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Kim JR, Jo H, Park B, Park YH, Chung YH, Shon YM, Seo DW, Hong SB, Hong SC, Seo SW, Joo EY. Identifying important factors for successful surgery in patients with lateral temporal lobe epilepsy. PLoS One 2023; 18:e0288054. [PMID: 37384651 PMCID: PMC10310033 DOI: 10.1371/journal.pone.0288054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 06/18/2023] [Indexed: 07/01/2023] Open
Abstract
OBJECTIVE Lateral temporal lobe epilepsy (LTLE) has been diagnosed in only a small number of patients; therefore, its surgical outcome is not as well-known as that of mesial temporal lobe epilepsy. We aimed to evaluate the long-term (5 years) and short-term (2 years) surgical outcomes and identify possible prognostic factors in patients with LTLE. METHODS This retrospective cohort study was conducted between January 1995 and December 2018 among patients who underwent resective surgery in a university-affiliated hospital. Patients were classified as LTLE if ictal onset zone was in lateral temporal area. Surgical outcomes were evaluated at 2 and 5 years. We subdivided based on outcomes and compared clinical and neuroimaging data including cortical thickness between two groups. RESULTS Sixty-four patients were included in the study. The mean follow-up duration after the surgery was 8.4 years. Five years after surgery, 45 of the 63 (71.4%) patients achieved seizure freedom. Clinically and statistically significant prognostic factors for postsurgical outcomes were the duration of epilepsy before surgery and focal cortical dysplasia on postoperative histopathology at the 5-year follow-up. Optimal cut-off point for epilepsy duration was eight years after the seizure onset (odds ratio 4.375, p-value = 0.0214). Furthermore, we propose a model for predicting seizure outcomes 5 years after surgery using the receiver operating characteristic curve and nomogram (area under the curve = 0.733; 95% confidence interval, 0.588-0.879). Cortical thinning was observed in ipsilateral cingulate gyrus and contralateral parietal lobe in poor surgical group compared to good surgical group (p-value < 0.01, uncorrected). CONCLUSIONS The identified predictors of unfavorable surgical outcomes may help in selecting optimal candidates and identifying the optimal timing for surgery among patients with LTLE. Additionally, cortical thinning was more extensive in the poor surgical group.
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Affiliation(s)
- Jae Rim Kim
- Department of Neurology, Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hyunjin Jo
- Department of Neurology, Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Boram Park
- Biomedical Statistics Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, South Korea
| | - Yu Hyun Park
- Department of Neurology, Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, South Korea
- Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, South Korea
| | - Yeon Hak Chung
- Department of Neurology, Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Young-Min Shon
- Department of Neurology, Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, South Korea
| | - Dae-Won Seo
- Department of Neurology, Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Seung Bong Hong
- Department of Neurology, Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Seung-Chyul Hong
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sang Won Seo
- Department of Neurology, Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
- Biomedical Statistics Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, South Korea
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, South Korea
- Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, South Korea
| | - Eun Yeon Joo
- Department of Neurology, Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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Liu Y, Bao S, Englot DJ, Morgan VL, Taylor WD, Wei Y, Oguz I, Landman BA, Lyu I. Hierarchical particle optimization for cortical shape correspondence in temporal lobe resection. Comput Biol Med 2023; 152:106414. [PMID: 36525831 PMCID: PMC9832438 DOI: 10.1016/j.compbiomed.2022.106414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 11/18/2022] [Accepted: 12/03/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Anterior temporal lobe resection is an effective treatment for temporal lobe epilepsy. The post-surgical structural changes could influence the follow-up treatment. Capturing post-surgical changes necessitates a well-established cortical shape correspondence between pre- and post-surgical surfaces. Yet, most cortical surface registration methods are designed for normal neuroanatomy. Surgical changes can introduce wide ranging artifacts in correspondence, for which conventional surface registration methods may not work as intended. METHODS In this paper, we propose a novel particle method for one-to-one dense shape correspondence between pre- and post-surgical surfaces with temporal lobe resection. The proposed method can handle partial structural abnormality involving non-rigid changes. Unlike existing particle methods using implicit particle adjacency, we consider explicit particle adjacency to establish a smooth correspondence. Moreover, we propose hierarchical optimization of particles rather than full optimization of all particles at once to avoid trappings of locally optimal particle update. RESULTS We evaluate the proposed method on 25 pairs of T1-MRI with pre- and post-simulated resection on the anterior temporal lobe and 25 pairs of patients with actual resection. We show improved accuracy over several cortical regions in terms of ROI boundary Hausdorff distance with 4.29 mm and Dice similarity coefficients with average value 0.841, compared to existing surface registration methods on simulated data. In 25 patients with actual resection of the anterior temporal lobe, our method shows an improved shape correspondence in qualitative and quantitative evaluation on parcellation-off ratio with average value 0.061 and cortical thickness changes. We also show better smoothness of the correspondence without self-intersection, compared with point-wise matching methods which show various degrees of self-intersection. CONCLUSION The proposed method establishes a promising one-to-one dense shape correspondence for temporal lobe resection. The resulting correspondence is smooth without self-intersection. The proposed hierarchical optimization strategy could accelerate optimization and improve the optimization accuracy. According to the results on the paired surfaces with temporal lobe resection, the proposed method outperforms the compared methods and is more reliable to capture cortical thickness changes.
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Affiliation(s)
- Yue Liu
- College of Information Science and Engineering, Northeastern University, Shenyang, China; Department of Electrical Engineering and Computer Science, Vanderbilt University, TN, USA
| | - Shunxing Bao
- Department of Electrical Engineering and Computer Science, Vanderbilt University, TN, USA
| | - Dario J Englot
- Department of Neurological Surgery, Vanderbilt University Medical Center, TN, USA
| | - Victoria L Morgan
- Department of Radiology & Radiological Science, Vanderbilt University Medical Center, TN, USA
| | - Warren D Taylor
- Department of Psychiatry & Behavioral Science, Vanderbilt University Medical Center, TN, USA
| | - Ying Wei
- College of Information Science and Engineering, Northeastern University, Shenyang, China; Information Technology R&D Innovation Center of Peking University, Shaoxing, China; Changsha Hisense Intelligent System Research Institute Co., Ltd, China
| | - Ipek Oguz
- Department of Electrical Engineering and Computer Science, Vanderbilt University, TN, USA
| | - Bennett A Landman
- Department of Electrical Engineering and Computer Science, Vanderbilt University, TN, USA
| | - Ilwoo Lyu
- Department of Computer Science and Engineering, UNIST, Ulsan, South Korea.
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Sarbisheh I, Tapak L, Fallahi A, Fardmal J, Sadeghifar M, Nazemzadeh M, Mehvari Habibabadi J. Cortical thickness analysis in temporal lobe epilepsy using fully Bayesian spectral method in magnetic resonance imaging. BMC Med Imaging 2022; 22:222. [PMID: 36544100 PMCID: PMC9768883 DOI: 10.1186/s12880-022-00949-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Temporal lobe epilepsy (TLE) is the most common type of epilepsy associated with changes in the cerebral cortex throughout the brain. Magnetic resonance imaging (MRI) is widely used for detecting such anomalies; nevertheless, it produces spatially correlated data that cannot be considered by the usual statistical models. This study aimed to compare cortical thicknesses between patients with TLE and healthy controls by considering the spatial dependencies across different regions of the cerebral cortex in MRI. METHODS In this study, T1-weighted MRI was performed on 20 healthy controls and 33 TLE patients. Nineteen patients had a left TLE and 14 had a right TLE. Cortical thickness was measured for all individuals in 68 regions of the cerebral cortex based on images. Fully Bayesian spectral method was utilized to compare the cortical thickness of different brain regions between groups. Neural networks model was used to classify the patients using the identified regions. RESULTS For the left TLE patients, cortical thinning was observed in bilateral caudal anterior cingulate, lateral orbitofrontal (ipsilateral), the bilateral rostral anterior cingulate, frontal pole and temporal pole (ipsilateral), caudal middle frontal and rostral middle frontal (contralateral side). For the right TLE patients, cortical thinning was only observed in the entorhinal area (ipsilateral). The AUCs of the neural networks for classification of left and right TLE patients versus healthy controls were 0.939 and 1.000, respectively. CONCLUSION Alteration of cortical gray matter thickness was evidenced as common effect of epileptogenicity, as manifested by the patients in this study using the fully Bayesian spectral method by taking into account the complex structure of the data.
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Affiliation(s)
- Iman Sarbisheh
- grid.411950.80000 0004 0611 9280Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Leili Tapak
- grid.411950.80000 0004 0611 9280Department of Biostatistics, School of Public Health and Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Alireza Fallahi
- grid.411705.60000 0001 0166 0922Research Center for Molecular and Cellular Imaging, Advanced Medical Technologies and Instruments Institute (AMTII), Tehran University of Medical Sciences, Tehran, Iran ,grid.459564.f0000 0004 0482 9174Biomedical Engineering Department, Hamedan University of Technology, Hamedan, Iran
| | - Javad Fardmal
- grid.411950.80000 0004 0611 9280Department of Biostatistics, School of Public Health and Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Majid Sadeghifar
- grid.411807.b0000 0000 9828 9578Department of Statistics, Faculty of Science, Bu-Ali Sina University, Hamadan, Iran
| | - MohammadReza Nazemzadeh
- grid.411705.60000 0001 0166 0922Research Center for Molecular and Cellular Imaging, Advanced Medical Technologies and Instruments Institute (AMTII), Tehran University of Medical Sciences, Tehran, Iran ,grid.411705.60000 0001 0166 0922Physics and Biomedical Engineering Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Jafar Mehvari Habibabadi
- grid.411036.10000 0001 1498 685XDepartment of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Chacón LMM, García LG, García-Ramón KB, Báez Martin MM, Bayard JB, Alfonso MA, Batista SB, Bermudez TDLP, González JG, Coroneaux AS, Ruiz ÁÁ, Roque MP, Matamoro LM. Common ictal and interictal perfusion patterns. A window into the epileptogenic network and SUDEP mechanism in Drug Resistant Focal Epilepsy? Curr Pharm Des 2022; 28:1198-1209. [PMID: 35658889 DOI: 10.2174/1381612828666220603125328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 03/17/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Focal epilepsies have been described as network disease. Noninvasive investigative techniques have been used to characterize epileptogenic networks. OBJETIVE To describe ictal and interictal cortical and subcortical perfusion patterns using single photon emission computed tomography (SPECT), in patients with drug-resistant epilepsy (DRE). METHODS Thirty-five interictal- ictal SPECT scans were obtained from 15 patients with DRE. A methodology was developed to get a relative perfusion index (PI) of 74 cortical and sub-cortical brain structures. K-means algorithm together with a modified v-fold cross-validation were used to identify the two regions of interest (ROI's) that represent hypoperfused and hyperperfused areas. RESULTS In common with the individual analysis, the statistical analysis evidenced that the hyperperfusion ROIs resulting from group analysis during interictal, and ictal involved mainly the cingulate gyrus, cuneus, the lingual gyrus, gyrus rectus as well as the putamen. ROIs hypoperfused included the red nucleus, the substantia nigra, and the medulla. The medians of the group analysis of the hypoperfusion and hyperperfusion ROIs were 0.601-0.565 and 1,133 - 1,119 for the ictal and interictal states, correspondingly. A group of mostly cortical structures involved in the hyperperfused ROIs in both interictal and ictal states showed no change or negative change in the transition from interictal to ictal state (mean change of -0.002). On the other hand, the brain stem, basal ganglia, red nucleus, and thalamus revealed a mean global change of 0.19, indicating a mild increase in the PI. However, some of these structures (red nucleus, substantia nigra, and medulla oblongata) remained hypoperfused during the interictal to ictal transition. CONCLUSION The methodology employed made it possible to identify common cortical and subcortical perfusion patterns not directly linked to epileptogenicity, but open a window for the epileptogenic network and sudden unexpected death (SUDEP) mechanism in DRE .
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Affiliation(s)
| | - Lidice Galan García
- Clinical Neurophysiology International Center of Neurologic Restoration Cuba
| | | | | | - Jorge Bosch Bayard
- Clinical Neurophysiology International Center of Neurologic Restoration Cuba
| | | | | | | | | | | | - Ángel Águila Ruiz
- Clinical Neurophysiology International Center of Neurologic Restoration Cuba
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Pulli EP, Silver E, Kumpulainen V, Copeland A, Merisaari H, Saunavaara J, Parkkola R, Lähdesmäki T, Saukko E, Nolvi S, Kataja EL, Korja R, Karlsson L, Karlsson H, Tuulari JJ. Feasibility of FreeSurfer Processing for T1-Weighted Brain Images of 5-Year-Olds: Semiautomated Protocol of FinnBrain Neuroimaging Lab. Front Neurosci 2022; 16:874062. [PMID: 35585923 PMCID: PMC9108497 DOI: 10.3389/fnins.2022.874062] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 04/12/2022] [Indexed: 02/03/2023] Open
Abstract
Pediatric neuroimaging is a quickly developing field that still faces important methodological challenges. Pediatric images usually have more motion artifact than adult images. The artifact can cause visible errors in brain segmentation, and one way to address it is to manually edit the segmented images. Variability in editing and quality control protocols may complicate comparisons between studies. In this article, we describe in detail the semiautomated segmentation and quality control protocol of structural brain images that was used in FinnBrain Birth Cohort Study and relies on the well-established FreeSurfer v6.0 and ENIGMA (Enhancing Neuro Imaging Genetics through Meta Analysis) consortium tools. The participants were typically developing 5-year-olds [n = 134, 5.34 (SD 0.06) years, 62 girls]. Following a dichotomous quality rating scale for inclusion and exclusion of images, we explored the quality on a region of interest level to exclude all regions with major segmentation errors. The effects of manual edits on cortical thickness values were relatively minor: less than 2% in all regions. Supplementary Material cover registration and additional edit options in FreeSurfer and comparison to the computational anatomy toolbox (CAT12). Overall, we conclude that despite minor imperfections FreeSurfer can be reliably used to segment cortical metrics from T1-weighted images of 5-year-old children with appropriate quality assessment in place. However, custom templates may be needed to optimize the results for the subcortical areas. Through visual assessment on a level of individual regions of interest, our semiautomated segmentation protocol is hopefully helpful for investigators working with similar data sets, and for ensuring high quality pediatric neuroimaging data.
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Affiliation(s)
- Elmo P. Pulli
- Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychiatry, Turku University Hospital, University of Turku, Turku, Finland
| | - Eero Silver
- Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychiatry, Turku University Hospital, University of Turku, Turku, Finland
| | - Venla Kumpulainen
- Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychiatry, Turku University Hospital, University of Turku, Turku, Finland
| | - Anni Copeland
- Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Harri Merisaari
- Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Radiology, University of Turku, Turku, Finland
| | - Jani Saunavaara
- Department of Medical Physics, Turku University Hospital, Turku, Finland
| | - Riitta Parkkola
- Department of Radiology, University of Turku, Turku, Finland
- Department of Radiology, Turku University Hospital, Turku, Finland
| | - Tuire Lähdesmäki
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital, University of Turku, Turku, Finland
| | - Ekaterina Saukko
- Department of Radiology, Turku University Hospital, Turku, Finland
| | - Saara Nolvi
- Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Turku Institute for Advanced Studies, University of Turku, Turku, Finland
- Department of Psychology, University of Turku, Turku, Finland
| | - Eeva-Leena Kataja
- Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Riikka Korja
- Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychology, University of Turku, Turku, Finland
| | - Linnea Karlsson
- Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychiatry, Turku University Hospital, University of Turku, Turku, Finland
- Centre for Population Health Research, Turku University Hospital, University of Turku, Turku, Finland
| | - Hasse Karlsson
- Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychiatry, Turku University Hospital, University of Turku, Turku, Finland
- Centre for Population Health Research, Turku University Hospital, University of Turku, Turku, Finland
| | - Jetro J. Tuulari
- Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychiatry, Turku University Hospital, University of Turku, Turku, Finland
- Turku Collegium for Science, Medicine and Technology, University of Turku, Turku, Finland
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
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Matuz-Budai T, Lábadi B, Kohn E, Matuz A, Zsidó AN, Inhóf O, Kállai J, Szolcsányi T, Perlaki G, Orsi G, Nagy SA, Janszky J, Darnai G. Individual differences in the experience of body ownership are related to cortical thickness. Sci Rep 2022; 12:808. [PMID: 35039541 PMCID: PMC8764083 DOI: 10.1038/s41598-021-04720-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 12/21/2021] [Indexed: 11/09/2022] Open
Abstract
The widely used rubber hand illusion (RHI) paradigm provides insight into how the brain manages conflicting multisensory information regarding bodily self-consciousness. Previous functional neuroimaging studies have revealed that the feeling of body ownership is linked to activity in the premotor cortex, the intraparietal areas, the occipitotemporal cortex, and the insula. The current study investigated whether the individual differences in the sensation of body ownership over a rubber hand, as measured by subjective report and the proprioceptive drift, are associated with structural brain differences in terms of cortical thickness in 67 healthy young adults. We found that individual differences measured by the subjective report of body ownership are associated with the cortical thickness in the somatosensory regions, the temporo-parietal junction, the intraparietal areas, and the occipitotemporal cortex, while the proprioceptive drift is linked to the premotor area and the anterior cingulate cortex. These results are in line with functional neuroimaging studies indicating that these areas are indeed involved in processes such as cognitive-affective perspective taking, visual processing of the body, and the experience of body ownership and bodily awareness. Consequently, these individual differences in the sensation of body ownership are pronounced in both functional and structural differences.
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Affiliation(s)
- Timea Matuz-Budai
- Institute of Psychology, University of Pécs, 6 Ifjúság str., Pécs, 7624, Hungary.
| | - Beatrix Lábadi
- Institute of Psychology, University of Pécs, 6 Ifjúság str., Pécs, 7624, Hungary
| | - Eszter Kohn
- Institute of Philosophy and Art Theory, University of Pécs, Pécs, Hungary
| | - András Matuz
- Department of Behavioural Sciences, Medical School, University of Pécs, Pécs, Hungary
| | - András Norbert Zsidó
- Institute of Psychology, University of Pécs, 6 Ifjúság str., Pécs, 7624, Hungary
| | - Orsolya Inhóf
- Institute of Psychology, University of Pécs, 6 Ifjúság str., Pécs, 7624, Hungary
| | - János Kállai
- Department of Behavioural Sciences, Medical School, University of Pécs, Pécs, Hungary
| | - Tibor Szolcsányi
- Department of Behavioural Sciences, Medical School, University of Pécs, Pécs, Hungary
| | - Gábor Perlaki
- Department of Neurology, Medical School, University of Pécs, Pécs, Hungary
- MTA-PTE, Clinical Neuroscience MR Research Group, Pécs, Hungary
- Pécs Diagnostic Centre, Pécs, Hungary
| | - Gergely Orsi
- MTA-PTE, Clinical Neuroscience MR Research Group, Pécs, Hungary
- Pécs Diagnostic Centre, Pécs, Hungary
- Department of Neurosurgery, Medical School, University of Pécs, Pécs, Hungary
| | - Szilvia Anett Nagy
- MTA-PTE, Clinical Neuroscience MR Research Group, Pécs, Hungary
- Pécs Diagnostic Centre, Pécs, Hungary
- Neurobiology of Stress Research Group, Szentágothai Research Centre, University of Pécs, Pécs, Hungary
- Department of Laboratory Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - József Janszky
- Department of Neurology, Medical School, University of Pécs, Pécs, Hungary
- MTA-PTE, Clinical Neuroscience MR Research Group, Pécs, Hungary
| | - Gergely Darnai
- Department of Behavioural Sciences, Medical School, University of Pécs, Pécs, Hungary
- Department of Neurology, Medical School, University of Pécs, Pécs, Hungary
- MTA-PTE, Clinical Neuroscience MR Research Group, Pécs, Hungary
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Dong Y, Xu R, Zhang Y, Shi Y, Du K, Jia T, Wang J, Wang F. Different Frequency Bands in Various Regions of the Brain Play Different Roles in the Onset and Wake-Sleep Stages of Infantile Spasms. Front Pediatr 2022; 10:878099. [PMID: 35633963 PMCID: PMC9135356 DOI: 10.3389/fped.2022.878099] [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] [Received: 02/17/2022] [Accepted: 04/20/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The study aimed to identify the signatures of brain networks using electroencephalogram (EEG) in patients with infantile spasms (IS). METHODS Scalp EEGs of subjects with IS were prospectively collected in the first year of life (n = 8; age range 4-8 months; 3 males, 5 females). Ten minutes of ictal and interictal EEGs were clipped and filtered into different EEG frequency bands. The values of each pair of EEG channels were directly compared between ictal with interictal onsets and the sleep-wake phase to calculate IS brain network attributes: characteristic path length (CPL), node degree (ND), clustering coefficient (CC), and betweenness centrality (BC). RESULTS CPL, ND, and CC of the fast waves decreased while BC increased. CPL and BC of the slow waves decreased, while ND and CC increased during the IS ictal onset (P < 0.05). CPL of the alpha decreased, and BC increased during the waking time (P < 0.05). CONCLUSION The transmission capability of the fast waves, the local connectivity, and the defense capability of the slow waves during the IS ictal onset were enhanced. The alpha band played the most important role in both the global and local networks during the waking time. These may represent the brain network signatures of IS.
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Affiliation(s)
- Yan Dong
- Henan Provincial Key Laboratory of Child Brain Injury, Department of Pediatrics, Third Associated Hospital of Zheng Zhou University, Zhengzhou, China
| | - Ruijuan Xu
- Henan Provincial Key Laboratory of Child Brain Injury, Department of Pediatrics, Third Associated Hospital of Zheng Zhou University, Zhengzhou, China
| | - Yaodong Zhang
- Henan Key Laboratory of Children's Genetics and Metabolic Diseases, Henan Neurodevelopment Engineering Research Center for Children, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Yali Shi
- Henan Provincial Key Laboratory of Child Brain Injury, Department of Pediatrics, Third Associated Hospital of Zheng Zhou University, Zhengzhou, China
| | - Kaixian Du
- Henan Provincial Key Laboratory of Child Brain Injury, Department of Pediatrics, Third Associated Hospital of Zheng Zhou University, Zhengzhou, China
| | - Tianming Jia
- Henan Provincial Key Laboratory of Child Brain Injury, Department of Pediatrics, Third Associated Hospital of Zheng Zhou University, Zhengzhou, China
| | - Jun Wang
- Department of Children's Rehabilitation, Third Associated Hospital of Zheng Zhou University, Zhengzhou, China
| | - Fang Wang
- Department of Medical Record Management, Third Associated Hospital of Zheng Zhou University, Zhengzhou, China
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Frontal lobe hypometabolism associated with Sudden Unexpected Death in Epilepsy (SUDEP) risk: An objective PET study. Epilepsy Behav 2021; 122:108185. [PMID: 34252829 DOI: 10.1016/j.yebeh.2021.108185] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 06/20/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Abnormalities of brain structures and neuronal networks have been identified in MRI studies of patients with Sudden Unexpected Death in Epilepsy (SUDEP) as well as in those at elevated risk. The goal of this study was to identify common patterns of objectively detected brain glucose metabolic abnormalities associated with SUDEP patients and those at high SUDEP risk. METHODS Patients with refractory epilepsy (n = 78, age: 16-61 years, 44 females), who underwent comprehensive presurgical evaluation, were assessed for their risk of SUDEP using the revised SUDEP-7 inventory. From the 57 patients with low SUDEP risk, 35 were selected to match their demographic and clinical characteristics to those with high SUDEP risk (n = 21). [18F]fluoro-deoxy-glucose positron emission tomography (FDG-PET) abnormalities were evaluated in the high- and low-SUDEP risk subgroups compared to FDG-PET scans of a healthy adult control group using statistical parametric mapping (SPM). Individual FDG-PET scans of 4 additional patients, who died from SUDEP, were also analyzed by SPM. RESULTS Mean SUDEP-7 score was 6.1 in the high and 2.7 in the low SUDEP risk group. MRI showed no lesion in 36 patients (64%). Statistical parametric mapping analysis of the high SUDEP risk subgroup showed bilateral medial frontal and inferior frontal hypometabolism as a common pattern. The low-risk group showed no specific common metabolic abnormalities on SPM group analysis. Individual PET scans of all 4 patients who died from SUDEP also showed bilateral frontal lobe hypometabolism. CONCLUSIONS These data show that bilateral frontal lobe involvement on FDG-PET, especially the medial and inferior frontal cortex, may be a common metabolic pattern associated with high SUDEP risk and SUDEP itself, in patients with refractory focal epilepsy.
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Jber M, Habibabadi JM, Sharifpour R, Marzbani H, Hassanpour M, Seyfi M, Mobarakeh NM, Keihani A, Hashemi-Fesharaki SS, Ay M, Nazem-Zadeh MR. Temporal and extratemporal atrophic manifestation of temporal lobe epilepsy using voxel-based morphometry and corticometry: clinical application in lateralization of epileptogenic zone. Neurol Sci 2021; 42:3305-3325. [PMID: 33389247 DOI: 10.1007/s10072-020-05003-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 12/14/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Advances in MRI acquisition and data processing have become important for revealing brain structural changes. Previous studies have reported widespread structural brain abnormalities and cortical thinning in patients with temporal lobe epilepsy (TLE), as the most common form of focal epilepsy. METHODS In this research, healthy control cases (n = 20) and patients with left TLE (n = 19) and right TLE (n = 14) were recruited, all underwent 3.0 T MRI with magnetization-prepared rapid gradient echo sequence to acquire T1-weighted images. Morphometric alterations in gray matter were identified using voxel-based morphometry (VBM). Volumetric alterations in subcortical structures and cortical thinning were also determined. RESULTS Patients with left TLE demonstrated more prevailing and widespread changes in subcortical volumes and cortical thickness than right TLE, mainly in the left hemisphere, compared to the healthy group. Both VBM analysis and subcortical volumetry detected significant hippocampal atrophy in ipsilateral compared to contralateral side in TLE group. In addition to hippocampus, subcortical volumetry found the thalamus and pallidum bilaterally vulnerable to the TLE. Furthermore, the TLE patients underwent cortical thinning beyond the temporal lobe, affecting gray matter cortices in frontal, parietal, and occipital lobes in the majority of patients, more prevalently for left TLE cases. Exploiting volume changes in individual patients in the hippocampus alone led to 63.6% sensitivity and 100% specificity for lateralization of TLE. CONCLUSION Alteration of gray matter volumes in subcortical regions and neocortical temporal structures and also cortical gray matter thickness were evidenced as common effects of epileptogenicity, as manifested by the majority of cases in this study.
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Affiliation(s)
- Majdi Jber
- Medical School, International Campus, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Roya Sharifpour
- Physics and Biomedical Engineering Department, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for Molecular and Cellular Imaging, Advanced Medical Technologies and Equipment Institute (AMTEI), Tehran University of Medical Sciences, Tehran, Iran
| | - Hengameh Marzbani
- Department of Biomedical Engineering, Amirkabir University of Technology (AUT), Tehran, Iran
| | - Masoud Hassanpour
- Research Center for Molecular and Cellular Imaging, Advanced Medical Technologies and Equipment Institute (AMTEI), Tehran University of Medical Sciences, Tehran, Iran
| | - Milad Seyfi
- Physics and Biomedical Engineering Department, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for Molecular and Cellular Imaging, Advanced Medical Technologies and Equipment Institute (AMTEI), Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Mohammadi Mobarakeh
- Research Center for Molecular and Cellular Imaging, Advanced Medical Technologies and Equipment Institute (AMTEI), Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmedreza Keihani
- Physics and Biomedical Engineering Department, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mohammadreza Ay
- Physics and Biomedical Engineering Department, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for Molecular and Cellular Imaging, Advanced Medical Technologies and Equipment Institute (AMTEI), Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad-Reza Nazem-Zadeh
- Physics and Biomedical Engineering Department, Tehran University of Medical Sciences, Tehran, Iran.
- Research Center for Molecular and Cellular Imaging, Advanced Medical Technologies and Equipment Institute (AMTEI), Tehran University of Medical Sciences, Tehran, Iran.
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10
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Microstructural features of the cerebral cortex: Implications for predicting epilepsy relapse after drug withdrawal. Brain Res 2020; 1751:147200. [PMID: 33166509 DOI: 10.1016/j.brainres.2020.147200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 10/31/2020] [Accepted: 11/02/2020] [Indexed: 02/05/2023]
Abstract
A considerable portion of patients with well-controlled seizures and visually normal brain structures experience seizure recurrence after anti-seizure medication is withdrawn. Microstructural abnormalities of the cortex may play an essential role in epilepsy relapse. Patients with idiopathic/cryptogenic epilepsy were registered. At the follow-up endpoint, 18 patients with relapse (PR+ group), 20 patients without relapse (PR- group), and 30 healthy controls were included. High-resolution T1-weighted images were obtained at the time of drug withdrawal. Microstructural features including cortical thickness, surface area, cortical volume and mean curvature in 68 cortical areas were calculated. A general linear model was applied to investigate intergroup differences, and then post hoc analysis was performed. Additionally, factor analysis was conducted to extract components from imaging measures showing a difference between PR- and PR+ groups, and independent associations between components and epilepsy relapse were assessed using a logistic regression model. Cortical thickness of the left paracentral lobule, left temporal pole and right superior frontal gyrus; surface area of the bilateral lingual gyrus and bilateral pericalcarine cortex; and cortical volume of the bilateral pericalcarine cortex had significant intergroup differences (false discovery rate correction, P < 0.05). All measures, except for cortical thickness of the left temporal pole, showed differences between PR- and PR+ groups. Two dominant components were extracted from these measures, and both were independently associated with epilepsy relapse. In conclusion, epilepsy patients with relapse presented distinct microstructural features of cortex at the time of drug withdrawal, which may serve as a potential biomarker for predicting seizure recurrence.
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Wilson AT, Den Ottelander BK, De Goederen R, Van Veelen MLC, Dremmen MHG, Persing JA, Vrooman HA, Mathijssen IMJ. Intracranial hypertension and cortical thickness in syndromic craniosynostosis. Dev Med Child Neurol 2020; 62:799-805. [PMID: 32060907 DOI: 10.1111/dmcn.14487] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/07/2020] [Indexed: 12/13/2022]
Abstract
AIM To evaluate the impact of risk factors for intracranial hypertension (ICH) on cerebral cortex thickness in syndromic craniosynostosis. METHOD ICH risk factors including papilloedema, hydrocephalus, obstructive sleep apnea (OSA), cerebellar tonsillar position, occipitofrontal circumference (OFC) curve deflection, age, and sex were collected from the records of patients with syndromic craniosynostosis (Apert, Crouzon, Pfeiffer, Muenke, Saethre-Chotzen syndromes) and imaging. Magnetic resonance images were analysed and exported for statistical analysis. A linear mixed model was developed to determine correlations with cerebral cortex thickness changes. RESULTS In total, 171 scans from 107 patients (83 males, 88 females [including repeated scans], mean age 8y 10mo, range 1y 1mo-34y, SD 5y 9mo) were evaluated. Mean cortical thickness in this cohort was 2.78mm (SD 0.17). Previous findings of papilloedema (p=0.036) and of hydrocephalus (p=0.007) were independently associated with cortical thinning. Cortical thickness did not vary significantly by sex (p=0.534), syndrome (p=0.896), OSA (p=0.464), OFC (p=0.375), or tonsillar position (p=0.682). INTERPRETATION Detection of papilloedema or hydrocephalus in syndromic craniosynostosis is associated with significant changes in cortical thickness, supporting the need for preventative rather than reactive treatment strategies. WHAT THIS PAPER ADDS Papilloedema is associated with thinning of the cerebral cortex in syndromic craniosynostosis, independently of hydrocephalus.
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Affiliation(s)
- Alexander T Wilson
- Department of Plastic and Reconstructive Surgery, Erasmus Medical Center, Rotterdam, the Netherlands.,Department of Surgery, Section of Plastic Surgery, Yale School of Medicine, New Haven, CT, USA
| | - Bianca K Den Ottelander
- Department of Plastic and Reconstructive Surgery, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Robbin De Goederen
- Department of Plastic and Reconstructive Surgery, Erasmus Medical Center, Rotterdam, the Netherlands
| | | | | | - John A Persing
- Department of Surgery, Section of Plastic Surgery, Yale School of Medicine, New Haven, CT, USA
| | - Henri A Vrooman
- Department of Radiology, Erasmus Medical Center, Rotterdam, the Netherlands.,Department of Medical Informatics, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Irene M J Mathijssen
- Department of Plastic and Reconstructive Surgery, Erasmus Medical Center, Rotterdam, the Netherlands
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12
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Boutzoukas EM, Crutcher J, Somoza E, Sepeta LN, You X, Gaillard WD, Wallace GL, Berl MM. Cortical thickness in childhood left focal epilepsy: Thinning beyond the seizure focus. Epilepsy Behav 2020; 102:106825. [PMID: 31816479 PMCID: PMC6962541 DOI: 10.1016/j.yebeh.2019.106825] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 11/20/2019] [Accepted: 11/24/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Structural brain differences are found in adults and children with epilepsy, yet pediatric samples have been heterogeneous regarding seizure type, magnetic resonance imaging (MRI) findings, and hemisphere of seizure focus. This study examines whether cortical thickness and surface area differ between children with left-hemisphere focal epilepsy (LHE) and age-matched typically developing (TD) peers. We examined whether age differentially moderated cortical thickness between groups and if cortical thickness was associated with duration of epilepsy, seizure frequency, or neuropsychological functioning. METHODS Thirty-five children with LHE and 35 TD children completed neuropsychological testing and 3T MR imaging. Neuropsychological measures included general intelligence and executive functioning. All MRIs were normal. Surface-based morphometric processing and analyses were conducted using FreeSurfer 6.0. Regression analyses compared age by cortical thickness differences between groups. Correlational analyses examined associations between cortical thickness in these areas with neuropsychological functioning or epilepsy characteristics. RESULTS Left-hemisphere focal epilepsy displayed decreased cortical thickness bilaterally compared to TD controls across 6 brain regions but no differences in surface area. Moderation analyses revealed quadratic relationships between age and cortical thickness for left frontoparietal-cingulate and right superior frontal regions. Higher performance intelligence quotient (IQ) (PIQ) and verbal IQ (VIQ) and fewer parent reported executive function problems were associated with greater cortical thickness in TD children. SIGNIFICANCE Children with LHE displayed thinner cortex extending beyond the hemisphere of seizure focus. The nonlinear pattern of cortical thickness across age occurring in TD children is not evident in the same manner in children with LHE. These differences in cortical thickness patterns were greatest in children 8-12 years old. Greater cortical thickness was associated with higher IQ and fewer executive control problems in daily activities in TD children. Thus, differences in cortical thickness in the absence of differences in surface area, suggest cortical thickness may be a sensitive proxy of subtle neuroanatomical changes that are related to neuropsychological functioning.
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Affiliation(s)
- Emanuel M Boutzoukas
- Comprehensive Pediatric Epilepsy Program, Children's National Medical Center, Washington, DC, USA
| | - Jason Crutcher
- Laboratory of Brain and Cognition, National Institute of Mental Health, Bethesda, MD, USA
| | - Eduardo Somoza
- Comprehensive Pediatric Epilepsy Program, Children's National Medical Center, Washington, DC, USA
| | - Leigh N Sepeta
- Comprehensive Pediatric Epilepsy Program, Children's National Medical Center, Washington, DC, USA; Department of Psychiatry and Behavioral Sciences, The George Washington University, Washington, DC, USA
| | - Xiaozhen You
- Comprehensive Pediatric Epilepsy Program, Children's National Medical Center, Washington, DC, USA; Department of Pediatrics and Neurology, The George Washington University, Washington, DC, USA
| | - William D Gaillard
- Comprehensive Pediatric Epilepsy Program, Children's National Medical Center, Washington, DC, USA; Department of Pediatrics and Neurology, The George Washington University, Washington, DC, USA
| | - Gregory L Wallace
- Laboratory of Brain and Cognition, National Institute of Mental Health, Bethesda, MD, USA; Department of Speech, Language, and Hearing Sciences, The George Washington University, Washington, DC, USA
| | - Madison M Berl
- Comprehensive Pediatric Epilepsy Program, Children's National Medical Center, Washington, DC, USA; Department of Psychiatry and Behavioral Sciences, The George Washington University, Washington, DC, USA.
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13
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Juhász C, John F. Utility of MRI, PET, and ictal SPECT in presurgical evaluation of non-lesional pediatric epilepsy. Seizure 2019; 77:15-28. [PMID: 31122814 DOI: 10.1016/j.seizure.2019.05.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Revised: 02/12/2019] [Accepted: 05/10/2019] [Indexed: 12/12/2022] Open
Abstract
Children with epilepsy and normal structural MRI pose a particular challenge in localization of epileptic foci for surgical resection. Many of these patients have subtle structural lesions such as mild cortical dysplasia that can be missed by conventional MRI but may become detectable by optimized and advanced MRI acquisitions and post-processing. Specificity of objective analytic techniques such as voxel-based morphometry remains an issue. Combination of MRI with functional imaging approaches can improve the accuracy of detecting epileptogenic brain regions. Analysis of glucose positron emission tomography (PET) combined with high-resolution MRI can optimize detection of hypometabolic cortex associated with subtle cortical malformations and can also enhance presurgical evaluation in children with epileptic spasms. Additional PET tracers may detect subtle epileptogenic lesions and cortex with enhanced specificity in carefully selected subgroups with various etiologies; e.g., increased tryptophan uptake can identify epileptogenic cortical dysplasia in the interictal state. Subtraction ictal SPECT can be also useful to delineate ictal foci in those with non-localizing PET or after failed surgical resection. Presurgical delineation of language and motor cortex and the corresponding white matter tracts is increasingly reliable by functional MRI and DTI techniques; with careful preparation, these can be useful even in young and sedated children. While evidence-based pediatric guidelines are still lacking, the data accumulated in the last decade strongly indicate that multimodal imaging with combined analysis of MRI, PET, and/or ictal SPECT data can optimize the detection of subtle epileptogenic lesions and facilitate seizure-free outcome while minimizing the postsurgical functional deficit in children with normal conventional MRI.
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Affiliation(s)
- Csaba Juhász
- Department of Pediatrics, Wayne State University, PET Center and Translational Imaging Laboratory, Children's Hospital of Michigan, 3901 Beaubien St., Detroit, Michigan, 48201, USA; Departments of Neurology and Neurosurgery, Wayne State University, 4201 St. Antoine St., Detroit, Michigan, 48201, USA.
| | - Flóra John
- Department of Pediatrics, Wayne State University, PET Center and Translational Imaging Laboratory, Children's Hospital of Michigan, 3901 Beaubien St., Detroit, Michigan, 48201, USA; Department of Neurology, University of Pécs, H-7623, Rét u. 2., Pécs, Hungary.
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14
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Ogren JA, Tripathi R, Macey PM, Kumar R, Stern JM, Eliashiv DS, Allen LA, Diehl B, Engel J, Rani MRS, Lhatoo SD, Harper RM. Regional cortical thickness changes accompanying generalized tonic-clonic seizures. Neuroimage Clin 2018; 20:205-215. [PMID: 30094170 PMCID: PMC6073085 DOI: 10.1016/j.nicl.2018.07.015] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 06/27/2018] [Accepted: 07/15/2018] [Indexed: 12/12/2022]
Abstract
Objective Generalized tonic-clonic seizures are accompanied by cardiovascular and respiratory sequelae that threaten survival. The frequency of these seizures is a major risk factor for sudden unexpected death in epilepsy (SUDEP), a leading cause of untimely death in epilepsy. The circumstances accompanying such fatal events suggest a cardiovascular or respiratory failure induced by unknown neural processes rather than an inherent cardiac or lung deficiency. Certain cortical regions, especially the insular, cingulate, and orbitofrontal cortices, are key structures that integrate sensory input and influence diencephalic and brainstem regions regulating blood pressure, cardiac rhythm, and respiration; output from those cortical regions compromised by epilepsy-associated injury may lead to cardiorespiratory dysregulation. The aim here was to assess changes in cortical integrity, reflected as cortical thickness, relative to healthy controls. Cortical alterations in areas that influence cardiorespiratory action could contribute to SUDEP mechanisms. Methods High-resolution T1-weighted images were collected with a 3.0-Tesla MRI scanner from 53 patients with generalized tonic-clonic seizures (Mean age ± SD: 37.1 ± 12.6 years, 22 male) at Case Western Reserve University, University College London, and the University of California at Los Angeles. Control data included 530 healthy individuals (37.1 ± 12.6 years; 220 male) from UCLA and two open access databases (OASIS and IXI). Cortical thickness group differences were assessed at all non-cerebellar brain surface locations (P < 0.05 corrected). Results Increased cortical thickness appeared in post-central gyri, insula, and subgenual, anterior, posterior, and isthmus cingulate cortices. Post-central gyri increases were greater in females, while males showed more extensive cingulate increases. Frontal and temporal cortex, lateral orbitofrontal, frontal pole, and lateral parietal and occipital cortices showed thinning. The extents of thickness changes were sex- and hemisphere-dependent, with only males exhibiting right-sided and posterior cingulate thickening, while females showed only left lateral orbitofrontal thinning. Regional cortical thickness showed modest correlations with seizure frequency, but not epilepsy duration. Significance Cortical thickening and thinning occur in patients with generalized tonic-clonic seizures, in cardiovascular and somatosensory areas, with extent of changes sex- and hemisphere-dependent. The data show injury in key autonomic and respiratory cortical areas, which may contribute to dysfunctional cardiorespiratory patterns during seizures, as well as to longer-term SUDEP risk.
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Affiliation(s)
- Jennifer A Ogren
- Department of Neurobiology, David Geffen School of Medicine at UCLA, University of California at Los Angeles, Los Angeles, CA, USA
| | - Raghav Tripathi
- Department of Neurobiology, David Geffen School of Medicine at UCLA, University of California at Los Angeles, Los Angeles, CA, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Paul M Macey
- UCLA School of Nursing, University of California at Los Angeles, Los Angeles, CA, USA; Brain Research Institute, University of California at Los Angeles, Los Angeles, CA, USA
| | - Rajesh Kumar
- Brain Research Institute, University of California at Los Angeles, Los Angeles, CA, USA; Department of Anesthesiology, David Geffen School of Medicine at UCLA, University of California at Los Angeles, Los Angeles, CA, USA; Department of Radiological Sciences, David Geffen School of Medicine at UCLA, University of California at Los Angeles, Los Angeles, CA, USA
| | - John M Stern
- Department of Neurology, David Geffen School of Medicine at UCLA, University of California at Los Angeles, Los Angeles, CA, USA
| | - Dawn S Eliashiv
- Department of Neurology, David Geffen School of Medicine at UCLA, University of California at Los Angeles, Los Angeles, CA, USA
| | - Luke A Allen
- Institute of Neurology, University College London, London, United Kingdom
| | - Beate Diehl
- Institute of Neurology, University College London, London, United Kingdom
| | - Jerome Engel
- Department of Neurobiology, David Geffen School of Medicine at UCLA, University of California at Los Angeles, Los Angeles, CA, USA; Brain Research Institute, University of California at Los Angeles, Los Angeles, CA, USA; Department of Neurology, David Geffen School of Medicine at UCLA, University of California at Los Angeles, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, University of California at Los Angeles, Los Angeles, CA, USA
| | | | | | - Ronald M Harper
- Department of Neurobiology, David Geffen School of Medicine at UCLA, University of California at Los Angeles, Los Angeles, CA, USA; Brain Research Institute, University of California at Los Angeles, Los Angeles, CA, USA.
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