pathogenesis of febrile status epilepticus is poorly understood, but prior studies have suggested an association with temporal lobe abnormalities, including hippocampal malrotation. We used a quantitative morphometric method to assess the association between temporal lobe morphology and febrile status epilepticus. MATERIALS AND METHODS Brain MR imaging was performed in children presenting with febrile status epilepticus and control subjects as part of the Consequences of Prolonged Febrile Seizures in Childhood study. Medial temporal lobe morphologic parameters were measured manually, including the distance of the hippocampus from the midline, hippocampal height:width ratio, hippocampal angle, collateral sulcus angle, and width of the temporal horn. RESULTS Temporal lobe morphologic parameters were correlated with the presence of visual hippocampal malrotation; the strongest association was with left temporal horn width (P < .001; adjusted OR, 10.59). Multiple morphologic parameters correlated with febrile status epilepticus, encompassing both the right and left sides. This association was statistically strongest in the right temporal lobe, whereas hippocampal malrotation was almost exclusively left-sided in this cohort. The association between temporal lobe measurements and febrile status epilepticus persisted when the analysis was restricted to cases with visually normal imaging findings without hippocampal malrotation or other visually apparent abnormalities. CONCLUSIONS Several component morphologic features of hippocampal malrotation are independently associated with febrile status epilepticus, even when complete hippocampal malrotation is absent. Unexpectedly, this association predominantly involves the right temporal lobe. These findings suggest that a spectrum of bilateral temporal lobe anomalies are associated with febrile status epilepticus in children. Hippocampal malrotation may represent a visually apparent subset of this spectrum.
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Affiliation(s)
| | - W A Gomes
- From Departments of Radiology (A.C.M., W.A.G., J.A.B.)
| | - S Shinnar
- Neurology (S. Shinnar, S.L.M., R.C.S.).,Pediatrics (S. Shinnar, S.L.M.).,Epidemiology and Population Health (S. Shinnar)
| | | | - E Bagiella
- Department of Health Evidence and Policy (E.B.), Mount Sinai School of Medicine, New York, New York
| | - D V Lewis
- Departments of Pediatrics (Neurology) (D.V.L.)
| | - J A Bello
- From Departments of Radiology (A.C.M., W.A.G., J.A.B.)
| | - S Chan
- Radiology (S.C.), Gertrude H. Sergievsky Center, Columbia University, New York, New York
| | - J MacFall
- Radiology (J.M.), Duke University Medical Center, Durham, North Carolina
| | - M Chen
- Departments of Epidemiology (D.C.H., M.C.)
| | | | - D R Nordli
- Department of Neurology (D.R.N.), Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - L M Frank
- Department of Neurology (L.M.F.), Children's Hospital of The King's Daughters and Eastern Virginia Medical School, Norfolk, Virginia
| | - S L Moshé
- Neurology (S. Shinnar, S.L.M., R.C.S.).,Pediatrics (S. Shinnar, S.L.M.).,Neuroscience (S.L.M.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | | | - S Sun
- Biostatistics (S. Sun), Medical College of Virginia, Virginia Commonwealth University, Richmond, Virginia
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12
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Tsai MH, Vaughan DN, Perchyonok Y, Fitt GJ, Scheffer IE, Berkovic SF, Jackson GD. Hippocampal malrotation is an anatomic variant and has no clinical significance in MRI-negative temporal lobe epilepsy. Epilepsia 2016; 57:1719-1728. [DOI: 10.1111/epi.13505] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Meng-Han Tsai
- Department of Medicine; Epilepsy Research Centre; Austin Health; University of Melbourne; Heidelberg Victoria Australia
- Department of Neurology; Kaohsiung Chang Gung Memorial Hospital; Kaohsiung Taiwan
- Department of Nursing; Meiho University; Pingtung Taiwan
| | - David N. Vaughan
- Department of Neurology; Austin Health; Florey Institute of Neuroscience and Mental Health; Melbourne Victoria Australia
| | - Yuliya Perchyonok
- Department of Radiology; Austin Hospital; Melbourne Victoria Australia
| | - Greg J. Fitt
- Department of Radiology; Austin Hospital; Melbourne Victoria Australia
| | - Ingrid E. Scheffer
- Department of Medicine; Epilepsy Research Centre; Austin Health; University of Melbourne; Heidelberg Victoria Australia
- Department of Neurology; Austin Health; Florey Institute of Neuroscience and Mental Health; Melbourne Victoria Australia
- Department of Paediatrics; Royal Children's Hospital; University of Melbourne; Melbourne Victoria Australia
| | - Samuel F. Berkovic
- Department of Medicine; Epilepsy Research Centre; Austin Health; University of Melbourne; Heidelberg Victoria Australia
- Department of Radiology; Austin Hospital; Melbourne Victoria Australia
| | - Graeme D. Jackson
- Department of Neurology; Austin Health; Florey Institute of Neuroscience and Mental Health; Melbourne Victoria Australia
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13
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Leach JL, Awwad R, Greiner HM, Vannest JJ, Miles L, Mangano FT. Mesial temporal lobe morphology in intractable pediatric epilepsy: so-called hippocampal malrotation, associated findings, and relevance to presurgical assessment. J Neurosurg Pediatr 2016; 17:683-93. [PMID: 26870898 DOI: 10.3171/2015.11.peds15485] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Diagnostic criteria for hippocampal malrotation (HIMAL) on brain MRI typically include a rounded hippocampus, vertical collateral sulcus, and architectural blurring. Relationship to epileptogenesis remains speculative, and usefulness for surgical guidance is unknown. The study was performed to determine the prevalence of hippocampal rotational anomalies in a cohort of pediatric patients with intractable epilepsy undergoing evaluation for surgery and to determine the significance of this finding in the context of surgical planning. METHODS Forty-eight surgically treated children with intractable epilepsy were compared with matched healthy subjects; reviewers were blinded to surgical side. Each temporal lobe was evaluated for rounded hippocampus, blurring, vertical collateral sulcus, wide choroidal fissure, enlarged temporal horn, low fornix, hippocampal signal, and findings of hippocampal sclerosis. A mesial temporal lobe (MTL) score was calculated by summing the number of features, and the collateral sulcus angle (CSA) was measured in each temporal lobe. Surgical side, pathological diagnosis, and imaging findings elsewhere in the brain were tabulated. Presence of HIMAL, associated imaging features, and MTL score were compared between sides, between epilepsy and control groups, in relationship to side of surgery, and in relationship to postoperative outcome. RESULTS Only 3 epilepsy patients (6.2%) and no controls exhibited all 3 features of HIMAL (p = 0.12). Eight of 48 (16.7%) epilepsy versus 2 of 48 (4.6%) control subjects had both a rounded hippocampus and vertical collateral sulcus (suggesting HIMAL) (p = 0.045). In control and epilepsy subjects, most findings were more prevalent on the left, and the left CSA was more vertical (p < 0.0001). Epilepsy subjects had higher MTL scores (z = -2.95, p = 0.002) and more acute CSAs (p = 0.04) than controls. Only lateralizing raw MTL score had a significant association with surgical side (p = 0.03, OR 7.33); however, this was not significant when hippocampal sclerosis cases were excluded. HIMAL findings were more prevalent and MTL scores were higher in patients with resections involving the temporal lobes. On group analysis, HIMAL findings did not predict eventual surgical side and did not predict outcome, although the numbers are small. In 4 patients the abnormally rotated hippocampus was resected and showed hippocampal sclerosis and/or dysplastic changes on histopathology. All of these patients had a good outcome after surgery. CONCLUSIONS While increased in prevalence in children with intractable epilepsy, imaging findings of HIMAL did not have preoperative lateralizing utility in this group. Findings of HIMAL (including round hippocampus, architectural blurring, and vertical collateral sulcus) did not predict outcome after surgery, although the small number of patients with these findings limits evaluation. In the small number of patients in which the malrotated hippocampus was removed, outcome was good. Further research is needed to continue to define this association in children with intractable epilepsy, focusing on a temporal lobe cohort.
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Affiliation(s)
| | | | | | | | - Lili Miles
- Pathology, Comprehensive Epilepsy Treatment Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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14
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Colle R, Cury C, Chupin M, Deflesselle E, Hardy P, Nasser G, Falissard B, Ducreux D, Colliot O, Corruble E. Hippocampal volume predicts antidepressant efficacy in depressed patients without incomplete hippocampal inversion. NEUROIMAGE-CLINICAL 2016; 12:949-955. [PMID: 27995060 PMCID: PMC5153557 DOI: 10.1016/j.nicl.2016.04.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 04/15/2016] [Accepted: 04/26/2016] [Indexed: 12/16/2022]
Abstract
Background Incomplete hippocampal inversion (IHI), also called malrotation, is a frequent atypical anatomical pattern of the hippocampus. Because of the crucial implication of the hippocampus in Major Depressive Disorder (MDD) and the neurodevelopmental hypothesis of MDD, we aimed to assess the prevalence of IHI in patients with MDD, the link of IHI with hippocampal volume (HV) and the impact of IHI on the predictive value of HV for response and remission after antidepressant treatment. Methods IHI (right and left, partial and total and IHI scores) and HV were assessed in 60 patients with a current Major Depressive Episode (MDE) in a context of MDD and 60 matched controls. Patients were prospectively assessed at baseline and after one, three and six months of antidepressant treatment for response and remission. Results The prevalence of IHI did not significantly differ between MDD patients (right = 23.3%; left = 38.3%) and controls (right = 16.7%; left = 33.3%). IHI was not significantly associated with MDD clinical characteristics. IHI alone did not predict response and remission after antidepressant treatment. However, an interaction between left HV and left IHI predicted six-month response (p = 0.04), HDRS score decrease (p = 0.02) and both three-month (p = 0.04) and six-month (p = 0.03) remission. A case-control design in 30 matched patients with or without left IHI confirmed that interaction. In patients without left IHI, left HV at baseline were smaller in six-month non-remitters as compared to remitters (2.2(± 0.43) cm3 vs 2.97(± 0.5) cm3 p = 0.02), and in six-month non-responders as compared to responders (2.18(± 0.42) cm3 vs 2.86(± 0.54) cm3, p = 0.03). In patients with left IHI, no association was found between left HV at baseline and antidepressant response and remission. Conclusion IHI is not more frequent in MDD patients than in controls, is not associated with HV, but is a confounder that decreases the predictive value of hippocampal volume to predict response or remission after antidepressant treatment. IHI should be systematically assessed in future research studies assessing hippocampal volume in MDD. Incomplete hippocampal inversion (IHI) is not significantly more frequent in MDD than in controls. IHI is not significantly associated with MDD clinical characteristics. Hippocampal volume predicts antidepressant efficacy in MDD patients without IHI. Hippocampal volume does not predict antidepressant efficacy in patients with IHI.
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Affiliation(s)
- Romain Colle
- INSERM UMRS 1178, Team "Depression and Antidepressants", 94275 Le Kremlin Bicêtre, France; Univ. Paris-Sud, Faculté de Médecine Paris Sud, 94275 Le Kremlin Bicêtre, France; Service de Psychiatrie, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France
| | - Claire Cury
- INSERM U1127, F-75013 Paris, France; CNRS, UMR 7225, 75013 Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMRS 1127, F-75013 Paris, France; Institut du Cerveau et de la Moelle épinière, ICM, F-75013 Paris, France; Inria, Aramis project-team, Centre de Recherche de Paris, France; AP-HP, Hôpital de la Pitié-Salpêtrière, Departments of Neuroradiology and Neurology, F-75013 Paris, France
| | - Marie Chupin
- INSERM U1127, F-75013 Paris, France; CNRS, UMR 7225, 75013 Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMRS 1127, F-75013 Paris, France; Institut du Cerveau et de la Moelle épinière, ICM, F-75013 Paris, France; Inria, Aramis project-team, Centre de Recherche de Paris, France; AP-HP, Hôpital de la Pitié-Salpêtrière, Departments of Neuroradiology and Neurology, F-75013 Paris, France
| | - Eric Deflesselle
- INSERM UMRS 1178, Team "Depression and Antidepressants", 94275 Le Kremlin Bicêtre, France; Univ. Paris-Sud, Faculté de Médecine Paris Sud, 94275 Le Kremlin Bicêtre, France; Service de Psychiatrie, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France
| | - Patrick Hardy
- INSERM UMRS 1178, Team "Depression and Antidepressants", 94275 Le Kremlin Bicêtre, France; Univ. Paris-Sud, Faculté de Médecine Paris Sud, 94275 Le Kremlin Bicêtre, France; Service de Psychiatrie, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France
| | - Ghaidaa Nasser
- Univ. Paris-Sud, Faculté de Médecine Paris Sud, 94275 Le Kremlin Bicêtre, France; CNRS IR4M, UMR 8081, 94275 Le Kremlin Bicêtre, France; Service de Neuroradiologie, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France
| | - Bruno Falissard
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
| | - Denis Ducreux
- Univ. Paris-Sud, Faculté de Médecine Paris Sud, 94275 Le Kremlin Bicêtre, France; CNRS IR4M, UMR 8081, 94275 Le Kremlin Bicêtre, France; Service de Neuroradiologie, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France
| | - Olivier Colliot
- INSERM U1127, F-75013 Paris, France; CNRS, UMR 7225, 75013 Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMRS 1127, F-75013 Paris, France; Institut du Cerveau et de la Moelle épinière, ICM, F-75013 Paris, France; Inria, Aramis project-team, Centre de Recherche de Paris, France; AP-HP, Hôpital de la Pitié-Salpêtrière, Departments of Neuroradiology and Neurology, F-75013 Paris, France
| | - Emmanuelle Corruble
- INSERM UMRS 1178, Team "Depression and Antidepressants", 94275 Le Kremlin Bicêtre, France; Univ. Paris-Sud, Faculté de Médecine Paris Sud, 94275 Le Kremlin Bicêtre, France; Service de Psychiatrie, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France
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15
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Cury C, Toro R, Cohen F, Fischer C, Mhaya A, Samper-González J, Hasboun D, Mangin JF, Banaschewski T, Bokde ALW, Bromberg U, Buechel C, Cattrell A, Conrod P, Flor H, Gallinat J, Garavan H, Gowland P, Heinz A, Ittermann B, Lemaitre H, Martinot JL, Nees F, Paillère Martinot ML, Orfanos DP, Paus T, Poustka L, Smolka MN, Walter H, Whelan R, Frouin V, Schumann G, Glaunès JA, Colliot O. Incomplete Hippocampal Inversion: A Comprehensive MRI Study of Over 2000 Subjects. Front Neuroanat 2015; 9:160. [PMID: 26733822 PMCID: PMC4686650 DOI: 10.3389/fnana.2015.00160] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 11/30/2015] [Indexed: 11/13/2022] Open
Abstract
The incomplete-hippocampal-inversion (IHI), also known as malrotation, is an atypical anatomical pattern of the hippocampus, which has been reported in healthy subjects in different studies. However, extensive characterization of IHI in a large sample has not yet been performed. Furthermore, it is unclear whether IHI are restricted to the medial-temporal lobe or are associated with more extensive anatomical changes. Here, we studied the characteristics of IHI in a community-based sample of 2008 subjects of the IMAGEN database and their association with extra-hippocampal anatomical variations. The presence of IHI was assessed on T1-weighted anatomical magnetic resonance imaging (MRI) using visual criteria. We assessed the association of IHI with other anatomical changes throughout the brain using automatic morphometry of cortical sulci. We found that IHI were much more frequent in the left hippocampus (left: 17%, right: 6%, χ(2)-test, p < 10(-28)). Compared to subjects without IHI, subjects with IHI displayed morphological changes in several sulci located mainly in the limbic lobe. Our results demonstrate that IHI are a common left-sided phenomenon in normal subjects and that they are associated with morphological changes outside the medial temporal lobe.
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Affiliation(s)
- Claire Cury
- Institut national de la santé et de la recherche médicale, U1127Paris, France; Centre National de la Recherche Scientifique, UMR 7225 Institut du Cerveau et de la Moelle épinièreParis, France; Sorbonne Universités, Université Pierre et Marie Curie Univ Paris 06, UMR S 1127Paris, France; Institut du Cerveau et de la Moelle épinière, Institut du Cerveau et de la Moelle épinièreParis, France; Inria, Aramis Team, Centre de Recherche Paris-RocquencourtParis, France; Centre d'Acquisition et de Traitement des ImagesParis, France
| | - Roberto Toro
- Centre National de la Recherche Scientifique, Genes, Synapses and Cognition, URA 2182, Institut PasteurParis, France; Human Genetics and Cognitive Functions, Institut PasteurParis, France
| | - Fanny Cohen
- Institut national de la santé et de la recherche médicale, U1127Paris, France; Centre National de la Recherche Scientifique, UMR 7225 Institut du Cerveau et de la Moelle épinièreParis, France; Sorbonne Universités, Université Pierre et Marie Curie Univ Paris 06, UMR S 1127Paris, France; Institut du Cerveau et de la Moelle épinière, Institut du Cerveau et de la Moelle épinièreParis, France; Inria, Aramis Team, Centre de Recherche Paris-RocquencourtParis, France
| | - Clara Fischer
- Centre d'Acquisition et de Traitement des ImagesParis, France; Institut d'Imagerie Biomédicale; Commissariat à l'énergie atomique et aux énergies alternatives; Direction des Sciences du VivantGif-Sur-Yvette, France
| | - Amel Mhaya
- Institut national de la santé et de la recherche médicale, U1127Paris, France; Centre National de la Recherche Scientifique, UMR 7225 Institut du Cerveau et de la Moelle épinièreParis, France; Sorbonne Universités, Université Pierre et Marie Curie Univ Paris 06, UMR S 1127Paris, France; Institut du Cerveau et de la Moelle épinière, Institut du Cerveau et de la Moelle épinièreParis, France; Inria, Aramis Team, Centre de Recherche Paris-RocquencourtParis, France
| | - Jorge Samper-González
- Institut national de la santé et de la recherche médicale, U1127Paris, France; Centre National de la Recherche Scientifique, UMR 7225 Institut du Cerveau et de la Moelle épinièreParis, France; Sorbonne Universités, Université Pierre et Marie Curie Univ Paris 06, UMR S 1127Paris, France; Institut du Cerveau et de la Moelle épinière, Institut du Cerveau et de la Moelle épinièreParis, France; Inria, Aramis Team, Centre de Recherche Paris-RocquencourtParis, France
| | - Dominique Hasboun
- Institut national de la santé et de la recherche médicale, U1127Paris, France; Centre National de la Recherche Scientifique, UMR 7225 Institut du Cerveau et de la Moelle épinièreParis, France; Sorbonne Universités, Université Pierre et Marie Curie Univ Paris 06, UMR S 1127Paris, France; Institut du Cerveau et de la Moelle épinière, Institut du Cerveau et de la Moelle épinièreParis, France; Inria, Aramis Team, Centre de Recherche Paris-RocquencourtParis, France; Departments of Neuroradiology and Neurology, AP-HP, Hôpital de la Pitié-SalpétrièreParis, France
| | - Jean-François Mangin
- Centre d'Acquisition et de Traitement des ImagesParis, France; Institut d'Imagerie Biomédicale; Commissariat à l'énergie atomique et aux énergies alternatives; Direction des Sciences du VivantGif-Sur-Yvette, France
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Clinical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg Mannheim, Germany
| | - Arun L W Bokde
- Discipline of Psychiatry, School of Medicine, Trinity College DublinDublin, Ireland; Institute of Neuroscience, Trinity College DublinDublin, Ireland
| | - Uli Bromberg
- Department of Systems Neuroscience, Universitätsklinikum Hamburg Eppendorf Hamburg, Germany
| | - Christian Buechel
- Department of Systems Neuroscience, Universitätsklinikum Hamburg EppendorfHamburg, Germany; Department of Psychology, Stanford UniversityStanford, CA, USA
| | - Anna Cattrell
- Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondon, UK; MRC Social, Genetic and Developmental Psychiatry CentreLondon, UK
| | - Patricia Conrod
- Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondon, UK; Département de Psychiatrie, Centre Hospitalier Universitaire Sainte-Justine, Université de MontrealMontreal, QC, Canada
| | - Herta Flor
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University Mannheim, Germany
| | - Juergen Gallinat
- Department of Systems Neuroscience, Universitätsklinikum Hamburg EppendorfHamburg, Germany; Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité-Universitätsmedizin BerlinGermany
| | - Hugh Garavan
- Discipline of Psychiatry, School of Medicine, Trinity College Dublin Dublin, Ireland
| | - Penny Gowland
- School of Physics and Astronomy, University of Nottingham Nottingham, UK
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité-Universitätsmedizin Berlin Germany
| | | | - Hervé Lemaitre
- Institut national de la santé et de la recherche médicale U1000, Neuroimagerie en Psychiatrie, Université Paris-Sud, Université Paris Descartes Paris, France
| | - Jean-Luc Martinot
- Institut national de la santé et de la recherche médicale U1000, Neuroimagerie en Psychiatrie, Université Paris-Sud, Université Paris Descartes Paris, France
| | - Frauke Nees
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University Mannheim, Germany
| | - Marie-Laure Paillère Martinot
- Institut national de la santé et de la recherche médicale U1000, Neuroimagerie en Psychiatrie, Université Paris-Sud, Université Paris DescartesParis, France; AP-HP, Department of Adolescent Psychopathology and Medicine, Maison de Solenn, Cochin Hospital, University Paris Descartes, Sorbonne Paris CitéParis, France
| | - Dimitri P Orfanos
- Institut d'Imagerie Biomédicale; Commissariat à l'énergie atomique et aux énergies alternatives; Direction des Sciences du Vivant Gif-Sur-Yvette, France
| | - Tomas Paus
- Rotman Research Institute, BaycrestToronto, ON, Canada; Departments of Psychology and Psychiatry, University of TorontoToronto, Canada; Center for Developing Brain, Child Mind InstituteNew York, NY, USA
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, Clinical Faculty Mannheim, Central Institute of Mental Health, University of HeidelbergMannheim, Germany; Department of Child and Adolescent Psychiatry, Medical University of ViennaVienna, Austria
| | - Michael N Smolka
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden Dresden, Germany
| | - Henrik Walter
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité-Universitätsmedizin BerlinGermany; Berlin School of Mind and Brain, Humboldt University BerlinBerlin, Germany
| | - Robert Whelan
- Department of Psychology, University College Dublin Dublin, Ireland
| | - Vincent Frouin
- Institut d'Imagerie Biomédicale; Commissariat à l'énergie atomique et aux énergies alternatives; Direction des Sciences du Vivant Gif-Sur-Yvette, France
| | - Gunter Schumann
- Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondon, UK; MRC Social, Genetic and Developmental Psychiatry CentreLondon, UK
| | - Joan A Glaunès
- MAP5, Université Paris Descartes, Sorbonne Paris Cité Paris, France
| | - Olivier Colliot
- Institut national de la santé et de la recherche médicale, U1127Paris, France; Centre National de la Recherche Scientifique, UMR 7225 Institut du Cerveau et de la Moelle épinièreParis, France; Sorbonne Universités, Université Pierre et Marie Curie Univ Paris 06, UMR S 1127Paris, France; Institut du Cerveau et de la Moelle épinière, Institut du Cerveau et de la Moelle épinièreParis, France; Inria, Aramis Team, Centre de Recherche Paris-RocquencourtParis, France; Centre d'Acquisition et de Traitement des ImagesParis, France; Departments of Neuroradiology and Neurology, AP-HP, Hôpital de la Pitié-SalpétrièreParis, France
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16
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Abstract
OBJECTIVE The purpose of this article is to describe an MRI protocol optimized for epilepsy evaluation, common causes of epilepsy visualized on MR images of patients evaluated for medically intractable partial epilepsy, and the basic concepts of advanced imaging techniques in the evaluation of epilepsy. CONCLUSION Epilepsy is one of the most common neurologic disorders in the United States. The long-term seizure-free success of epilepsy surgery is related to the ability to define and completely resect the epileptogenic zone. Detection of structural lesions at preoperative imaging requires not only a dedicated epilepsy protocol but also meticulous examination of the images by the interpreting radiologist with particular attention to subtle abnormalities that might otherwise go unreported.
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Thompson DK, Adamson C, Roberts G, Faggian N, Wood SJ, Warfield SK, Doyle LW, Anderson PJ, Egan GF, Inder TE. Hippocampal shape variations at term equivalent age in very preterm infants compared with term controls: perinatal predictors and functional significance at age 7. Neuroimage 2013; 70:278-87. [PMID: 23296179 PMCID: PMC3584256 DOI: 10.1016/j.neuroimage.2012.12.053] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Revised: 12/14/2012] [Accepted: 12/16/2012] [Indexed: 11/30/2022] Open
Abstract
The hippocampus undergoes rapid growth and development in the perinatal months. Infants born very preterm (VPT) are vulnerable to hippocampal alterations, and can provide a model of disturbed early hippocampal development. Hippocampal shape alterations have previously been associated with memory impairment, but have never been investigated in infants. The aims of this study were to determine hippocampal shape differences between 184 VPT infants (<30 weeks' gestation or <1250 g at birth) and 32 full-term infants, effects of perinatal factors, and associations between infant hippocampal shape and volume, and 7 year verbal and visual memory (California Verbal Learning Test - Children's Version and Dot Locations). Infants underwent 1.5 T magnetic resonance imaging at term equivalent age. Hippocampi were segmented, and spherical harmonics-point distribution model shape analysis was undertaken. VPT infants' hippocampi were less infolded than full-term infants, being less curved toward the midline and less arched superior-inferiorly. Straighter hippocampi were associated with white matter injury and postnatal corticosteroid exposure. There were no significant associations between infant hippocampal shape and 7 year memory measures. However, larger infant hippocampal volumes were associated with better verbal memory scores. Altered hippocampal shape in VPT infants at term equivalent age may reflect delayed or disrupted development. This study provides further insight into early hippocampal development and the nature of hippocampal abnormalities in prematurity.
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Affiliation(s)
- Deanne K Thompson
- Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Australia.
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Yoong M, Madari R, Martinos M, Clark C, Chong K, Neville B, Chin R, Scott R. The role of magnetic resonance imaging in the follow-up of children with convulsive status epilepticus. Dev Med Child Neurol 2012; 54:328-33. [PMID: 22268666 DOI: 10.1111/j.1469-8749.2011.04215.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM The aim of this study was to determine the yield of magnetic resonance imaging (MRI) after an episode of childhood convulsive status epilepticus (CSE) and to identify the clinical predictors of an abnormal brain scan. METHOD Children were recruited following an episode of CSE from an established clinical network in north London. Eighty children (age range 1mo-16y; 39 males; 41 females) were enrolled and seen for clinical assessment and brain MRI within 13 weeks of suffering from an episode of CSE. Scans were reviewed by two neuroradiologists and classified as normal (normal/normal-variant) or abnormal (minor/major abnormality). Factors predictive of an abnormal scan were investigated using logistic regression. RESULTS Eighty children were recruited at a mean of 31.8 days (5-90d) after suffering from CSE. Structural abnormalities were found in 31%. Abnormal neurological examination at assessment (odds ratio [OR] 190.46), CSE that was not a prolonged febrile seizure (OR 77.12), and a continuous rather than an intermittent seizure (OR 29.98) were all predictive of an abnormal scan. No children with previous neuroimaging had new findings that altered their clinical management. INTERPRETATION Brain MRI should be considered for all children with a history of CSE who have not previously undergone MRI, especially those with non-prolonged febrile seizure CSE, those with persisting neurological abnormalities 2 to 13 weeks after CSE, and those with continuous CSE.
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