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Fadaie F, Caldairou B, Gill RS, Foit NA, Hall JA, Bernhardt BC, Bernasconi N, Bernasconi A. Region-specific MRI predictors of surgical outcome in temporal lobe epilepsy. Neuroimage Clin 2024; 43:103658. [PMID: 39178601 DOI: 10.1016/j.nicl.2024.103658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Revised: 08/18/2024] [Accepted: 08/19/2024] [Indexed: 08/26/2024]
Abstract
OBJECTIVE In drug-resistant temporal lobe epilepsy (TLE), it is not well-established in how far surgery should target morphological anomalies to achieve seizure freedom. Here, we assessed interactions between structural brain compromise and surgery to identify region-specific predictors of seizure outcome. METHODS We obtained pre- and post-operative 3D T1-weighted MRI in 55 TLE patients who underwent selective amygdalo-hippocampectomy (SAH) or anterior temporal lobectomy (ATL) and 40 age and sex-matched healthy subjects. We measured surface-based morphological alterations of the mesiotemporal lobe structures (hippocampus, amygdala, entorhinal and piriform cortices), the neocortex and the thalamus on both pre- and post-operative MRI. Using precise co-registration, in each patient we mapped the surgical cavity onto the MRI acquired before surgery, thereby quantifying the amount of pathological tissue resected; these features, together with the preoperative morphometric data, served as input to a supervised classification algorithm for postsurgical outcome prediction. RESULTS On pre-operative MRI, patients who became seizure-free (TLE-SF) presented with severe ipsilateral amygdalar and hippocampal atrophy, while not seizure-free patients (TLE-NSF) displayed amygdalar hypertrophy. Stratifying patients based on the surgical approach, post-operative MRI showed similar patterns of mesiotemporal and thalamic changes, but divergent neocortical thinning affecting the parieto-temporo-occipital regions following ATL and the frontal lobes after SAH. Irrespective of the surgical approach, hippocampal atrophy on pre-operative MRI and its extent of resection were the most predictive features of seizure-freedom in 89% of patients (selected 100% across validations). SIGNIFICANCE Our study indicates a critical role of the extent of resection of MRI-derived hippocampal morphological anomalies on seizure outcome. Precise pre-operative quantification of the mesiotemporal lobe provides non-invasive prognostics for individualized surgery.
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Affiliation(s)
- Fatemeh Fadaie
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Benoit Caldairou
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Ravnoor S Gill
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Niels A Foit
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada; Freiburg Medical Center, Department of Neurosurgery, University of Freiburg, Freiburg, Germany
| | - Jeffery A Hall
- Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Boris C Bernhardt
- Multimodal Imaging and Connectome Analysis Lab, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Neda Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Andrea Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada.
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Kang K, Sathe A, Mandloi S, Muller J, Ozuna GAG, Franco D, Miller C, Sharan A, Mohamed FB, Faro S, Alizadeh M, Wu C. Evaluation of eight registration algorithms applied to the insula and insular gyri. J Neuroimaging 2023; 33:446-454. [PMID: 36813464 DOI: 10.1111/jon.13091] [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: 10/20/2022] [Revised: 02/01/2023] [Accepted: 02/07/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND AND PURPOSE Spatial registration is crucial in establishing correspondence between anatomic brain regions for research and clinical purposes. The insular cortex (IC) and gyri (IG) are implicated in various functions and pathologies including epilepsy. Optimizing registration of the insula to a common atlas can improve the accuracy of group-level analyses. Here, we compared six nonlinear, one linear, and one semiautomated registration algorithms (RAs) for registering the IC and IG to the Montreal Neurologic Institute standard space (MNI152). METHODS 3T images acquired from 20 controls and 20 temporal lobe epilepsy patients with mesial temporal sclerosis underwent automated segmentation of the insula. This was followed by manual segmentation of the entire IC and six individual IGs. Consensus segmentations were created at 75% agreement for IC and IG before undergoing registration to MNI152 space with eight RAs. Dice similarity coefficients (DSCs) were calculated between segmentations after registration and the IC and IG in MNI152 space. Statistical analysis involved the Kruskal-Wallace test with Dunn's test for IC and two-way analysis of variance with Tukey's honest significant difference test for IG. RESULTS DSCs were significantly different between RAs. Based on multiple pairwise comparisons, we report that certain RAs performed better than others across population groups. Additionally, registration performance differed according to specific IG. CONCLUSION We compared different methods for registering the IC and IG to MNI152 space. We found differences in performance between RAs, which suggests that algorithm choice is important factor in analyses involving the insula.
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Affiliation(s)
- KiChang Kang
- Department of Neurological Surgery, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Anish Sathe
- Department of Neurological Surgery, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Shreya Mandloi
- Department of Neurological Surgery, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Jennifer Muller
- Department of Neurological Surgery, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Glenn Arturo Gonzalez Ozuna
- Department of Neurological Surgery, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Daniel Franco
- Department of Neurological Surgery, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Christopher Miller
- Department of Neurological Surgery, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Ashwini Sharan
- Department of Neurological Surgery, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Feroze B Mohamed
- Department of Neurological Surgery, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Scott Faro
- Department of Neurological Surgery, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Mahdi Alizadeh
- Department of Neurological Surgery, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.,Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Chengyuan Wu
- Department of Neurological Surgery, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.,Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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Cho KH, Lee HJ, Lee DA, Park KM. Mammillary Body Atrophy in Temporal Lobe Epilepsy With Hippocampal Sclerosis. J Clin Neurol 2022; 18:635-641. [DOI: 10.3988/jcn.2022.18.6.635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/30/2022] [Accepted: 04/04/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- Kyoo Ho Cho
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Korea
| | - Ho-Joon Lee
- Department of Radiology, Haeundae Paik Hospital, Inje Unversity College of Medicine, Busan, Korea
| | - Dong Ah Lee
- Department of Neurology, Haeundae Paik Hospital, Inje Unversity College of Medicine, Busan, Korea
| | - Kang Min Park
- Department of Neurology, Haeundae Paik Hospital, Inje Unversity College of Medicine, Busan, Korea
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Peixoto-Santos JE, Blumcke I. Neuropathology of the 21st century for the Latin American epilepsy community. Seizure 2021; 90:51-59. [DOI: 10.1016/j.seizure.2021.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 01/18/2021] [Accepted: 02/01/2021] [Indexed: 12/13/2022] Open
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Akinsoji EO, Leibovitch E, Billioux BJ, Abath Neto OL, Ray-Chaudhury A, Inati SK, Zaghloul K, Heiss J, Jacobson S, Theodore WH. HHV-6 and hippocampal volume in patients with mesial temporal sclerosis. Ann Clin Transl Neurol 2020; 7:1674-1680. [PMID: 33325656 PMCID: PMC7480901 DOI: 10.1002/acn3.51152] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 07/16/2020] [Indexed: 12/11/2022] Open
Abstract
Objective To study the effects of human herpes virus 6 (HHV‐6) on the hippocampal volume in patients with mesial temporal sclerosis (MTS). Background HHV‐6 may play an etiologic role in MTS. Previous studies found a possible association with febrile status epilepticus. Several investigators have reported a higher prevalence of HHV‐6 in MTS resections compared to other epilepsy etiologies. Design/Methods We used FreeSurfer to segment cortical structures and obtain whole hippocampal and subfield volumes in 41 patients with intractable epilepsy. In addition, an investigator blinded to other data traced hippocampi manually on each slice. The main study outcome measure was the asymmetry index (AI) between hippocampal volumes ipsilateral and contralateral to seizure foci compared between HHV‐6 positive and negative patients. Viral DNA was isolated from fresh brain tissue obtained at temporal lobectomy. For 25 patients, viral detection was performed using quantitative real‐time PCR specific for HHV‐6A and HHV‐6B. For 16 patients, viral DNA detection was performed using digital droplet PCR specific for HHV‐6A and HHV‐6B. Results Twenty‐two patients were positive (14 of 25 tested with real‐time PCR, and 8 of 16 with digital droplet PCR), and 19 negatives for HHV‐6. HHV‐6 negative patients had significantly greater AI and lower total hippocampal volume ipsilateral to seizure foci than HHV‐6 positive patients. Epilepsy duration and age of onset did not affect results. Interpretation Our data suggest multiple potential etiologies for MTS. HHV‐6 may have a less severe effect on the hippocampus than other etiologies.
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Affiliation(s)
- Elizabeth O Akinsoji
- Clinical Epilepsy Section, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, Maryland
| | - Emily Leibovitch
- Neuroimmunology Branch, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, Maryland
| | - B Jeanne Billioux
- Neuroimmunology Branch, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, Maryland
| | - Osorio Lopes Abath Neto
- National Institute of Neurological Disorders and Stroke, National Cancer Institute, NIH, Bethesda, Maryland
| | - Abhik Ray-Chaudhury
- Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, Maryland
| | - Sara K Inati
- EEG Laboratory, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, Maryland
| | - Kareem Zaghloul
- Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, Maryland
| | - John Heiss
- Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, Maryland
| | - Steven Jacobson
- Neuroimmunology Branch, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, Maryland
| | - William H Theodore
- Clinical Epilepsy Section, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, Maryland
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Carboni M, De Stefano P, Vorderwülbecke BJ, Tourbier S, Mullier E, Rubega M, Momjian S, Schaller K, Hagmann P, Seeck M, Michel CM, van Mierlo P, Vulliemoz S. Abnormal directed connectivity of resting state networks in focal epilepsy. NEUROIMAGE-CLINICAL 2020; 27:102336. [PMID: 32679553 PMCID: PMC7363703 DOI: 10.1016/j.nicl.2020.102336] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 06/30/2020] [Accepted: 07/01/2020] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Epilepsy diagnosis can be difficult in the absence of interictal epileptic discharges (IED) on scalp EEG. We used high-density EEG to measure connectivity in large-scale functional networks of patients with focal epilepsy (Temporal and Extratemporal Lobe Epilepsy, TLE and ETLE) and tested for network alterations during resting wakefulness without IEDs, compared to healthy controls. We measured global efficiency as a marker of integration within networks. METHODS We analysed 49 adult patients with focal epilepsy and 16 healthy subjects who underwent high-density-EEG and structural MRI. We estimated cortical activity using electric source analysis in 82 atlas-based cortical regions based on the individual MRI. We applied directed connectivity analysis (Partial Directed Coherence) on these sources and performed graph analysis: we computed the Global Efficiency on the whole brain and on each resting state network. We tested these features in different group of patients. RESULTS Compared to controls, efficiency was increased in both TLE and ETLE (p < 0.05). The somato-motor-network, the ventral-attention-network and the default-mode-network had a significantly increased efficiency (p < 0.05) in both TLE and ETLE as well as TLE with hippocampal sclerosis. SIGNIFICANCE During interictal scalp EEG epochs without IED, patients with focal epilepsy show brain functional connectivity alterations in the whole brain and in specific resting-state-networks. This higher integration reflects a chronic effect of pathological activity within these structures and complement previous work on altered information outflow. These findings could increase the diagnostic sensitivity of scalp EEG to identify epileptic activity in the absence of IED.
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Affiliation(s)
- Margherita Carboni
- EEG and Epilepsy Unit, Clinical Neuroscience Department, University Hospital and Faculty of Medicine of Geneva, Geneva, Switzerland; Functional Brain Mapping Lab, Department of Fundamental Neurosciences, University of Geneva, Geneva, Switzerland.
| | - Pia De Stefano
- EEG and Epilepsy Unit, Clinical Neuroscience Department, University Hospital and Faculty of Medicine of Geneva, Geneva, Switzerland
| | - Bernd J Vorderwülbecke
- EEG and Epilepsy Unit, Clinical Neuroscience Department, University Hospital and Faculty of Medicine of Geneva, Geneva, Switzerland; Epilepsy-Center Berlin-Brandenburg, Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Sebastien Tourbier
- Connectomics Lab, Department of Radiology, University Hospital of Lausanne, Lausanne, Switzerland
| | - Emeline Mullier
- Connectomics Lab, Department of Radiology, University Hospital of Lausanne, Lausanne, Switzerland
| | - Maria Rubega
- Functional Brain Mapping Lab, Department of Fundamental Neurosciences, University of Geneva, Geneva, Switzerland; Department of Neurosciences, University of Padova, Padova, Italy
| | - Shahan Momjian
- Department of Neurosurgery, University Hospital and Faculty of Medicine of Geneva, Geneva, Switzerland
| | - Karl Schaller
- Department of Neurosurgery, University Hospital and Faculty of Medicine of Geneva, Geneva, Switzerland
| | - Patric Hagmann
- Connectomics Lab, Department of Radiology, University Hospital of Lausanne, Lausanne, Switzerland
| | - Margitta Seeck
- EEG and Epilepsy Unit, Clinical Neuroscience Department, University Hospital and Faculty of Medicine of Geneva, Geneva, Switzerland
| | - Christoph M Michel
- Functional Brain Mapping Lab, Department of Fundamental Neurosciences, University of Geneva, Geneva, Switzerland
| | - Pieter van Mierlo
- Medical Image and Signal Processing Group, Department of Electronics and Information Systems, Ghent University, Ghent, Belgium
| | - Serge Vulliemoz
- EEG and Epilepsy Unit, Clinical Neuroscience Department, University Hospital and Faculty of Medicine of Geneva, Geneva, Switzerland
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Ono SE, de Carvalho Neto A, Joaquim MJM, Dos Santos GR, de Paola L, Silvado CES. Mesial temporal lobe epilepsy: Revisiting the relation of hippocampal volumetry with memory deficits. Epilepsy Behav 2019; 100:106516. [PMID: 31574430 DOI: 10.1016/j.yebeh.2019.106516] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 08/12/2019] [Accepted: 08/23/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Neuropsychological tests can infer the lateralization of the epileptogenic focus, associating verbal memory to mesial structures in the left temporal lobe and visual or nonverbal memory to the right side. High-field magnetic resonance imaging (MRI) with high-resolution protocols allows acquisitions suitable for advanced postprocessing with precise volumetry of brain structures, and functional MRI demonstrates evidence that epilepsy should be seen as a network pathology, involving several structures in the brain. Since the literature showing associations between the volumetry of brain structures in left and right mesial temporal lobe epilepsy (MTLE) and verbal and visual memory performance on neuropsychological tests is conflicting, we revisited these relationships, considering the hippocampal volumetry of patients with unilateral MTLE. METHODS Automatized hippocampal volumes were obtained using FreeSurfer software from MRI exams of 35 patients with unilateral MTLE and hippocampal atrophy and homolateral ictal onset zone defined by video electroencephalography concordant to the side of hippocampal volume reduction (15 on the left side). Verbal memory was assessed using the Rey Auditory-Verbal Learning Test (RAVLT), and visual memory tests employed the Rey-Osterrieth Complex Figure Test (ROCFT). The statistical analysis explored relationships between hippocampal volumetry, lateralization, and performance on memory tests. RESULTS In general, we observed deficits in both verbal and visual memory for patients with left and right hippocampal volume reduction. Patients with left hippocampal volume reduction had poorer performance on verbal memory tests compared with those with right hippocampal atrophy (t = -3.813, p < 0.001). Visual memory deficits were seen on both left and right MTLE without a statistically significant difference (t = 0.074, p = 0.942). The correlation between the Hippocampal Asymmetry Index (HAI) and visual and verbal Z-scores was significant only for visual Z-score in right MTLE (R = -0.45, p = 0.048). CONCLUSIONS Verbal memory deficit seems to be more consistent in patients with left hippocampal volume reduction. Although it had only a moderate correlation to HAI, visual memory deficit is suggested as a poorer indicator for right MTLE. Considering that verbal and visual memory deficits are seen on both right and left MTLE, MTLE should not be regarded as a unilateral, focal, or local insult but as a multifactorial and network pathology, possibly involving several brain structures.
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Affiliation(s)
- Sergio Eiji Ono
- Clínica Diagnóstico Avançado por Imagem - DAPI, Curitiba, PR, Brazil.
| | - Arnolfo de Carvalho Neto
- Clínica Diagnóstico Avançado por Imagem - DAPI, Curitiba, PR, Brazil; Epilepsy and EEG Service, Hospital de Clínicas, Federal University of Paraná, Curitiba, PR, Brazil
| | | | | | - Luciano de Paola
- Epilepsy and EEG Service, Hospital de Clínicas, Federal University of Paraná, Curitiba, PR, Brazil
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Gaça LB, Garcia MTFC, Sandim GB, Assumption Leme IB, Noffs MHS, Carrete H, Centeno RS, Sato JR, Yacubian EMT. Morphometric MRI features and surgical outcome in patients with epilepsy related to hippocampal sclerosis and low intellectual quotient. Epilepsy Behav 2018; 82:144-149. [PMID: 29625365 DOI: 10.1016/j.yebeh.2018.03.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Revised: 03/02/2018] [Accepted: 03/04/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVE The objectives of this study were to verify in a series of patients with mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) if those with low intellectual quotient (IQ) levels have more extended areas of atrophy compared with those with higher IQ levels and to analyze whether IQ could be a variable implicated on a surgical outcome. MATERIAL AND METHODS Patients (n=106) with refractory MTLE-HS submitted to corticoamygdalohippocampectomy (CAH) (57 left mesial temporal lobe epilepsy (MTLE); 45 males) were enrolled. To determine if the IQ was a predictor of seizure outcome, totally seizure-free (SF) versus nonseizure-free (NSF) patients were evaluated. FreeSurfer was used for cortical thickness and volume estimation, comparing groups with lower (<80) and higher IQ (90-109) levels. RESULTS In the whole series, 42.45% of patients were SF (Engel Class 1a; n=45), and 57.54% were NSF (n=61). Total cortical volume was significantly reduced in the group with lower IQ (p=0.01). Significant reductions in the left hemisphere included the following: rostral middle frontal (p=0.001), insula (p=0.002), superior temporal gyrus (p=0.003), thalamus (p=0.004), and precentral gyrus (p=0.02); and those in the right hemisphere included the following: rostral middle frontal (p=0.003), pars orbitalis (p=0.01), and insula (p=0.02). Cortical thickness analysis also showed reductions in the right superior parietal gyrus in patients with lower IQ. No significant relationship between IQ and seizure outcome was found. CONCLUSIONS This is the first study of a series of patients with pure MTLE-HS, including those with low IQ and their morphometric magnetic resonance imaging (MRI) features using FreeSurfer. Although patients with lower intellectual scores presented more areas of brain atrophy, IQ was not a predictor of surgical outcome. Therefore, when evaluating seizure follow-up, low IQ in patients with MTLE-HS might not contraindicate resective surgery.
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Affiliation(s)
- Larissa Botelho Gaça
- Unidade de Pesquisa e Tratamento das Epilepsias, Department of Neurology and Neurosurgery of Universidade Federal de São Paulo (UNIFESP), Rua Pedro de Toledo, 650, Vila Clementino, 04039-002 São Paulo, SP, Brazil
| | - Maria Teresa Fernandes Castilho Garcia
- Unidade de Pesquisa e Tratamento das Epilepsias, Department of Neurology and Neurosurgery of Universidade Federal de São Paulo (UNIFESP), Rua Pedro de Toledo, 650, Vila Clementino, 04039-002 São Paulo, SP, Brazil
| | - Gabriel Barbosa Sandim
- Department of Diagnostic Imaging of Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 800, Vila Clementino, 04024-002 São Paulo, SP, Brazil
| | - Idaiane Batista Assumption Leme
- Department of Psychiatry of Universidade Federal de São Paulo (UNIFESP), Rua Borges Lagoa, 570, Vila Clementino, 04038-0001 São Paulo, SP, Brazil
| | - Maria Helena Silva Noffs
- Unidade de Pesquisa e Tratamento das Epilepsias, Department of Neurology and Neurosurgery of Universidade Federal de São Paulo (UNIFESP), Rua Pedro de Toledo, 650, Vila Clementino, 04039-002 São Paulo, SP, Brazil
| | - Henrique Carrete
- Department of Diagnostic Imaging of Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 800, Vila Clementino, 04024-002 São Paulo, SP, Brazil
| | - Ricardo Silva Centeno
- Unidade de Pesquisa e Tratamento das Epilepsias, Department of Neurology and Neurosurgery of Universidade Federal de São Paulo (UNIFESP), Rua Pedro de Toledo, 650, Vila Clementino, 04039-002 São Paulo, SP, Brazil
| | - João Ricardo Sato
- Center of Mathematics, Computing and Cognition, Universidade Federal do ABC, Avenida dos Estados, 5001, 09210-580 São Paulo, SP, Brazil
| | - Elza Márcia Targas Yacubian
- Unidade de Pesquisa e Tratamento das Epilepsias, Department of Neurology and Neurosurgery of Universidade Federal de São Paulo (UNIFESP), Rua Pedro de Toledo, 650, Vila Clementino, 04039-002 São Paulo, SP, Brazil.
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Colnaghi S, Beltrami G, Poloni G, Pichiecchio A, Bastianello S, Galimberti CA, Versino M. Parahippocampal Involvement in Mesial Temporal Lobe Epilepsy with Hippocampal Sclerosis: A Proof of Concept from Memory-Guided Saccades. Front Neurol 2017; 8:595. [PMID: 29163352 PMCID: PMC5681931 DOI: 10.3389/fneur.2017.00595] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 10/23/2017] [Indexed: 02/04/2023] Open
Abstract
Objective Mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) may involve extrahippocampal areas of structural damage and dysfunction. The accuracy of medium-term spatial memory can be tested by memory-guided saccades (MGS) to evaluate a functional impairment of the parahippocampal cortex (PHC), while voxel-based morphometry (VBM) analysis can be used to detect a structural damage of the latter region. Methods MGS with 3- and 30-s memorization delays were compared between 7 patients affected by right MTLE-HS (r-MTLE-HS), 6 patients affected by left MTLE-HS, and 13 healthy controls. The same subjects underwent brain MRI for a VBM analysis. Correlation analysis was performed between the results of VBM and MGS and with patients’ clinical data. Results Right MTLE-HS patients showed impaired accuracy of leftward MGS with a 30-s memorization delay; their gray-matter volume was reduced in the right hippocampus and inferior temporal gyrus, and bilaterally in the cerebellum. Left MTLE-HS patients had normal MGS accuracy; their gray-matter volume was reduced in the left hippocampus, in the right-inferior temporal gyrus and corpus callosus, and bilaterally in the insular cortex and in the cerebellum. The difference between right and left parahippocampal volumes correlated with MGS accuracy, while right and left hippocampal volumes did not. Hippocampal and parahippocampal volume did not correlate with clinical variables such as febrile seizures, age at disease onset, disease duration, and seizure frequency. Conclusion MGS abnormalities suggested the functional involvement of the right PHC in patients with r-MTLE-HS, supporting a right lateralization of spatial memory control and showing a relation between functional impairment and degree of atrophy.
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Affiliation(s)
- Silvia Colnaghi
- Laboratory of Neuro-otology and Neuro-ophtalmology, Fondazione Istituto Neurologico Nazionale Casimiro Mondino (IRCCS), Pavia, Italy.,Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Giorgio Beltrami
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Guy Poloni
- Neuroradiology Department, Fondazione Istituto Neurologico Nazionale Casimiro Mondino (IRCCS), Pavia, Italy
| | - Anna Pichiecchio
- Neuroradiology Department, Fondazione Istituto Neurologico Nazionale Casimiro Mondino (IRCCS), Pavia, Italy
| | - Stefano Bastianello
- Neuroradiology Department, Fondazione Istituto Neurologico Nazionale Casimiro Mondino (IRCCS), Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Carlo Andrea Galimberti
- Epilepsy Centre, Fondazione Istituto Neurologico Nazionale Casimiro Mondino (IRCCS), Pavia, Italy
| | - Maurizio Versino
- Laboratory of Neuro-otology and Neuro-ophtalmology, Fondazione Istituto Neurologico Nazionale Casimiro Mondino (IRCCS), Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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