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Li Y, Liu P, Lin Q, Li W, Zhang Y, Li J, Li X, Gong Q, Zhang H, Li L, Sima X, Cao D, Huang X, Huang K, Zhou D, An D. Temporopolar blurring signifies abnormalities of white matter in mesial temporal lobe epilepsy. Ann Clin Transl Neurol 2024. [PMID: 39342438 DOI: 10.1002/acn3.52204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Revised: 08/19/2024] [Accepted: 08/26/2024] [Indexed: 10/01/2024] Open
Abstract
OBJECTIVE The single-center retrospective cohort study investigated underlying pathogenic mechanisms and clinical significance of patients with temporal lobe epilepsy and hippocampal sclerosis (TLE-HS), in the presence/absence of gray-white matter abnormalities (usually called "blurring"; GMB) in ipsilateral temporopolar region (TPR) on MRI. METHODS The study involved 105 patients with unilateral TLE-HS (60 GMB+ and 45 GMB-) who underwent standard anterior temporal lobectomy, along with 61 healthy controls. Resected specimens were examined under light microscope. With combined T1-weighted and DTI data, we quantitatively compared large-scale morphometric features and exacted diffusion parameters of ipsilateral TPR-related superficial and deep white matter (WM) by atlas-based segmentation. Along-tract analysis was added to detect heterogeneous microstructural alterations at various points along deep WM tracts, which were categorized into inferior longitudinal fasciculus (ILF), uncinate fasciculus (UF), and temporal cingulum. RESULTS Comparable seizure semiology and postoperative seizure outcome were found, while the GMB+ group had significantly higher rate of HS Type 1 and history of febrile seizures, contrasting with significantly lower proportion of interictal contralateral epileptiform discharges, HS Type 2, and increased wasteosomes in hippocampal specimens. Similar morphometric features but greater WM atrophy with more diffusion abnormalities of superficial WM was observed adjacent to ipsilateral TPR in the GMB+ group. Moreover, microstructural alterations resulting from temporopolar GMB were more localized in temporal cingulum while evenly and widely distributed along ILF and UF. INTERPRETATION Temporopolar GMB could signify more severe and widespread microstructural damage of white matter rather than a focal cortical lesion in TLE-HS, affecting selection of surgical procedures.
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Affiliation(s)
- Yuming Li
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Peiwen Liu
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Qiuxing Lin
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Wei Li
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Yingying Zhang
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Jinmei Li
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Xiuli Li
- Huaxi MR Research Center, Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Qiyong Gong
- Huaxi MR Research Center, Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Heng Zhang
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Luying Li
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Xiutian Sima
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Danyang Cao
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Xiang Huang
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Kailing Huang
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Dong Zhou
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Dongmei An
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, 610041, China
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Okromelidze L, Gupta V, Jain A, Gopal N, Feyissa AM, Tatum WO, Quiñones-Hinojosa A, Grewal SS, Middlebrooks EH. Temporal pole blurring in temporal lobe epilepsy revealed by 3D Edge-Enhancing Gradient Echo MRI. Neuroradiol J 2024; 37:386-389. [PMID: 34989268 PMCID: PMC11138332 DOI: 10.1177/19714009211067404] [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: 11/16/2022] Open
Abstract
While abnormalities of the hippocampus have been well characterized in temporal lobe epilepsy, various additional temporal lobe abnormalities have also been described. One poorly understood entity, the so-called temporal pole blurring (TPB), is one of the more frequently described neocortical abnormalities in TLE and is thought to represent dysmyelination and axonal loss due to chronic electrical perturbations in early age-onset temporal lobe epilepsy. In this study, we describe the first reported cases of TPB diagnosed by a recently described MRI sequence known as 3D Edge-Enhancing Gradient Echo (3D-EDGE), which has an effective "myelin weighting" making it exquisitely sensitive to this temporal pole dysmyelination. The value of detection of TPB lies in lateralizing seizure onset, as well as predicting a lower baseline neuropsychological performance compared to temporal lobe epilepsy without TPB. Additionally, it is critical to not mistake TPB for alternative diagnoses, such as focal cortical dysplasia or neoplasm.
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Affiliation(s)
| | - Vivek Gupta
- Department of Radiology, Mayo Clinic, Jacksonville, FL, USA
| | - Ayushi Jain
- Department of Radiology, Mayo Clinic, Jacksonville, FL, USA
| | - Neethu Gopal
- Department of Radiology, Mayo Clinic, Jacksonville, FL, USA
| | | | | | | | | | - Erik H Middlebrooks
- Department of Radiology, Mayo Clinic, Jacksonville, FL, USA
- Department of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA
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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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Leveraging manifold learning techniques to explore white matter anomalies: An application of the TractLearn pipeline in epilepsy. Neuroimage Clin 2022; 36:103209. [PMID: 36162235 PMCID: PMC9668609 DOI: 10.1016/j.nicl.2022.103209] [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: 05/22/2022] [Revised: 09/15/2022] [Accepted: 09/21/2022] [Indexed: 12/14/2022]
Abstract
An accurate description of brain white matter anatomy in vivo remains a challenge. However, technical progress allows us to analyze structural variations in an increasingly sophisticated way. Current methods of processing diffusion MRI data now make it possible to correct some limiting biases. In addition, the development of statistical learning algorithms offers the opportunity to analyze the data from a new perspective. We applied newly developed tractography models to extract quantitative white matter parameters in a group of patients with chronic temporal lobe epilepsy. Furthermore, we implemented a statistical learning workflow optimized for the MRI diffusion data - the TractLearn pipeline - to model inter-individual variability and predict structural changes in patients. Finally, we interpreted white matter abnormalities in the context of several other parameters reflecting clinical status, as well as neuronal and cognitive functioning for these patients. Overall, we show the relevance of such a diffusion data processing pipeline for the evaluation of clinical populations. The "global to fine scale" funnel statistical approach proposed in this study also contributes to the understanding of neuroplasticity mechanisms involved in refractory epilepsy, thus enriching previous findings.
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Pereira Dalio MTR, Velasco TR, Feitosa IDF, Assirati Junior JA, Carlotti Junior CG, Leite JP, Dos Santos AC, Alexandre V, Nakano FN, Saute RL, Wichert-Ana L, Sakamoto AC. Long-Term Outcome of Temporal Lobe Epilepsy Surgery in 621 Patients With Hippocampal Sclerosis: Clinical and Surgical Prognostic Factors. Front Neurol 2022; 13:833293. [PMID: 35547380 PMCID: PMC9084624 DOI: 10.3389/fneur.2022.833293] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 02/28/2022] [Indexed: 11/24/2022] Open
Abstract
Temporal lobe epilepsy (TLE) is the most common type of focal epilepsy and is frequently drug-resistant (DR) to antiseizure medication (ASM), corresponding to approximately one-third of the cases. When left inadequately treated, it can worsen the quality of life, cognitive deficits, and risk of death. The standard treatment for drug-resistant TLE is the surgical removal of the structures involved, with good long-term outcome rates of 60–70 % and a low rate of adverse effects. The goal of successful treatment is sustained seizure freedom. In our study, we evaluated sustained long-term (up to 23 years) surgical outcomes in 621 patients with DR-TLE associated with hippocampal sclerosis, who underwent a temporal lobectomy. We analyzed the main predictive factors that influence the surgical outcome related to seizure control, through a longitudinal and retrospective study, using a multivariable regression model. We found that 73.6% of the patients were free from disabling seizures (Engel Class I), maintained over time in 65% of patients followed up to 23 years after surgery. We found that four independent variables predicted seizure outcomes. The presence of dysmnesic and olfactory aura predicted a less favorable outcome. The history of febrile seizure and the surgical technique predicted a good outcome. Regarding the type of surgical technique, the standard anteromesial temporal lobectomy (ATL) led to significantly better outcomes (78.6% Engel Class I) when compared to the selective amygdalohippocampectomy via subtemporal approach (67.2% Engel Class I; p = 0.002), suggesting that the neuronal networks involved in the epileptogenic zone may be beyond mesial temporal structures. The multivariable regression model with the above-mentioned predictor variables revealed an ExpB = 3.627 (N = 621, p < 0.001), indicating that the model was able to distinguish between patients with a seizure-free. We conclude that epilepsy surgery is a safe procedure, with low rates of postoperative complications and good long-term results.
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Affiliation(s)
- Marina Teixeira Ramalho Pereira Dalio
- Epilepsy Surgery Center (CIREP), Department of Neurosciences and Behavioral Sciences, Hospital of Clinics of the Medical School of Ribeirão Preto of the University of São Paulo (HCFMRP-USP), Ribeirão Preto, Brazil
| | - Tonicarlo Rodrigues Velasco
- Epilepsy Surgery Center (CIREP), Department of Neurosciences and Behavioral Sciences, Hospital of Clinics of the Medical School of Ribeirão Preto of the University of São Paulo (HCFMRP-USP), Ribeirão Preto, Brazil
| | - Izabela Dayany Franca Feitosa
- Epilepsy Surgery Center (CIREP), Department of Neurosciences and Behavioral Sciences, Hospital of Clinics of the Medical School of Ribeirão Preto of the University of São Paulo (HCFMRP-USP), Ribeirão Preto, Brazil
| | - João Alberto Assirati Junior
- Department of Surgery and Neurosurgery, Hospital of Clinics of the Medical School of Ribeirão Preto of the University of São Paulo (HCFMRP-USP), Ribeirão Preto, Brazil
| | - Carlos Gilberto Carlotti Junior
- Department of Surgery and Neurosurgery, Hospital of Clinics of the Medical School of Ribeirão Preto of the University of São Paulo (HCFMRP-USP), Ribeirão Preto, Brazil
| | - João Pereira Leite
- Epilepsy Surgery Center (CIREP), Department of Neurosciences and Behavioral Sciences, Hospital of Clinics of the Medical School of Ribeirão Preto of the University of São Paulo (HCFMRP-USP), Ribeirão Preto, Brazil
| | - Antonio Carlos Dos Santos
- Department of Radiology, Hospital of Clinics of the Medical School of Ribeirão Preto of the University of São Paulo (HCFMRP-USP), Ribeirão Preto, Brazil
| | - Veriano Alexandre
- Epilepsy Surgery Center (CIREP), Department of Neurosciences and Behavioral Sciences, Hospital of Clinics of the Medical School of Ribeirão Preto of the University of São Paulo (HCFMRP-USP), Ribeirão Preto, Brazil
| | - Frederico Nakane Nakano
- Epilepsy Surgery Center (CIREP), Department of Neurosciences and Behavioral Sciences, Hospital of Clinics of the Medical School of Ribeirão Preto of the University of São Paulo (HCFMRP-USP), Ribeirão Preto, Brazil
| | - Ricardo Lutzky Saute
- Epilepsy Surgery Center (CIREP), Department of Neurosciences and Behavioral Sciences, Hospital of Clinics of the Medical School of Ribeirão Preto of the University of São Paulo (HCFMRP-USP), Ribeirão Preto, Brazil
| | - Lauro Wichert-Ana
- Epilepsy Surgery Center (CIREP), Department of Neurosciences and Behavioral Sciences, Hospital of Clinics of the Medical School of Ribeirão Preto of the University of São Paulo (HCFMRP-USP), Ribeirão Preto, Brazil
| | - Americo Ceiki Sakamoto
- Epilepsy Surgery Center (CIREP), Department of Neurosciences and Behavioral Sciences, Hospital of Clinics of the Medical School of Ribeirão Preto of the University of São Paulo (HCFMRP-USP), Ribeirão Preto, Brazil
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6
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Banjac S, Roger E, Cousin E, Mosca C, Minotti L, Krainik A, Kahane P, Baciu M. Mapping of Language-and-Memory Networks in Patients With Temporal Lobe Epilepsy by Using the GE2REC Protocol. Front Hum Neurosci 2022; 15:752138. [PMID: 35069148 PMCID: PMC8772037 DOI: 10.3389/fnhum.2021.752138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 12/13/2021] [Indexed: 11/17/2022] Open
Abstract
Preoperative mapping of language and declarative memory functions in temporal lobe epilepsy (TLE) patients is essential since they frequently encounter deterioration of these functions and show variable degrees of cerebral reorganization. Due to growing evidence on language and declarative memory interdependence at a neural and neuropsychological level, we propose the GE2REC protocol for interactive language-and-memory network (LMN) mapping. GE2REC consists of three inter-related tasks, sentence generation with implicit encoding (GE) and two recollection (2REC) memory tasks: recognition and recall. This protocol has previously been validated in healthy participants, and in this study, we showed that it also maps the LMN in the left TLE (N = 18). Compared to healthy controls (N = 19), left TLE (LTLE) showed widespread inter- and intra-hemispheric reorganization of the LMN through reduced activity of regions engaged in the integration and the coordination of this meta-network. We also illustrated how this protocol could be implemented in clinical practice individually by presenting two case studies of LTLE patients who underwent efficient surgery and became seizure-free but showed different cognitive outcomes. This protocol can be advantageous for clinical practice because it (a) is short and easy to perform; (b) allows brain mapping of essential cognitive functions, even at an individual level; (c) engages language-and-memory interaction allowing to evaluate the integrative processes within the LMN; (d) provides a more comprehensive assessment by including both verbal and visual modalities, as well as various language and memory processes. Based on the available postsurgical data, we presented preliminary results obtained with this protocol in LTLE patients that could potentially inform the clinical practice. This implies the necessity to further validate the potential of GE2REC for neurosurgical planning, along with two directions, guiding resection and describing LMN neuroplasticity at an individual level.
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Affiliation(s)
- Sonja Banjac
- Université Grenoble Alpes, CNRS LPNC UMR 5105, Grenoble, France
| | - Elise Roger
- Université Grenoble Alpes, CNRS LPNC UMR 5105, Grenoble, France
| | - Emilie Cousin
- Université Grenoble Alpes, CNRS LPNC UMR 5105, Grenoble, France
- Université Grenoble Alpes, UMS IRMaGe CHU Grenoble, Grenoble, France
| | - Chrystèle Mosca
- Université Grenoble Alpes, Grenoble Institute of Neuroscience ‘Synchronisation et modulation des réseaux neuronaux dans l’épilepsie’ & Neurology Department, Grenoble, France
| | - Lorella Minotti
- Université Grenoble Alpes, Grenoble Institute of Neuroscience ‘Synchronisation et modulation des réseaux neuronaux dans l’épilepsie’ & Neurology Department, Grenoble, France
| | - Alexandre Krainik
- Université Grenoble Alpes, UMS IRMaGe CHU Grenoble, Grenoble, France
| | - Philippe Kahane
- Université Grenoble Alpes, Grenoble Institute of Neuroscience ‘Synchronisation et modulation des réseaux neuronaux dans l’épilepsie’ & Neurology Department, Grenoble, France
| | - Monica Baciu
- Université Grenoble Alpes, CNRS LPNC UMR 5105, Grenoble, France
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7
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Cossu M, d'Orio P, Barba C, Asioli S, Cardinale F, Casciato S, Caulo M, Colicchio G, Consales A, D'Aniello A, De Benedictis A, De Palma L, Didato G, Di Gennaro G, Di Giacomo R, Esposito V, Guerrini R, Nichelatti M, Revay M, Rizzi M, Vatti G, Villani F, Zamponi N, Tassi L, Marras CE. Focal Cortical Dysplasia IIIa in Hippocampal Sclerosis-Associated Epilepsy: Anatomo-Electro-Clinical Profile and Surgical Results From a Multicentric Retrospective Study. Neurosurgery 2021; 88:384-393. [PMID: 32860416 DOI: 10.1093/neuros/nyaa369] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 06/24/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Hippocampal sclerosis (HS) may be associated with focal cortical dysplasia IIIa (FCD IIIa) in patients undergoing surgery for temporal lobe epilepsy (TLE). OBJECTIVE To investigate whether the anatomo-electro-clinical profile and surgical outcome in patients with HS-related TLE are affected by coexisting FCD IIIa. METHODS A total of 220 patients, operated in 5 centers, with at least 24 mo follow-up (FU), were retrospectively studied. Preliminary univariate and subsequent multivariate analyses were performed to investigate possible associations between several potential presurgical, surgical, and postsurgical predictors and different variables (Engel's class I and Engel's class Ia, co-occurrence of FCD IIIa). RESULTS At last available postoperative control (FU: range 24-95 mo, median 47 mo), 182 (82.7%) patients were classified as Engel's class I and 142 (64.5%) as Engel's class Ia. At multivariate analysis, extension of neocortical resection and postoperative electroencephalogram were significantly associated with Engel's class I, whereas length of FU had a significant impact on class Ia in the whole cohort and in isolated HS (iHS) patients, but not in the FCD IIIa group. No differences emerged in the anatomo-electro-clinical profile and surgical results between patients with FCD IIIa and with iHS. CONCLUSION Coexistence of FCD IIIa did not confer a distinct anatomo-electro-clinical profile to patients with HS-related epilepsy. Postoperative seizure outcome was similar in FCD IIIa and iHS cases. These findings indicate limited clinical relevance of FCD IIIa in HS-related epilepsy and might be useful for refining future FCD classifications. Further studies are needed to clarify the correlation of class Ia outcome with the duration of FU.
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Affiliation(s)
- Massimo Cossu
- "C. Munari" Epilepsy Surgery Center, Niguarda Hospital, Milan, Italy
| | - Piergiorgio d'Orio
- "C. Munari" Epilepsy Surgery Center, Niguarda Hospital, Milan, Italy.,Institute of Neuroscience, National Research Council, Parma, Italy
| | - Carmen Barba
- Neuroscience Department, Meyer Children's Hospital, University of Florence, Florence, Italy
| | - Sofia Asioli
- Department of Biomedical and Neuromotor Sciences, Section of Anatomic Pathology "M. Malpighi", Bellaria Hospital, Bologna, Italy
| | | | | | - Massimo Caulo
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti, Italy
| | | | - Alessandro Consales
- Division of Neurosurgery, IRCCS Giannina Gaslini Children's Hospital, Genoa, Italy
| | | | | | - Luca De Palma
- Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children Hospital, Rome, Italy
| | - Giuseppe Didato
- Epilepsy Unit, IRCCS "C. Besta" Neurological Institute Foundation, Milan, Italy
| | | | - Roberta Di Giacomo
- Epilepsy Unit, IRCCS "C. Besta" Neurological Institute Foundation, Milan, Italy
| | - Vincenzo Esposito
- IRCCS Neuromed, Pozzilli (IS), Italy.,Department of Neurology and Psychiatry, Sapienza University, Rome, Italy
| | - Renzo Guerrini
- Neuroscience Department, Meyer Children's Hospital, University of Florence, Florence, Italy
| | | | - Martina Revay
- "C. Munari" Epilepsy Surgery Center, Niguarda Hospital, Milan, Italy
| | - Michele Rizzi
- "C. Munari" Epilepsy Surgery Center, Niguarda Hospital, Milan, Italy
| | - Giampaolo Vatti
- Department of Neurological and Sensorial Sciences, University of Siena, Siena, Italy
| | - Flavio Villani
- Epilepsy Unit, IRCCS "C. Besta" Neurological Institute Foundation, Milan, Italy.,Division of Neurophysiology and Epilepsy Centre, IRCCS San Martino Policlinic Hospital, Genoa, Italy
| | - Nelia Zamponi
- Child Neuropsychiatric Unit, University of Ancona, Ancona, Italy
| | - Laura Tassi
- "C. Munari" Epilepsy Surgery Center, Niguarda Hospital, Milan, Italy
| | - Carlo Efisio Marras
- Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children Hospital, Rome, Italy
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8
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Mutti C, Riccò M, Bartolini Y, Bernabè G, Trippi I, Melpignano A, Ciliento R, Zinno L, Florindo I, Sasso E, Odone A, Parrino L, Vaudano AE. Incomplete hippocampal inversion and epilepsy: A systematic review and meta-analysis. Epilepsia 2020; 62:383-396. [PMID: 33325054 DOI: 10.1111/epi.16787] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 11/20/2020] [Accepted: 11/20/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Incomplete hippocampal inversion (IHI) is a relatively frequent radiological finding at visual inspection in both epilepsy and healthy controls, but its clinical significance is unclear. Here, we systematically retrieve and assess the association between epilepsy and IHI using a meta-analytic approach. Additionally, we estimate the prevalence of IHI in patients with malformation of cortical development (MCD). METHODS We systematically searched two databases (Embase and PubMed) to identify potentially eligible studies from their inception to December 2019. For inclusion, studies were population-based, case-control, observational studies reporting on epilepsy and IHI. The risk of developing epilepsy in IHI (estimated with odds ratio [ORs]) and the frequency of IHI among patients with MCD are provided. RESULTS We screened 3601 records and assessed eligibility of 2812 full-text articles. The final material included 13 studies involving 1630 subjects. Seven studies (1329 subjects: 952 epileptic and 377 nonepileptic) were included for the estimation of the risk of developing epilepsy in the presence of IHI. The estimated OR of active epilepsy in IHI was 1.699 (95% confidence interval = 0.880-3.281), with moderate heterogeneity across studies (I2 = 71%). Seven studies (591 patients) provided information about the frequency of IHI in MCD. Up to one third of patients with MCD (27.9%) presented coexistent IHI. SIGNIFICANCE The present findings confirm that IHI is commonly observed in patients with MCD especially in periventricular nodular heterotopia or polymicrogyria. However, the estimated OR indicates overall weak increased odds of epilepsy in people with IHI, suggesting that the presence of isolated IHI cannot be considered a strong independent predictor for epilepsy development. Clear-cut neuroradiological criteria for IHI and advanced postprocessing analyses on structural magnetic resonance imaging scans are recommended to highlight differences between epileptogenic and nonepileptogenic IHI.
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Affiliation(s)
- Carlotta Mutti
- Neurology Unit, Department of Medicine and Surgery, Sleep Disorders Center, University of Parma, Parma, Italy
| | - Matteo Riccò
- AUSL-IRCCS of Reggio Emilia, Occupational Health and Safety Service, Reggio Emilia, Italy
| | - Yerma Bartolini
- Neurology Unit, Department of Medicine and Surgery, Sleep Disorders Center, University of Parma, Parma, Italy
| | - Giorgia Bernabè
- Neurology Unit, Department of Medicine and Surgery, Sleep Disorders Center, University of Parma, Parma, Italy
| | - Irene Trippi
- Neurology Unit, Department of Medicine and Surgery, Sleep Disorders Center, University of Parma, Parma, Italy
| | - Andrea Melpignano
- Neurology Unit, Department of Medicine and Surgery, Sleep Disorders Center, University of Parma, Parma, Italy
| | - Rosario Ciliento
- Neurology Unit, Department of Medicine and Surgery, Sleep Disorders Center, University of Parma, Parma, Italy
| | - Lucia Zinno
- Neurology Unit, Department of Medicine and Surgery, Sleep Disorders Center, University of Parma, Parma, Italy
| | - Irene Florindo
- Neurology Unit, Department of Medicine and Surgery, Sleep Disorders Center, University of Parma, Parma, Italy
| | - Enrico Sasso
- Neurology Unit, Department of Medicine and Surgery, Sleep Disorders Center, University of Parma, Parma, Italy
| | - Anna Odone
- School of Medicine, University Vita-Salute San Raffaele, Milan, Italy
| | - Liborio Parrino
- Neurology Unit, Department of Medicine and Surgery, Sleep Disorders Center, University of Parma, Parma, Italy
| | - Anna Elisabetta Vaudano
- Neurology Unit, Baggiovara Hospital, University Hospital of Modena, Modena, Italy.,Department of Biomedical, Metabolic, and Neural Science, and Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy
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9
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Wang K, Cao X, Wu D, Liao C, Zhang J, Ji C, Zhong J, He H, Chen Y. Magnetic resonance fingerprinting of temporal lobe white matter in mesial temporal lobe epilepsy. Ann Clin Transl Neurol 2019; 6:1639-1646. [PMID: 31359636 PMCID: PMC6764497 DOI: 10.1002/acn3.50851] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 05/21/2019] [Accepted: 07/02/2019] [Indexed: 12/15/2022] Open
Abstract
Objective Mesial temporal lobe epilepsy (MTLE) is a network disorder. We aimed to quantify the white matter alterations in the temporal lobe of MTLE patients with hippocampal sclerosis (MTLE‐HS) by using magnetic resonance fingerprinting (MRF), a novel imaging technique, which allows simultaneous measurements of multiple parameters with a single acquisition. Methods We consecutively recruited 27 unilateral MTLE‐HS patients and 22 healthy controls. Measurements including T1, T2, and PD values in the temporopolar white matter and temporal stem were recorded and analyzed. Results We found increased T2 value in both sides, and increased T1 value in the ipsilateral temporopolar white matter of MTLE‐HS patients, as compared with healthy controls. The T1 and T2 values were higher in the ipsilateral than the contralateral side. In the temporal stem, increased T1 and T2 values in the ipsilateral side of the MTLE‐HS patients were also observed. Only increased T2 values were observed in the contralateral temporal stem. No significant differences in PD values were observed in either the temporopolar white matter or temporal stem of the MTLE‐HS patients. Correlation analysis revealed that T1 and T2 values in the ipsilateral temporopolar white matter were negatively correlated with the age at epilepsy onset. Interpretation By using MRF, we were able to assess the alterations of T1 and T2 in the temporal lobe white matter of MTLE‐HS patients. MRF could be a promising imaging technique in identifying mild changes in MTLE patients, which might optimize the pre‐surgical evaluation and therapeutic interventions in these patients.
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Affiliation(s)
- Kang Wang
- Department of Neurology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xiaozhi Cao
- Center for Brain Imaging Science and Technology, Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering and Instrumental Science, Zhejiang University, Hangzhou, China
| | - Dengchang Wu
- Department of Neurology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Congyu Liao
- Center for Brain Imaging Science and Technology, Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering and Instrumental Science, Zhejiang University, Hangzhou, China
| | - Jianfang Zhang
- Department of Neurology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Caihong Ji
- Department of Neurology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jianhui Zhong
- Center for Brain Imaging Science and Technology, Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering and Instrumental Science, Zhejiang University, Hangzhou, China.,Department of Imaging Sciences, University of Rochester, Rochester, New York
| | - Hongjian He
- Center for Brain Imaging Science and Technology, Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering and Instrumental Science, Zhejiang University, Hangzhou, China
| | - Yanxing Chen
- Department of Neurology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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10
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Adler S, Blackwood M, Northam GB, Gunny R, Hong SJ, Bernhardt BC, Bernasconi A, Bernasconi N, Jacques T, Tisdall M, Carmichael DW, Cross JH, Baldeweg T. Multimodal computational neocortical anatomy in pediatric hippocampal sclerosis. Ann Clin Transl Neurol 2018; 5:1200-1210. [PMID: 30349855 PMCID: PMC6186946 DOI: 10.1002/acn3.634] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 08/01/2018] [Indexed: 12/16/2022] Open
Abstract
Objective In contrast to adult cohorts, neocortical changes in epileptic children with hippocampal damage are not well characterized. Here, we mapped multimodal neocortical markers of epilepsy‐related structural compromise in a pediatric cohort of temporal lobe epilepsy and explored how they relate to clinical factors. Methods We measured cortical thickness, gray–white matter intensity contrast and intracortical FLAIR intensity in 22 patients with hippocampal sclerosis (HS) and 30 controls. Surface‐based linear models assessed between‐group differences in morphological and MR signal intensity markers. Structural integrity of the hippocampus was measured by quantifying atrophy and FLAIR patterns. Linear models were used to evaluate the relationships between hippocampal and neocortical MRI markers and clinical factors. Results In the hippocampus, patients demonstrated ipsilateral atrophy and bilateral FLAIR hyperintensity. In the neocortex, patients showed FLAIR signal hyperintensities and gray–white matter boundary blurring in the ipsilesional mesial and lateral temporal neocortex. In contrast, cortical thinning was minimal and restricted to a small area of the ipsilesional temporal pole. Furthermore, patients with a history of febrile convulsions demonstrated more pronounced FLAIR hyperintensity in the ipsilesional temporal neocortex. Interpretation Pediatric HS patients do not yet demonstrate the widespread cortical thinning present in adult cohorts, which may reflect consequences of a protracted disease process. However, pronounced temporal neocortical FLAIR hyperintensity and blurring of the gray–white matter boundary are already detectable, suggesting that alterations in MR signal intensities may reflect a different underlying pathophysiology that is detectable earlier in the disease and more pervasive in patients with a history of febrile convulsions.
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Affiliation(s)
- Sophie Adler
- Developmental Neurosciences UCL Great Ormond Street Institute of Child Health University College London London United Kingdom.,Great Ormond Street Hospital for Children London United Kingdom
| | - Mallory Blackwood
- Institute of Neurology University College London London United Kingdom
| | - Gemma B Northam
- Developmental Neurosciences UCL Great Ormond Street Institute of Child Health University College London London United Kingdom
| | - Roxana Gunny
- Great Ormond Street Hospital for Children London United Kingdom
| | - Seok-Jun Hong
- Neuroimaging of Epilepsy Laboratory McConnell Brain Imaging Centre Montreal Neurological Institute and Hospital McGill University Montreal Quebec Canada
| | - Boris C Bernhardt
- Multimodal Imaging and Connectome Analysis Lab McConnell Brain Imaging Centre Montreal Neurological Institute McGill University Montreal Quebec Canada
| | - Andrea Bernasconi
- Neuroimaging of Epilepsy Laboratory McConnell Brain Imaging Centre Montreal Neurological Institute and Hospital McGill University Montreal Quebec Canada
| | - Neda Bernasconi
- Neuroimaging of Epilepsy Laboratory McConnell Brain Imaging Centre Montreal Neurological Institute and Hospital McGill University Montreal Quebec Canada
| | - Thomas Jacques
- Developmental Biology and Cancer Programme UCL Great Ormond Street Institute of Child Health University College London London United Kingdom.,Department of Histopathology Great Ormond Street Hospital for Children NHS Foundation Trust London United Kingdom
| | - Martin Tisdall
- Developmental Neurosciences UCL Great Ormond Street Institute of Child Health University College London London United Kingdom.,Great Ormond Street Hospital for Children London United Kingdom
| | - David W Carmichael
- Developmental Neurosciences UCL Great Ormond Street Institute of Child Health University College London London United Kingdom.,Great Ormond Street Hospital for Children London United Kingdom
| | - J Helen Cross
- Developmental Neurosciences UCL Great Ormond Street Institute of Child Health University College London London United Kingdom.,Great Ormond Street Hospital for Children London United Kingdom
| | - Torsten Baldeweg
- Developmental Neurosciences UCL Great Ormond Street Institute of Child Health University College London London United Kingdom.,Great Ormond Street Hospital for Children London United Kingdom
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11
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Schmeiser B, Wagner K, Schulze-Bonhage A, Mader I, Wendling AS, Steinhoff BJ, Prinz M, Scheiwe C, Weyerbrock A, Zentner J. Surgical Treatment of Mesiotemporal Lobe Epilepsy: Which Approach is Favorable? Neurosurgery 2017; 81:992-1004. [DOI: 10.1093/neuros/nyx138] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 05/24/2017] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND
Mesiotemporal lobe epilepsy is one of the most frequent causes for pharmacoresistant epilepsy. Different surgical approaches to the mesiotemporal area are used.
OBJECTIVE
To analyze epileptological and neuropsychological results as well as complications of different surgical strategies.
METHODS
This retrospective study is based on a consecutive series of 458 patients all harboring pharmacoresistant mesiotemporal lobe epilepsy. Following procedures were performed: standard anterior temporal lobectomy, anterior temporal or key-hole resection, extended lesionectomy, and transsylvian and subtemporal selective amygdalohippocampectomy. Postoperative outcome was evaluated according to different surgical procedures.
RESULTS
Overall, 1 yr after surgery 315 of 432 patients (72.9%) were classified Engel I; in particular, 72.8% were seizure-free after anterior temporal lobectomy, 76.9% after key-hole resection, 84.4% after extended lesionectomy, 70.3% after transylvian selective amygdalohippocampectomy, and 59.1% after subtemporal selective amygdalohippocampectomy. No significant differences in seizure outcome were found between different resective procedures, neither in short-term nor long-term follow-up. There was no perioperative mortality. Permanent morbidity was encountered in 4.4%. There were no significant differences in complications between different resection types. In the majority of patients, selective attention improved following surgery. Patients after left-sided operations performed significantly worse regarding verbal memory as compared to right-sided procedures. However, surgical approach had no significant effect on memory outcome.
CONCLUSION
Different surgical approaches for mesiotemporal epilepsy analyzed resulted in similar epileptological, neuropsychological results, and complication rates. Therefore, the approach for the individual patient does not only depend on the specific localization of the epileptogenic area, but also on the experience of the surgeon.
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Affiliation(s)
- Barbara Schmeiser
- Department of Neurosurgery, University Hospital Freiburg, Freiburg, Germany
| | - Kathrin Wagner
- Department of Epileptology, University Hospital Freiburg, Freiburg, Germany
| | | | - Irina Mader
- Department of Neuroradiology, University Hospital Freiburg, Freiburg, Germany
| | | | | | - Marco Prinz
- Institute of Neuropathology, University Hospital Freiburg, BIOSS Centre for Biological Signalling Studies, University of Freiburg, Freiburg, Germany
| | - Christian Scheiwe
- Department of Neurosurgery, University Hospital Freiburg, Freiburg, Germany
| | - Astrid Weyerbrock
- Department of Neurosurgery, University Hospital Freiburg, Freiburg, Germany
| | - Josef Zentner
- Department of Neurosurgery, University Hospital Freiburg, Freiburg, Germany
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12
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Temporal pole abnormalities detected by 3 T MRI in temporal lobe epilepsy due to hippocampal sclerosis: No influence on seizure outcome after surgery. Seizure 2017; 48:74-78. [DOI: 10.1016/j.seizure.2017.04.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Revised: 03/21/2017] [Accepted: 04/08/2017] [Indexed: 11/17/2022] Open
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13
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Bartolini L, Whitehead MT, Ho C, Sepeta LN, Oluigbo CO, Havens K, Freilich ER, Schreiber JM, Gaillard WD. Temporal lobe epilepsy and focal cortical dysplasia in children: A tip to find the abnormality. Epilepsia 2016; 58:113-122. [DOI: 10.1111/epi.13615] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2016] [Indexed: 12/16/2022]
Affiliation(s)
- Luca Bartolini
- Center for Neuroscience Children's National Health System George Washington University Washington District of Columbia U.S.A
| | - Matthew T. Whitehead
- Department of Diagnostic Imaging and Radiology Children's National Health System George Washington University Washington District of Columbia U.S.A
| | - Cheng‐Ying Ho
- Department of Pathology Children's National Health System George Washington University Washington District of Columbia U.S.A
- Department of Pathology University of Maryland Baltimore Maryland U.S.A
| | - Leigh N. Sepeta
- Center for Neuroscience Children's National Health System George Washington University Washington District of Columbia U.S.A
| | - Chima O. Oluigbo
- Center for Neuroscience Children's National Health System George Washington University Washington District of Columbia U.S.A
| | - Kathryn Havens
- Center for Neuroscience Children's National Health System George Washington University Washington District of Columbia U.S.A
| | - Emily R. Freilich
- Center for Neuroscience Children's National Health System George Washington University Washington District of Columbia U.S.A
| | - John M. Schreiber
- Center for Neuroscience Children's National Health System George Washington University Washington District of Columbia U.S.A
| | - William D. Gaillard
- Center for Neuroscience Children's National Health System George Washington University Washington District of Columbia U.S.A
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14
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Martinoni M, Berti PP, Marucci G, Rubboli G, Volpi L, Riguzzi P, Marliani F, Toni F, Bisulli F, Tinuper P, Michelucci R, Baruzzi A, Giulioni M. Pathology-Based Approach to Seizure Outcome After Surgery for Pharmacoresistant Medial Temporal Lobe Epilepsy. World Neurosurg 2016; 90:448-453. [PMID: 26968448 DOI: 10.1016/j.wneu.2016.02.072] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 02/14/2016] [Accepted: 02/15/2016] [Indexed: 01/04/2023]
Abstract
BACKGROUND Hippocampal sclerosis (HS) is the most common cause of drug-resistant medial temporal lobe epilepsy (MTLE). Structural abnormalities such as HS, granule cell pathology (GCP), and focal cortical dysplasia (FCD) have been classified histopathologically, possibly allowing a more accurate assessment of prognostic seizure and neuropsychologic outcomes. We correlated seizure outcome with comprehensive temporal lobe pathologic findings, identified according to the most recent classification systems of HS, GCP, and FCD. METHODS All the 83 patients who underwent anterior temporal lobectomy (ATL) for drug-resistant MTLE and with a proven diagnosis of HS between April 2001 and May 2014 were collected. Patients were divided in 2 main groups: 1) isolated HS with/without GCP (HS +/- GCP); and 2) HS associated with FCD with/without GCP (HS+FCD +/- GCP). Patients were followed up at least 1 year, and seizure outcome was reported in accordance with Engel classification. RESULTS Group I: HS +/- GCP: Statistical analysis confirmed a better outcome in HS + GCP patients than in HS-no GCP (P < 0.05). Moreover, a better outcome for the patients affected by GCP type I was observed (P < 0.05). Group II: HS+FCD +/- GCP: Patients with HS variant type I presented a better seizure outcome than the patients with HS type II (Engel class IA HS type I vs. type II: 69% vs. 40%). CONCLUSIONS A pathology-based approach to epilepsy surgery might improve the interpretation of the results, could predict which cases will enjoy a better seizure outcome, and could help to the comprehension of the causes of failures.
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Affiliation(s)
- Matteo Martinoni
- IRCCS Institute of Neurological Science of Bologna, Division of Neurosurgery, Bellaria Hospital, Bologna, Italy.
| | - Pier Paolo Berti
- IRCCS Institute of Neurological Science of Bologna, Division of Neurosurgery, Bellaria Hospital, Bologna, Italy
| | - Gianluca Marucci
- Section of Pathology, "M. Malpighi," Bellaria Hospital, Azienda USL-IRCCS Institute of Neurological Sciences, Bologna, Italy
| | - Guido Rubboli
- IRCCS Institute of Neurological Science of Bologna, Division of Neurology, Bellaria Hospital, Bologna, Italy; Danish Epilepsy Centre, Dianalund, Denmark
| | - Lilia Volpi
- IRCCS Institute of Neurological Science of Bologna, Division of Neurology, Bellaria Hospital, Bologna, Italy
| | - Patrizia Riguzzi
- IRCCS Institute of Neurological Science of Bologna, Division of Neurology, Bellaria Hospital, Bologna, Italy
| | - Federica Marliani
- IRCCS Institute of Neurological Science of Bologna, Division of Neuroradiology, Bellaria Hospital, Bologna, Italy
| | - Francesco Toni
- IRCCS Institute of Neurological Science of Bologna, Division of Neuroradiology, Bellaria Hospital, Bologna, Italy
| | - Francesca Bisulli
- IRCCS Institute of Neurological Science of Bologna, Division of Neurology, Bellaria Hospital, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Paolo Tinuper
- IRCCS Institute of Neurological Science of Bologna, Division of Neurology, Bellaria Hospital, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Roberto Michelucci
- IRCCS Institute of Neurological Science of Bologna, Division of Neurology, Bellaria Hospital, Bologna, Italy
| | - Agostino Baruzzi
- IRCCS Institute of Neurological Science of Bologna, Division of Neurology, Bellaria Hospital, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Marco Giulioni
- IRCCS Institute of Neurological Science of Bologna, Division of Neurosurgery, Bellaria Hospital, Bologna, Italy
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15
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Barba C, Rheims S, Minotti L, Guénot M, Hoffmann D, Chabardès S, Isnard J, Kahane P, Ryvlin P. Reply: Temporal plus epilepsy is a major determinant of temporal lobe surgery failures. Brain 2016; 139:e36. [PMID: 26966138 DOI: 10.1093/brain/aww047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Carmen Barba
- Paediatric Neurology Unit, Children's Hospital meyer-University of Florence, 50139, Florence, Italy
| | - Sylvain Rheims
- Department of Functional Neurology and Epileptology, Hospices Civils de Lyon, 69500, Lyon and Lyon 1 University, France Lyon's Research Neuroscience Centre, INSERM U1028/CNRS UMR5292, Lyon, France Institute of Epilepsies (IDEE), Lyon, France
| | - Lorella Minotti
- Epilepsy Unit, Neurology Department, 38043, Michallon Hospital, Grenoble, France
| | - Marc Guénot
- Department of Functional Neurosurgery, Hospices Civils de Lyon, 69003 Lyon, and Lyon 1 University, France
| | | | - Stephan Chabardès
- Neurosurgery Department, Michallon Hospital, 38043, Grenoble, France
| | - Jean Isnard
- Department of Functional Neurology and Epileptology, Hospices Civils de Lyon, 69500, Lyon and Lyon 1 University, France
| | - Philippe Kahane
- Epilepsy Unit, Neurology Department, 38043, Michallon Hospital, Grenoble, France GIN, Inserm U836, University Grenoble-Alpes, Grenoble, France
| | - Philippe Ryvlin
- Lyon's Research Neuroscience Centre, INSERM U1028/CNRS UMR5292, Lyon, France Institute of Epilepsies (IDEE), Lyon, France Department of Clinical Neurosciences, Centre Hospitalo-Universitaire Vaudois, 1011, Lausanne, Switzerland
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16
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Giulioni M, Martinoni M, Marucci G. Temporal plus epilepsy is a major determinant of temporal lobe surgery failures. Brain 2016; 139:e35. [PMID: 26966137 DOI: 10.1093/brain/aww040] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Affiliation(s)
- Marco Giulioni
- IRCCS Institute of Neurological Sciences of Bologna, Section of Neurosurgery, Bellaria Hospital, Bologna, Italy
| | - Matteo Martinoni
- IRCCS Institute of Neurological Sciences of Bologna, Section of Neurosurgery, Bellaria Hospital, Bologna, Italy
| | - Gianluca Marucci
- Section of Pathology "M. Malpighi", Bellaria Hospital, Azienda USL - IRCCS Institute of Neurological Sciences, Bologna, Italy
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17
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Di Gennaro G, D'Aniello A, De Risi M, Grillea G, Quarato PP, Mascia A, Grammaldo LG, Casciato S, Morace R, Esposito V, Picardi A. Temporal pole abnormalities in temporal lobe epilepsy with hippocampal sclerosis: Clinical significance and seizure outcome after surgery. Seizure 2015; 32:84-91. [PMID: 26552570 DOI: 10.1016/j.seizure.2015.09.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 09/16/2015] [Accepted: 09/20/2015] [Indexed: 10/23/2022] Open
Abstract
PURPOSE To assess the clinical significance of temporal pole abnormalities (temporopolar blurring, TB, and temporopolar atrophy, TA) in patients with temporal lobe epilepsy (TLE) and hippocampal sclerosis (HS) with a long post-surgical follow-up. METHODS We studied 60 consecutive patients with TLE-HS and 1.5 preoperative MRI scans who underwent surgery and were followed up for at least 5 years (mean follow-up 7.3 years). Based on findings of pre-surgical MRI, patients were classified according to the presence of TB or TA. Groups were compared on demographic, clinical, neuropsychological data, and seizure outcome. RESULTS TB was found in 37 (62%) patients, while TA was found in 35 (58%) patients, always ipsilateral to HS, with a high degree of overlap (83%) between TB and TA (p<0.001). Patients with TB did not differ from those without TB with regard to history of febrile convulsions, GTCSs, age of epilepsy onset, side of surgery, seizure frequency, seizure outcome, and neuropsychological outcome. On the other hand, they were significantly older, had a longer duration of epilepsy, and displayed lower preoperative scores on several neuropsychological tests. Similar findings were observed for TA. Multivariate analysis corroborated the association between temporopolar abnormalities and age at onset, age at surgery (for TB only), and lower preoperative scores on some neuropsychological tests. CONCLUSIONS Temporopolar abnormalities are frequent in patients with TLE-HS. Our data support the hypothesis that TB and TA are caused by seizure-related damages. These abnormalities did not influence seizure outcome, even after a long-term post-surgical follow-up.
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Affiliation(s)
| | | | | | | | | | | | | | - Sara Casciato
- Department of Neurology and Psychiatry, Sapienza University of Rome, Italy
| | | | - Vincenzo Esposito
- IRCCS "NEUROMED", Pozzilli, IS, Italy; Department of Neurosurgery, Sapienza University of Rome, Italy
| | - Angelo Picardi
- Mental Health Unit, Centre of Epidemiology, Surveillance and Health Promotion, Italian National Institute of Health, Rome, Italy
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