1
|
Middlebrooks EH, Gupta V, Agarwal AK, Freund BE, Messina SA, Tatum WO, Sabsevitz DS, Feyissa AM, Mirsattari SM, Galan FN, Quinones-Hinojosa A, Grewal SS, Murray JV. Radiologic Classification of Hippocampal Sclerosis in Epilepsy. AJNR Am J Neuroradiol 2024; 45:1185-1193. [PMID: 38383054 PMCID: PMC11392372 DOI: 10.3174/ajnr.a8214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 02/14/2024] [Indexed: 02/23/2024]
Abstract
Temporal lobe epilepsy is a common form of epilepsy that is often associated with hippocampal sclerosis (HS). Although HS is commonly considered a binary assessment in radiologic evaluation, it is known that histopathologic changes occur in distinct clusters. Some subtypes of HS only affect certain subfields, resulting in minimal changes to the overall volume of the hippocampus. This is likely a major reason why whole hippocampal volumetrics have underperformed versus expert readers in the diagnosis of HS. With recent advancements in MRI technology, it is now possible to characterize the substructure of the hippocampus more accurately. However, this is not consistently addressed in radiographic evaluations. The histologic subtype of HS is critical for prognosis and treatment decision-making, necessitating improved radiologic classification of HS. The International League Against Epilepsy (ILAE) has issued a consensus classification scheme for subtyping HS histopathologic changes. This review aims to explore how the ILAE subtypes of HS correlate with radiographic findings, introduce a grading system that integrates radiologic and pathologic reporting in HS, and outline an approach to detecting HS subtypes by using MRI. This framework will not only benefit current clinical evaluations, but also enhance future studies involving high-resolution MRI in temporal lobe epilepsy.
Collapse
Affiliation(s)
- Erik H Middlebrooks
- From the Department of Radiology (E.H.M., V.G., A.K.A., J.V.M.), Mayo Clinic, Jacksonville, Florida
| | - Vivek Gupta
- From the Department of Radiology (E.H.M., V.G., A.K.A., J.V.M.), Mayo Clinic, Jacksonville, Florida
| | - Amit K Agarwal
- From the Department of Radiology (E.H.M., V.G., A.K.A., J.V.M.), Mayo Clinic, Jacksonville, Florida
| | - Brin E Freund
- Department of Neurology (B.E.F., W.O.T., A.M.F.), Mayo Clinic, Jacksonville, Florida
| | - Steven A Messina
- Department of Radiology (S.A.M.), Mayo Clinic, Rochester, Minnesota
| | - William O Tatum
- Department of Neurology (B.E.F., W.O.T., A.M.F.), Mayo Clinic, Jacksonville, Florida
| | - David S Sabsevitz
- Department of Psychiatry and Psychology (D.S.S.), Mayo Clinic, Jacksonville, Florida
| | - Anteneh M Feyissa
- Department of Neurology (B.E.F., W.O.T., A.M.F.), Mayo Clinic, Jacksonville, Florida
| | - Seyed M Mirsattari
- Departments of Clinical Neurological Sciences, Medical Imaging, Medical Biophysics, and Psychology (S.M.M.), University of Western Ontario, London, Ontario, Canada
| | - Fernando N Galan
- Department of Neurology (F.N.G.), Nemours Children's Health, Jacksonville, Florida
| | | | - Sanjeet S Grewal
- Department of Neurosurgery (A.Q.-H., S.S.G.), Mayo Clinic, Jacksonville, Florida
| | - John V Murray
- From the Department of Radiology (E.H.M., V.G., A.K.A., J.V.M.), Mayo Clinic, Jacksonville, Florida
| |
Collapse
|
2
|
Ellsay AC, Winston GP. Advances in MRI-based diagnosis of temporal lobe epilepsy: Correlating hippocampal subfield volumes with histopathology. J Neuroimaging 2024. [PMID: 39092876 DOI: 10.1111/jon.13225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/27/2024] [Accepted: 07/17/2024] [Indexed: 08/04/2024] Open
Abstract
Epilepsy, affecting 0.5%-1% of the global population, presents a significant challenge with 30% of patients resistant to medical treatment. Temporal lobe epilepsy, a common cause of medically refractory epilepsy, is often caused by hippocampal sclerosis (HS). HS can be divided further by subtype, as defined by the International League Against Epilepsy (ILAE). Type 1 HS, the most prevalent form (60%-80% of all cases), is characterized by cell loss and gliosis predominantly in the subfields cornu ammonis (CA1) and CA4. Type 2 HS features cell loss and gliosis primarily in the CA1 sector, and type 3 HS features cell loss and gliosis predominantly in the CA4 subfield. This literature review evaluates studies on hippocampal subfields, exploring whether observable atrophy patterns from in vivo and ex vivo magnetic resonance imaging (MRI) scans correlate with histopathological examinations with manual or automated segmentation techniques. Our findings suggest only ex vivo 1.5 Tesla (T) or 3T MRI with manual segmentation or in vivo 7T MRI with manual or automated segmentations can consistently correlate subfield patterns with histopathologically derived ILAE-HS subtypes. In conclusion, manual and automated segmentation methods offer advantages and limitations in diagnosing ILAE-HS subtypes, with ongoing research crucial for refining hippocampal subfield segmentation techniques and enhancing clinical applicability.
Collapse
Affiliation(s)
- Andrea C Ellsay
- Centre for Neuroscience Studies, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Gavin P Winston
- Centre for Neuroscience Studies, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
- Division of Neurology, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| |
Collapse
|
3
|
Schira MM, Isherwood ZJ, Kassem MS, Barth M, Shaw TB, Roberts MM, Paxinos G. HumanBrainAtlas: an in vivo MRI dataset for detailed segmentations. Brain Struct Funct 2023; 228:1849-1863. [PMID: 37277567 PMCID: PMC10516788 DOI: 10.1007/s00429-023-02653-8] [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: 11/02/2022] [Accepted: 05/13/2023] [Indexed: 06/07/2023]
Abstract
We introduce HumanBrainAtlas, an initiative to construct a highly detailed, open-access atlas of the living human brain that combines high-resolution in vivo MR imaging and detailed segmentations previously possible only in histological preparations. Here, we present and evaluate the first step of this initiative: a comprehensive dataset of two healthy male volunteers reconstructed to a 0.25 mm isotropic resolution for T1w, T2w, and DWI contrasts. Multiple high-resolution acquisitions were collected for each contrast and each participant, followed by averaging using symmetric group-wise normalisation (Advanced Normalisation Tools). The resulting image quality permits structural parcellations rivalling histology-based atlases, while maintaining the advantages of in vivo MRI. For example, components of the thalamus, hypothalamus, and hippocampus are often impossible to identify using standard MRI protocols-can be identified within the present data. Our data are virtually distortion free, fully 3D, and compatible with the existing in vivo Neuroimaging analysis tools. The dataset is suitable for teaching and is publicly available via our website (hba.neura.edu.au), which also provides data processing scripts. Instead of focusing on coordinates in an averaged brain space, our approach focuses on providing an example segmentation at great detail in the high-quality individual brain. This serves as an illustration on what features contrasts and relations can be used to interpret MRI datasets, in research, clinical, and education settings.
Collapse
Affiliation(s)
- Mark M Schira
- School of Psychology, University of Wollongong, Wollongong, NSW, 2522, Australia.
- Neuroscience Research Australia, Randwick, NSW, 2031, Australia.
| | - Zoey J Isherwood
- School of Psychology, University of Wollongong, Wollongong, NSW, 2522, Australia
- Department of Psychology, University of Nevada, Reno, NV, 89557, USA
| | - Mustafa S Kassem
- Neuroscience Research Australia, Randwick, NSW, 2031, Australia
- School of Psychology, The University of New South Wales, Sydney, NSW, 2052, Australia
| | - Markus Barth
- Centre for Advanced Imaging, The University of Queensland, St Lucia, QLD, 4067, Australia
- School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, QLD, 7067, Australia
| | - Thomas B Shaw
- Centre for Advanced Imaging, The University of Queensland, St Lucia, QLD, 4067, Australia
- School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, QLD, 7067, Australia
| | - Michelle M Roberts
- School of Psychology, University of Wollongong, Wollongong, NSW, 2522, Australia
- School of Psychology, The University of New South Wales, Sydney, NSW, 2052, Australia
| | - George Paxinos
- Neuroscience Research Australia, Randwick, NSW, 2031, Australia
- School of Psychology, The University of New South Wales, Sydney, NSW, 2052, Australia
| |
Collapse
|
4
|
Reppert L, Sepeta LN, Panjeti-Moore D, Akinsoji E, Sherer C, Hamidullah-Thiam A, Theodore WH. Cognitive function and the longitudinal hippocampal axis in mesial temporal sclerosis. Epilepsy Behav 2023; 147:109413. [PMID: 37716331 PMCID: PMC10591949 DOI: 10.1016/j.yebeh.2023.109413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/10/2023] [Accepted: 08/19/2023] [Indexed: 09/18/2023]
Abstract
OBJECTIVE The relationship of preoperative memory deficits in patients with mesial temporal lobe epilepsy (mTLE) and hippocampal sclerosis (HS) to the distribution of neuronal loss is uncertain. Building on the material specificity theory, we tested the hypothesis that visual memory deficits are associated with posterior hippocampal atrophy, whereas verbal memory deficits are associated with anterior hippocampal atrophy. METHODS We studied 22 adults with mTLE and HS, calculating hippocampal head, body, and tail volumes, correcting for estimated total intracranial volume, using automated segmentation. Preoperative memory ability was evaluated with the Wechsler Memory Scale (WMS-II: logical memory, verbal paired associates, family pictures, and faces subtests). We correlated memory ability with hippocampal division volumes using SPSS 26.1 (repeated measures ANOVAs, one-way ANOVAs, Pearson r correlations) for statistical analysis. RESULTS We found a significant main effect of hippocampal subdivision, reporting volumetric differences between the head, body, and tail. Pairwise comparisons reported that the hippocampal head had significantly greater volume than both the body and tail (p < 0.001). For both left and right focus groups, the ipsilateral hippocampi were significantly smaller than the contralateral. Linear regression reported a left hippocampal model (head, body, and tail volumes) predicted performance on logical memory with the left hippocampal tail volume being the strongest predictor. A right hippocampal model (head, body, and tail volumes) predicted memory ability for family pictures and verbal paired associates at a trend level. CONCLUSIONS Ipsilateral hippocampal head and tail seem more vulnerable to injury than the body in both the left and right mTLE. Our study suggests there may be functional differences along the hippocampal longitudinal axis, particularly for the left hippocampal tail with verbal memory. Our findings are consistent with material-specific right-left differences in memory processing.
Collapse
Affiliation(s)
- L Reppert
- National Institute of Neurological Disorders and Stroke, United States; Department of Neurology, Children's National Medical Center, United States
| | - L N Sepeta
- National Institute of Neurological Disorders and Stroke, United States; Department of Neurology, Children's National Medical Center, United States
| | - D Panjeti-Moore
- National Institute of Neurological Disorders and Stroke, United States
| | - E Akinsoji
- National Institute of Neurological Disorders and Stroke, United States
| | - C Sherer
- National Institute of Neurological Disorders and Stroke, United States
| | | | - W H Theodore
- National Institute of Neurological Disorders and Stroke, United States.
| |
Collapse
|
5
|
Filimonova EA, Pashkov AA, Moysak GI, Tropynina AY, Zhanaeva SY, Shvaikovskaya AA, Akopyan AA, Danilenko KV, Aftanas LI, Tikhonova MA, Rzaev JA. Brain but not serum BDNF levels are associated with structural alterations in the hippocampal regions in patients with drug-resistant mesial temporal lobe epilepsy. Front Neurosci 2023; 17:1217702. [PMID: 37539386 PMCID: PMC10395949 DOI: 10.3389/fnins.2023.1217702] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 07/03/2023] [Indexed: 08/05/2023] Open
Abstract
Mesial temporal lobe epilepsy is the most common type of focal epilepsy, imposing a significant burden on the health care system worldwide. Approximately one-third of patients with this disease who do not adequately respond to pharmacotherapy are considered drug-resistant subjects. Despite having some clues of how such epileptic activity and resistance to therapy emerge, coming mainly from preclinical models, we still witness a scarcity of human data. To narrow this gap, in this study, we aimed to estimate the relationship between hippocampal and serum levels of brain-derived neurotrophic factor (BDNF), one of the main and most widely studied neurotrophins, and hippocampal subfield volumes in patients with drug-resistant mesial temporal epilepsy undergoing neurosurgical treatment. We found that hippocampal (but not serum) BDNF levels were negatively correlated with the contralateral volumes of the CA1 and CA4 subfields, presubiculum, subiculum, dentate gyrus, and molecular layer of the hippocampus. Taken together, these findings are generally in accordance with existing data, arguing for a proepileptic nature of BDNF effects in the hippocampus and related brain structures.
Collapse
Affiliation(s)
- Elena A. Filimonova
- FSBI "Federal Center of Neurosurgery", Novosibirsk, Russia
- Department of Neurosurgery, Novosibirsk State Medical University, Novosibirsk, Russia
| | - Anton A. Pashkov
- FSBI "Federal Center of Neurosurgery", Novosibirsk, Russia
- Biomedical School, South Ural State University, Chelyabinsk, Russia
| | - Galina I. Moysak
- FSBI "Federal Center of Neurosurgery", Novosibirsk, Russia
- Department of Neuroscience, Institute of Medicine and Psychology, Novosibirsk State University, Novosibirsk, Russia
| | - Anastasia Y. Tropynina
- Department of Neuroscience, Institute of Medicine and Psychology, Novosibirsk State University, Novosibirsk, Russia
- Scientific Research Institute of Neurosciences and Medicine, Novosibirsk, Russia
| | - Svetlana Y. Zhanaeva
- Scientific Research Institute of Neurosciences and Medicine, Novosibirsk, Russia
| | | | - Anna A. Akopyan
- Scientific Research Institute of Neurosciences and Medicine, Novosibirsk, Russia
| | | | - Lyubomir I. Aftanas
- Department of Neuroscience, Institute of Medicine and Psychology, Novosibirsk State University, Novosibirsk, Russia
- Scientific Research Institute of Neurosciences and Medicine, Novosibirsk, Russia
| | - Maria A. Tikhonova
- Scientific Research Institute of Neurosciences and Medicine, Novosibirsk, Russia
| | - Jamil A. Rzaev
- FSBI "Federal Center of Neurosurgery", Novosibirsk, Russia
- Department of Neurosurgery, Novosibirsk State Medical University, Novosibirsk, Russia
- Department of Neuroscience, Institute of Medicine and Psychology, Novosibirsk State University, Novosibirsk, Russia
| |
Collapse
|
6
|
Comino Garcia-Munoz A, Alemán-Gómez Y, Toledano R, Poch C, García-Morales I, Aledo-Serrano Á, Gil-Nagel A, Campo P. Morphometric and microstructural characteristics of hippocampal subfields in mesial temporal lobe epilepsy and their correlates with mnemonic discrimination. Front Neurol 2023; 14:1096873. [PMID: 36864916 PMCID: PMC9972498 DOI: 10.3389/fneur.2023.1096873] [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: 11/12/2022] [Accepted: 01/18/2023] [Indexed: 02/16/2023] Open
Abstract
Introduction Pattern separation (PS) is a fundamental aspect of memory creation that defines the ability to transform similar memory representations into distinct ones, so they do not overlap when storing and retrieving them. Experimental evidence in animal models and the study of other human pathologies have demonstrated the role of the hippocampus in PS, in particular of the dentate gyrus (DG) and CA3. Patients with mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HE) commonly report mnemonic deficits that have been associated with failures in PS. However, the link between these impairments and the integrity of the hippocampal subfields in these patients has not yet been determined. The aim of this work is to explore the association between the ability to perform mnemonic functions and the integrity of hippocampal CA1, CA3, and DG in patients with unilateral MTLE-HE. Method To reach this goal we evaluated the memory of patients with an improved object mnemonic similarity test. We then analyzed the hippocampal complex structural and microstructural integrity using diffusion weighted imaging. Results Our results indicate that patients with unilateral MTLE-HE present alterations in both volume and microstructural properties at the level of the hippocampal subfields DG, CA1, CA3, and the subiculum, that sometimes depend on the lateralization of their epileptic focus. However, none of the specific changes was found to be directly related to the performance of the patients in a pattern separation task, which might indicate a contribution of various alterations to the mnemonic deficits or the key contribution of other structures to the function. Discussion we established for the first time the alterations in both the volume and the microstructure at the level of the hippocampal subfields in a group of unilateral MTLE patients. We observed that these changes are greater in the DG and CA1 at the macrostructural level, and in CA3 and CA1 in the microstructural level. None of these changes had a direct relation to the performance of the patients in a pattern separation task, which suggests a contribution of various alterations to the loss of function.
Collapse
Affiliation(s)
- Alicia Comino Garcia-Munoz
- Centre de Résonance Magnétique Biologique et Médicale-Unité Mixte de Recherche 7339, Aix-Marseille Université, Marseille, France
| | - Yasser Alemán-Gómez
- Connectomics Lab, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Rafael Toledano
- Epilepsy Unit, Neurology Department, Hospital Ruber Internacional, Madrid, Spain,Epilepsy Unit, Neurology Department, University Hospital Ramón y Cajal, Madrid, Spain
| | - Claudia Poch
- Facultad de Lenguas y Educación, Universidad de Nebrija, Madrid, Spain
| | - Irene García-Morales
- Epilepsy Unit, Neurology Department, Hospital Ruber Internacional, Madrid, Spain,Epilepsy Unit, Neurology Department, University Hospital of San Carlos, Madrid, Spain
| | - Ángel Aledo-Serrano
- Epilepsy Unit, Neurology Department, Hospital Ruber Internacional, Madrid, Spain
| | - Antonio Gil-Nagel
- Epilepsy Unit, Neurology Department, Hospital Ruber Internacional, Madrid, Spain
| | - Pablo Campo
- Department of Basic Psychology, Autonoma University of Madrid, Madrid, Spain,*Correspondence: Pablo Campo ✉
| |
Collapse
|
7
|
Xie L, Wisse LEM, Wang J, Ravikumar S, Khandelwal P, Glenn T, Luther A, Lim S, Wolk DA, Yushkevich PA. Deep label fusion: A generalizable hybrid multi-atlas and deep convolutional neural network for medical image segmentation. Med Image Anal 2023; 83:102683. [PMID: 36379194 PMCID: PMC10009820 DOI: 10.1016/j.media.2022.102683] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 10/18/2022] [Accepted: 11/03/2022] [Indexed: 11/07/2022]
Abstract
Deep convolutional neural networks (DCNN) achieve very high accuracy in segmenting various anatomical structures in medical images but often suffer from relatively poor generalizability. Multi-atlas segmentation (MAS), while less accurate than DCNN in many applications, tends to generalize well to unseen datasets with different characteristics from the training dataset. Several groups have attempted to integrate the power of DCNN to learn complex data representations and the robustness of MAS to changes in image characteristics. However, these studies primarily focused on replacing individual components of MAS with DCNN models and reported marginal improvements in accuracy. In this study we describe and evaluate a 3D end-to-end hybrid MAS and DCNN segmentation pipeline, called Deep Label Fusion (DLF). The DLF pipeline consists of two main components with learnable weights, including a weighted voting subnet that mimics the MAS algorithm and a fine-tuning subnet that corrects residual segmentation errors to improve final segmentation accuracy. We evaluate DLF on five datasets that represent a diversity of anatomical structures (medial temporal lobe subregions and lumbar vertebrae) and imaging modalities (multi-modality, multi-field-strength MRI and Computational Tomography). These experiments show that DLF achieves comparable segmentation accuracy to nnU-Net (Isensee et al., 2020), the state-of-the-art DCNN pipeline, when evaluated on a dataset with similar characteristics to the training datasets, while outperforming nnU-Net on tasks that involve generalization to datasets with different characteristics (different MRI field strength or different patient population). DLF is also shown to consistently improve upon conventional MAS methods. In addition, a modality augmentation strategy tailored for multimodal imaging is proposed and demonstrated to be beneficial in improving the segmentation accuracy of learning-based methods, including DLF and DCNN, in missing data scenarios in test time as well as increasing the interpretability of the contribution of each individual modality.
Collapse
Affiliation(s)
- Long Xie
- Penn Image Computing and Science Laboratory (PICSL), Department of Radiology, University of Pennsylvania, Philadelphia, USA.
| | - Laura E M Wisse
- Department of Diagnostic Radiology, Lund University, Lund, Sweden
| | - Jiancong Wang
- Penn Image Computing and Science Laboratory (PICSL), Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - Sadhana Ravikumar
- Penn Image Computing and Science Laboratory (PICSL), Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - Pulkit Khandelwal
- Penn Image Computing and Science Laboratory (PICSL), Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - Trevor Glenn
- Penn Image Computing and Science Laboratory (PICSL), Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - Anica Luther
- Department of Diagnostic Radiology, Lund University, Lund, Sweden
| | - Sydney Lim
- Penn Image Computing and Science Laboratory (PICSL), Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - David A Wolk
- Penn Memory Center, University of Pennsylvania, Philadelphia, USA; Department of Neurology, University of Pennsylvania, Philadelphia, USA
| | - Paul A Yushkevich
- Penn Image Computing and Science Laboratory (PICSL), Department of Radiology, University of Pennsylvania, Philadelphia, USA
| |
Collapse
|
8
|
Sone D. Neurobiological mechanisms of psychosis in epilepsy: Findings from neuroimaging studies. Front Psychiatry 2022; 13:1079295. [PMID: 36506456 PMCID: PMC9728542 DOI: 10.3389/fpsyt.2022.1079295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 11/08/2022] [Indexed: 11/24/2022] Open
Abstract
Despite the high prevalence and clinical importance of comorbid psychosis in epilepsy, its neurobiological mechanisms remain understudied. This narrative mini-review aims to provide an overview of recent updates in in vivo neuroimaging studies on psychosis in epilepsy, including structural and diffusion magnetic resonance imaging (MRI) and functional and molecular imaging, and to discuss future directions in this field. While the conventional morphological analysis of structural MRI has provided relatively inconsistent results, advanced methods, including brain network analysis, hippocampal subregion volumetry, and machine learning models, have recently provided novel findings. Diffusion MRI, for example, has revealed a reduction in white matter integrity mainly in the frontal and temporal lobes, as well as a disruption of brain white matter networks. Functional neuroimaging, such as perfusion single-photon emission computed tomography (SPECT) or fluorodeoxyglucose positron emission tomography (FDG-PET), often identifies hyperactivity in various brain regions. The current limitations of these more recent studies may include small and sometimes heterogeneous samples, insufficient control groups, the effects of psychoactive drugs, and the lack of longitudinal analysis. Further investigations are required to establish novel treatments and identify clinical diagnostic or disease-monitoring biomarkers in psychosis in epilepsy.
Collapse
Affiliation(s)
- Daichi Sone
- Department of Psychiatry, Jikei University School of Medicine, Tokyo, Japan
| |
Collapse
|
9
|
Jo H, Kim J, Kim D, Hwang Y, Seo D, Hong S, Shon YM. Lateralizing Characteristics of Morphometric Changes to Hippocampus and Amygdala in Unilateral Temporal Lobe Epilepsy with Hippocampal Sclerosis. Medicina (B Aires) 2022; 58:medicina58040480. [PMID: 35454319 PMCID: PMC9029741 DOI: 10.3390/medicina58040480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 03/21/2022] [Accepted: 03/23/2022] [Indexed: 11/16/2022] Open
Abstract
Background andObjective: In the present study, a detailed investigation of substructural volume change in the hippocampus (HC) and amygdala (AMG) was performed and the association with clinical features in patients with mesial temporal lobe epilepsy with hippocampal sclerosis (TLE-HS) determined. Methods: The present study included 22 patients with left-sided TLE-HS (LTLE-HS) and 26 patients with right-sided TLE-HS (RTLE-HS). In addition, 28 healthy controls underwent high-resolution T2-weighted image (T2WI) and T1-weighted image (T1WI) MRI scanning. Subfield analysis of HC and AMG was performed using FreeSurfer version 6.0. Results: Patients with TLE-HS showed a decrease in the volume of substructures in both HC and AMG, and this change was observed on the contralateral side and the ipsilateral side with HS. The volume reduction pattern of substructures showed laterality-dependent characteristics. Patients with LTLE-HS had smaller volumes of the ipsilateral subiculum (SUB), contralateral SUB, and ipsilateral cortical nucleus of AMG than patients with RTLE-HS. Patients with RTLE-HS had reduced ipsilateral cornu ammonis (CA) 2/3 and contralateral cortico-amygdaloid transition area (CAT) volumes. The relationship between clinical variables and subregions was different based on the lateralization of the seizure focus. Focal to bilateral tonic-clonic seizures (FTBTCS) was associated with contralateral and ipsilateral side subregions only in LTLE-HS. The abdominal FAS was associated with the volume reduction of AMG subregions only in LTLE-HS, but the volume reduction was less than in patients without FAS. Conclusions: The results indicate that unilateral TLE-HS is a bilateral disease that shows different laterality-dependent characteristics based on the subfield analysis of HC and AMG. Subfield volumes of HC and AMG were associated with clinical variables, and the more damaged substructures depended on laterality in TLE-HS. These findings support the evidence that LTLE-HS and RTLE-HS are disparate epilepsy entities rather than simply identical syndromes harboring a mesial temporal lesion. In addition, the presence of FAS supports good localization value, and abdominal FAS has a high localization value, especially in patients with LTLE-HS.
Collapse
Affiliation(s)
- Hyunjin Jo
- Samsung Medical Center, Department of Neurology, Sungkyunkwan University School of Medicine, Seoul 06355, Korea; (H.J.); (J.K.); (D.S.); (S.H.)
| | - Jeongsik Kim
- Samsung Medical Center, Department of Neurology, Sungkyunkwan University School of Medicine, Seoul 06355, Korea; (H.J.); (J.K.); (D.S.); (S.H.)
| | - Dongyeop Kim
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul 03760, Korea;
| | - Yoonha Hwang
- Department of Neurology, The Catholic University of Korea Eunpyeong St. Mary’s Hospital, Seoul 07345, Korea;
| | - Daewon Seo
- Samsung Medical Center, Department of Neurology, Sungkyunkwan University School of Medicine, Seoul 06355, Korea; (H.J.); (J.K.); (D.S.); (S.H.)
| | - Seungbong Hong
- Samsung Medical Center, Department of Neurology, Sungkyunkwan University School of Medicine, Seoul 06355, Korea; (H.J.); (J.K.); (D.S.); (S.H.)
| | - Young-Min Shon
- Samsung Medical Center, Department of Neurology, Sungkyunkwan University School of Medicine, Seoul 06355, Korea; (H.J.); (J.K.); (D.S.); (S.H.)
- Department of Medical Device Management and Research, Samsung Advanced Institute for Health Sciences & Technology (SAHIST), Sunkyunkwan University, Seoul 06355, Korea
- Correspondence: ; Tel.: +82-2-3410-2701
| |
Collapse
|
10
|
Niaz MR, Ridwan AR, Wu Y, Bennett DA, Arfanakis K. Development and evaluation of a high resolution 0.5mm isotropic T1-weighted template of the older adult brain. Neuroimage 2022; 248:118869. [PMID: 34986396 PMCID: PMC8855670 DOI: 10.1016/j.neuroimage.2021.118869] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 12/08/2021] [Accepted: 12/29/2021] [Indexed: 10/28/2022] Open
Abstract
Investigating the structure of the older adult brain at high spatial resolution is of high significance, and a dedicated older adult structural brain template with sub-millimeter resolution is currently lacking. Therefore, the purpose of this work was twofold: (A) to develop a 0.5mm isotropic resolution standardized T1-weighted template of the older adult brain by applying principles of super resolution to high quality MRI data from 222 older adults (65-95 years of age), and (B) to systematically compare the new template to other standardized and study-specific templates in terms of image quality and performance when used as a reference for alignment of older adult data. The new template exhibited higher spatial resolution and improved visualization of fine structural details of the older adult brain compared to a template constructed using a conventional template building approach and the same data. In addition, the new template exhibited higher image sharpness and did not contain image artifacts observed in some of the other templates considered in this work. Due to the above enhancements, the new template provided higher inter-subject spatial normalization precision for older adult data compared to the other templates, and consequently enabled detection of smaller inter-group morphometric differences in older adult data. Finally, the new template was among those that were most representative of older adult brain data. Overall, the new template constructed here is an important resource for studies of aging, and the findings of the present work have important implications in template selection for investigations on older adults.
Collapse
Affiliation(s)
- Mohammad Rakeen Niaz
- Department of Biomedical Engineering, Illinois Institute of Technology, 3440 S Dearborn St, M-100, Chicago, IL 60616, United States
| | - Abdur Raquib Ridwan
- Department of Biomedical Engineering, Illinois Institute of Technology, 3440 S Dearborn St, M-100, Chicago, IL 60616, United States
| | - Yingjuan Wu
- Department of Biomedical Engineering, Illinois Institute of Technology, 3440 S Dearborn St, M-100, Chicago, IL 60616, United States
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, United States
| | - Konstantinos Arfanakis
- Department of Biomedical Engineering, Illinois Institute of Technology, 3440 S Dearborn St, M-100, Chicago, IL 60616, United States; Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, United States; Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, Chicago, IL, United States.
| |
Collapse
|
11
|
Abdelgawad EA, Mounir SM, Abdelhay MM, Ameen MA. Magnetic resonance imaging (MRI) volumetry in children with nonlesional epilepsy, does it help? THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2021. [DOI: 10.1186/s43055-021-00409-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Epilepsy is a chronic condition characterized by repeated spontaneous seizures. It affects up to 1% of the population worldwide. Children with magnetic resonance imaging (MRI) negative (or “nonlesional”) focal epilepsy constitute the most challenging pharmacoresistant group undergoing pre-neurosurgical evaluation. Volumetric magnetic resonance imaging (VMRI) is a non-invasive brain imaging technique done to measure the volume and structure of specific regions of the brain. It is useful for many things, but primarily for discovering atrophy (wasting away of body tissue) and measuring its progression. The aim of this study is to assess role of volumetric magnetic resonance imaging in evaluation of nonlesional childhood epilepsy in which no specific findings detected in conventional MRI.
Results
There were 20 children with normal MRI brain volumetry (33.3%) and 40 children (66.6%) with abnormal MRI brain volumetry.
Grey matter volume in the abnormal group was significantly higher (P value was 0.001*) than the normal group (mean ± S.D 934.04 ± 118.12 versus 788.57 ± 57.71 respectively). White matter volume in the abnormal group was significantly smaller (P value was < 0.0001*) than in the normal group (mean ± S.D 217.79 ± 65.22 versus 418.07 ± 103.76 respectively). Right hippocampus CA4-DG volume in the abnormal volume group was found to be significantly smaller (P value < 0.0001*) than that of the normal group volume (mean ± S.D 0.095 ± 0.04 versus 0.32 ± 0.36 respectively). Right hippocampus subiculum volume in the abnormal volume group were found to be significantly smaller (P value was < 0.0001*) than that of the normal group volume (mean ± S.D 0.42 ± 0.11 versus 0.84 ± 0.09 respectively). Thalamus volume in the abnormal group was significantly smaller (P value 0.048*) than in the normal group (mean ± S.D 10.235 ± 3.22 versus 11.82 ± 0.75 respectively). Right thalamus was significantly smaller (P value was 0.028*) than in the normal group (mean ± S.D 5.01 ± 1.62 versus 5.91 ± 0.39 respectively). The sensitivity of the right hippocampus subiculum volume and right hippocampus CA4-DG was 100%. The sensitivity of white matter volume and grey matter volume and thalamus was 85% and 75% and 55% respectively. The specificity of the right hippocampus subiculum volume and right hippocampus CA4-DG was 90% and 90% respectively. The specificity of the right hippocampus subiculum volume and right hippocampus CA4-DG and grey matter volume and white matter volume and total hippocampus and thalamus was 100%. The specificity of brain volume was 60%. The accuracy of the right hippocampus subiculum volume and right hippocampus CA4-DG was 100%. The specificity of white matter volume, grey matter volume, thalamus, total hippocampus, and brain volume was 97%, 87%, 65%, 61%, and 57% respectively.
Conclusion
Volumetric magnetic resonance imaging is a promising imaging technique that can provide assistance in evaluation of nonlesional pharmacoresistant childhood epilepsy.
Collapse
|
12
|
Pai A, Marcuse LV, Alper J, Delman BN, Rutland JW, Feldman RE, Hof PR, Fields M, Young J, Balchandani P. Detection of Hippocampal Subfield Asymmetry at 7T With Automated Segmentation in Epilepsy Patients With Normal Clinical Strength MRIs. Front Neurol 2021; 12:682615. [PMID: 34867703 PMCID: PMC8634833 DOI: 10.3389/fneur.2021.682615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 10/21/2021] [Indexed: 12/05/2022] Open
Abstract
While the etiology of hippocampal sclerosis (HS) in epilepsy patients remains unknown, distinct phenotypes of hippocampal subfield atrophy have been associated with different clinical presentations and surgical outcomes. The advent of novel techniques including ultra-high field 7T magnetic resonance imaging (MRI) and automated subfield volumetry have further enabled detection of hippocampal pathology in patients with epilepsy, however, studies combining both 7T MRI and automated segmentation in epilepsy patients with normal-appearing clinical MRI are limited. In this study, we present a novel application of the automated segmentation of hippocampal subfields (ASHS) software to determine subfield volumes of the CA1, CA2/3, CA4/DG, and the subiculum using ultra high-field 7T MRI scans, including T1-weighted MP2RAGE and T2-TSE sequences, in 27 patients with either mesial temporal lobe epilepsy (mTLE) or neocortical epilepsy (NE) compared to age and gender matched healthy controls. We found that 7T improved visualization of structural abnormalities not otherwise seen on clinical strength MRIs in patients with unilateral mTLE. Additionally, our automated segmentation algorithm was able to detect structural differences in volume and asymmetry across hippocampal subfields in unilateral mTLE patients compared to controls. Specifically, amongst unilateral mTLE patients with longer disease durations, volume loss was observed in the ipsilateral CA1 and CA2/3 subfields and contralateral CA1. There were no differences in subfield volumes in patients with NE compared to controls. We report the first application of 7T with automated segmentation to characterize the relationship between disease duration burden and asymmetry across specific hippocampal subfields in this population. Disease duration was found to have a statistically significant positive relationship with subfield asymmetry within the unilateral mTLE cohort. These findings highlight the ability of 7T MRI and automated segmentation to provide novel qualitative and quantitative information in epilepsy patients who are otherwise MRI-negative at clinical field strengths.
Collapse
Affiliation(s)
- Akila Pai
- Icahn School of Medicine at Mount Sinai, New York, NY, United States
- *Correspondence: Akila Pai
| | - Lara V. Marcuse
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Judy Alper
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Bradley N. Delman
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - John W. Rutland
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Rebecca E. Feldman
- Department of Computer Science, Math, Physics, and Statistics, University of British Columbia, Okanagan, BC, Canada
| | - Patrick R. Hof
- Nash Family Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Madeline Fields
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - James Young
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Priti Balchandani
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| |
Collapse
|
13
|
Mizutani M, Sone D, Sano T, Kimura Y, Maikusa N, Shigemoto Y, Goto Y, Takao M, Iwasaki M, Matsuda H, Sato N, Saito Y. Histopathological validation and clinical correlates of hippocampal subfield volumetry based on T2-weighted MRI in temporal lobe epilepsy with hippocampal sclerosis. Epilepsy Res 2021; 177:106759. [PMID: 34521044 DOI: 10.1016/j.eplepsyres.2021.106759] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 08/13/2021] [Accepted: 09/07/2021] [Indexed: 12/01/2022]
Abstract
The objectives of this study were 1) to histologically validate the hippocampal subfield volumetry based on T2-weighted MRI, and 2) to explore its clinical impact on postsurgical memory function and seizure outcome in temporal lobe epilepsy (TLE) with hippocampal sclerosis (HS). We analyzed the cases of 24 patients with medial TLE (12 left, 12 right) and HS who were preoperatively examined with T2-weighted high-resolution MRI. The volume of each hippocampal subfield was calculated with an automatic segmentation of hippocampal subfields (ASHS) program. Hippocampal sclerosis patterns were determined pathologically, and the cross-sectional area and neuronal cell density of the CA1 and CA4 subfields were calculated using tissue specimens. Pre- and postoperative memory evaluations based on the Wechsler Memory Scale-Revised (WMS-R) were performed. We compared the presurgical MRI-based volumes with the pathological measurements in each subfield and then compared them with the change in the patients' neurocognitive function. As a result, there was a significant relationship between the presurgical MRI-based volume of CA4/dentate gyrus (DG) and the cross-sectional area of CA4 calculated with tissue specimens (Spearman's rs = 0.482, p = 0.023), and a similar trend-level correlation was observed in CA1 (rs = 0.455, p = 0.058). Some of MRI-based or pathology-based parameters in the subfields preliminarily showed relationships with the postsurgical memory changes. In conclusion, automated subfield volumetry for patients with hippocampal sclerosis moderately reflects their subfield atrophy and might be useful to predict the postsurgical change of memory function in these patients.
Collapse
Affiliation(s)
- Masashi Mizutani
- Department of Laboratory Medicine, National Center of Neurology and Psychiatry, Tokyo, Japan; Department of Neuropsychiatry, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan.
| | - Daichi Sone
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Tokyo, Japan; Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK; Department of Psychiatry, The Jikei University School of Medicine, 3-25-8 Nishishimbashi, Minato, Tokyo, 105-8461, Japan.
| | - Terunori Sano
- Department of Laboratory Medicine, National Center of Neurology and Psychiatry, Tokyo, Japan.
| | - Yukio Kimura
- Department of Radiology, National Center of Neurology and Psychiatry, Tokyo, Japan.
| | - Norihide Maikusa
- Department of Radiology, National Center of Neurology and Psychiatry, Tokyo, Japan.
| | - Yoko Shigemoto
- Department of Radiology, National Center of Neurology and Psychiatry, Tokyo, Japan.
| | - Yuichi Goto
- Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo, Japan.
| | - Masaki Takao
- Department of Laboratory Medicine, National Center of Neurology and Psychiatry, Tokyo, Japan.
| | - Masaki Iwasaki
- Department of Neurosurgery, National Center of Neurology and Psychiatry, Tokyo, Japan.
| | - Hiroshi Matsuda
- Department of Radiology, National Center of Neurology and Psychiatry, Tokyo, Japan.
| | - Noriko Sato
- Department of Radiology, National Center of Neurology and Psychiatry, Tokyo, Japan.
| | - Yuko Saito
- Department of Laboratory Medicine, National Center of Neurology and Psychiatry, Tokyo, Japan; Department of Neuropathology, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
| |
Collapse
|
14
|
Liu C, Ye Z, Chen C, Axmacher N, Xue G. Hippocampal Representations of Event Structure and Temporal Context during Episodic Temporal Order Memory. Cereb Cortex 2021; 32:1520-1534. [PMID: 34464439 DOI: 10.1093/cercor/bhab304] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 07/31/2021] [Accepted: 08/01/2021] [Indexed: 11/13/2022] Open
Abstract
The hippocampus plays an important role in representing spatial locations and sequences and in transforming representations. How these representational structures and operations support memory for the temporal order of random items is still poorly understood. We addressed this question by leveraging the method of loci, a powerful mnemonic strategy for temporal order memory that particularly recruits hippocampus-dependent computations of spatial locations and associations. Applying representational similarity analysis to functional magnetic resonance imaging activation patterns revealed that hippocampal subfields contained representations of multiple features of sequence structure, including spatial locations, location distance, and sequence boundaries, as well as episodic-like temporal context. Critically, the hippocampal CA1 exhibited spatial transformation of representational patterns, showing lower pattern similarity for items in same locations than closely matched different locations during retrieval, whereas the CA23DG exhibited sequential transformation of representational patterns, showing lower pattern similarity for items in near locations than in far locations during encoding. These transformations enabled the encoding of multiple items in the same location and disambiguation of adjacent items. Our results suggest that the hippocampus can flexibly reconfigure multiplexed event structure representations to support accurate temporal order memory.
Collapse
Affiliation(s)
- Chuqi Liu
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute of Brain Research, Beijing Normal University, Beijing 100875, PR China
| | - Zhifang Ye
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute of Brain Research, Beijing Normal University, Beijing 100875, PR China.,Department of Psychology, University of Oregon, Eugene, OR 97403, USA
| | - Chuansheng Chen
- Department of Psychological Science, University of California, Irvine, CA 92697, USA
| | - Nikolai Axmacher
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute of Brain Research, Beijing Normal University, Beijing 100875, PR China.,Department of Neuropsychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr University Bochum, Bochum 44801, Germany
| | - Gui Xue
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute of Brain Research, Beijing Normal University, Beijing 100875, PR China
| |
Collapse
|
15
|
Princich JP, Donnelly-Kehoe PA, Deleglise A, Vallejo-Azar MN, Pascariello GO, Seoane P, Veron Do Santos JG, Collavini S, Nasimbera AH, Kochen S. Diagnostic Performance of MRI Volumetry in Epilepsy Patients With Hippocampal Sclerosis Supported Through a Random Forest Automatic Classification Algorithm. Front Neurol 2021; 12:613967. [PMID: 33692740 PMCID: PMC7937810 DOI: 10.3389/fneur.2021.613967] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 01/18/2021] [Indexed: 01/07/2023] Open
Abstract
Introduction: Several methods offer free volumetry services for MR data that adequately quantify volume differences in the hippocampus and its subregions. These methods are frequently used to assist in clinical diagnosis of suspected hippocampal sclerosis in temporal lobe epilepsy. A strong association between severity of histopathological anomalies and hippocampal volumes was reported using MR volumetry with a higher diagnostic yield than visual examination alone. Interpretation of volumetry results is challenging due to inherent methodological differences and to the reported variability of hippocampal volume. Furthermore, normal morphometric differences are recognized in diverse populations that may need consideration. To address this concern, we highlighted procedural discrepancies including atlas definition and computation of total intracranial volume that may impact volumetry results. We aimed to quantify diagnostic performance and to propose reference values for hippocampal volume from two well-established techniques: FreeSurfer v.06 and volBrain-HIPS. Methods: Volumetry measures were calculated using clinical T1 MRI from a local population of 61 healthy controls and 57 epilepsy patients with confirmed unilateral hippocampal sclerosis. We further validated the results by a state-of-the-art machine learning classification algorithm (Random Forest) computing accuracy and feature relevance to distinguish between patients and controls. This validation process was performed using the FreeSurfer dataset alone, considering morphometric values not only from the hippocampus but also from additional non-hippocampal brain regions that could be potentially relevant for group classification. Mean reference values and 95% confidence intervals were calculated for left and right hippocampi along with hippocampal asymmetry degree to test diagnostic accuracy. Results: Both methods showed excellent classification performance (AUC:> 0.914) with noticeable differences in absolute (cm3) and normalized volumes. Hippocampal asymmetry was the most accurate discriminator from all estimates (AUC:1~0.97). Similar results were achieved in the validation test with an automatic classifier (AUC:>0.960), disclosing hippocampal structures as the most relevant features for group differentiation among other brain regions. Conclusion: We calculated reference volumetry values from two commonly used methods to accurately identify patients with temporal epilepsy and hippocampal sclerosis. Validation with an automatic classifier confirmed the principal role of the hippocampus and its subregions for diagnosis.
Collapse
Affiliation(s)
- Juan Pablo Princich
- ENyS (Estudios en Neurociencias y Sistemas Complejos), Consejo Nacional de Investigaciones Científicas y Técnicas, Universidad Nacional Arturo Jauretche y Hospital El Cruce, Florencio Varela, Argentina.,Hospital de Pediatría J.P Garrahan, Departamento de Neuroimágenes, Buenos Aires, Argentina
| | - Patricio Andres Donnelly-Kehoe
- Centro Internacional Franco Argentino de Ciencias de la Información y de Sistemas (CIFASIS) - Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Grupo de Procesamiento de Señales Multimedia - División Neuroimágenes, Universidad Nacional de Rosario, Rosario, Argentina
| | - Alvaro Deleglise
- Instituto de Fisiología y Biofísica B. Houssay (IFIBIO), Consejo Nacional de Investigaciones Científicas y Técnicas, Departamento de Fisiología y Biofísica, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Mariana Nahir Vallejo-Azar
- ENyS (Estudios en Neurociencias y Sistemas Complejos), Consejo Nacional de Investigaciones Científicas y Técnicas, Universidad Nacional Arturo Jauretche y Hospital El Cruce, Florencio Varela, Argentina
| | - Guido Orlando Pascariello
- Centro Internacional Franco Argentino de Ciencias de la Información y de Sistemas (CIFASIS) - Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Grupo de Procesamiento de Señales Multimedia - División Neuroimágenes, Universidad Nacional de Rosario, Rosario, Argentina
| | - Pablo Seoane
- ENyS (Estudios en Neurociencias y Sistemas Complejos), Consejo Nacional de Investigaciones Científicas y Técnicas, Universidad Nacional Arturo Jauretche y Hospital El Cruce, Florencio Varela, Argentina.,Hospital J.M Ramos Mejía, Centro de Epilepsia, Buenos Aires, Argentina
| | - Jose Gabriel Veron Do Santos
- ENyS (Estudios en Neurociencias y Sistemas Complejos), Consejo Nacional de Investigaciones Científicas y Técnicas, Universidad Nacional Arturo Jauretche y Hospital El Cruce, Florencio Varela, Argentina
| | - Santiago Collavini
- ENyS (Estudios en Neurociencias y Sistemas Complejos), Consejo Nacional de Investigaciones Científicas y Técnicas, Universidad Nacional Arturo Jauretche y Hospital El Cruce, Florencio Varela, Argentina.,Instituto de investigación en Electrónica, Control y Procesamiento de Señales (LEICI), Universidad Nacional de La Plata-Consejo Nacional de Investigaciones Científicas y Técnicas, La Plata, Argentina.,Instituto de Ingeniería y Agronomía, Universidad Nacional Arturo Jauretche, Florencio Varela, Argentina
| | - Alejandro Hugo Nasimbera
- ENyS (Estudios en Neurociencias y Sistemas Complejos), Consejo Nacional de Investigaciones Científicas y Técnicas, Universidad Nacional Arturo Jauretche y Hospital El Cruce, Florencio Varela, Argentina.,Hospital J.M Ramos Mejía, Centro de Epilepsia, Buenos Aires, Argentina
| | - Silvia Kochen
- ENyS (Estudios en Neurociencias y Sistemas Complejos), Consejo Nacional de Investigaciones Científicas y Técnicas, Universidad Nacional Arturo Jauretche y Hospital El Cruce, Florencio Varela, Argentina
| |
Collapse
|
16
|
Sasabayashi D, Yoshimura R, Takahashi T, Takayanagi Y, Nishiyama S, Higuchi Y, Mizukami Y, Furuichi A, Kido M, Nakamura M, Noguchi K, Suzuki M. Reduced Hippocampal Subfield Volume in Schizophrenia and Clinical High-Risk State for Psychosis. Front Psychiatry 2021; 12:642048. [PMID: 33828496 PMCID: PMC8019805 DOI: 10.3389/fpsyt.2021.642048] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 02/19/2021] [Indexed: 11/13/2022] Open
Abstract
Magnetic resonance imaging (MRI) studies in schizophrenia demonstrated volume reduction in hippocampal subfields divided on the basis of specific cytoarchitecture and function. However, it remains unclear whether this abnormality exists prior to the onset of psychosis and differs across illness stages. MRI (3 T) scans were obtained from 77 patients with schizophrenia, including 24 recent-onset and 40 chronic patients, 51 individuals with an at-risk mental state (ARMS) (of whom 5 subsequently developed psychosis within the follow-up period), and 87 healthy controls. Using FreeSurfer software, hippocampal subfield volumes were measured and compared across the groups. Both schizophrenia and ARMS groups exhibited significantly smaller volumes for the bilateral Cornu Ammonis 1 area, left hippocampal tail, and right molecular layer of the hippocampus than the healthy control group. Within the schizophrenia group, chronic patients exhibited a significantly smaller volume for the left hippocampal tail than recent-onset patients. The left hippocampal tail volume was positively correlated with onset age, and negatively correlated with duration of psychosis and duration of medication in the schizophrenia group. Reduced hippocampal subfield volumes observed in both schizophrenia and ARMS groups may represent a common biotype associated with psychosis vulnerability. Volumetric changes of the left hippocampal tail may also suggest ongoing atrophy after the onset of schizophrenia.
Collapse
Affiliation(s)
- Daiki Sasabayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Ryo Yoshimura
- Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Yoichiro Takayanagi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Arisawabashi Hospital, Toyama, Japan
| | - Shimako Nishiyama
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Health Administration Center, University of Toyama, Toyama, Japan
| | - Yuko Higuchi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Yuko Mizukami
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Atsushi Furuichi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Mikio Kido
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Mihoko Nakamura
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Kyo Noguchi
- Department of Radiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Michio Suzuki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| |
Collapse
|
17
|
Sämann PG, Iglesias JE, Gutman B, Grotegerd D, Leenings R, Flint C, Dannlowski U, Clarke‐Rubright EK, Morey RA, Erp TG, Whelan CD, Han LKM, Velzen LS, Cao B, Augustinack JC, Thompson PM, Jahanshad N, Schmaal L. FreeSurfer
‐based segmentation of hippocampal subfields: A review of methods and applications, with a novel quality control procedure for
ENIGMA
studies and other collaborative efforts. Hum Brain Mapp 2020; 43:207-233. [PMID: 33368865 PMCID: PMC8805696 DOI: 10.1002/hbm.25326] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 11/26/2020] [Accepted: 12/13/2020] [Indexed: 12/11/2022] Open
Abstract
Structural hippocampal abnormalities are common in many neurological and psychiatric disorders, and variation in hippocampal measures is related to cognitive performance and other complex phenotypes such as stress sensitivity. Hippocampal subregions are increasingly studied, as automated algorithms have become available for mapping and volume quantification. In the context of the Enhancing Neuro Imaging Genetics through Meta Analysis Consortium, several Disease Working Groups are using the FreeSurfer software to analyze hippocampal subregion (subfield) volumes in patients with neurological and psychiatric conditions along with data from matched controls. In this overview, we explain the algorithm's principles, summarize measurement reliability studies, and demonstrate two additional aspects (subfield autocorrelation and volume/reliability correlation) with illustrative data. We then explain the rationale for a standardized hippocampal subfield segmentation quality control (QC) procedure for improved pipeline harmonization. To guide researchers to make optimal use of the algorithm, we discuss how global size and age effects can be modeled, how QC steps can be incorporated and how subfields may be aggregated into composite volumes. This discussion is based on a synopsis of 162 published neuroimaging studies (01/2013–12/2019) that applied the FreeSurfer hippocampal subfield segmentation in a broad range of domains including cognition and healthy aging, brain development and neurodegeneration, affective disorders, psychosis, stress regulation, neurotoxicity, epilepsy, inflammatory disease, childhood adversity and posttraumatic stress disorder, and candidate and whole genome (epi‐)genetics. Finally, we highlight points where FreeSurfer‐based hippocampal subfield studies may be optimized.
Collapse
Affiliation(s)
| | - Juan Eugenio Iglesias
- Centre for Medical Image Computing University College London London UK
- The Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology Massachusetts General Hospital/Harvard Medical School Boston Massachusetts US
- Computer Science and AI Laboratory (CSAIL), Massachusetts Institute of Technology (MIT) Cambridge Massachusetts US
| | - Boris Gutman
- Department of Biomedical Engineering Illinois Institute of Technology Chicago USA
| | | | - Ramona Leenings
- Department of Psychiatry University of Münster Münster Germany
| | - Claas Flint
- Department of Psychiatry University of Münster Münster Germany
- Department of Mathematics and Computer Science University of Münster Germany
| | - Udo Dannlowski
- Department of Psychiatry University of Münster Münster Germany
| | - Emily K. Clarke‐Rubright
- Brain Imaging and Analysis Center, Duke University Durham North Carolina USA
- VISN 6 MIRECC, Durham VA Durham North Carolina USA
| | - Rajendra A. Morey
- Brain Imaging and Analysis Center, Duke University Durham North Carolina USA
- VISN 6 MIRECC, Durham VA Durham North Carolina USA
| | - Theo G.M. Erp
- Clinical Translational Neuroscience Laboratory, Department of Psychiatry and Human Behavior University of California Irvine California USA
- Center for the Neurobiology of Learning and Memory University of California Irvine Irvine California USA
| | - Christopher D. Whelan
- Imaging Genetics Center Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California Los Angeles California USA
| | - Laura K. M. Han
- Department of Psychiatry Amsterdam University Medical Centers, Vrije Universiteit and GGZ inGeest, Amsterdam Neuroscience Amsterdam The Netherlands
| | - Laura S. Velzen
- Orygen Parkville Australia
- Centre for Youth Mental Health The University of Melbourne Melbourne Australia
| | - Bo Cao
- Department of Psychiatry, Faculty of Medicine & Dentistry University of Alberta Edmonton Canada
| | - Jean C. Augustinack
- The Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology Massachusetts General Hospital/Harvard Medical School Boston Massachusetts US
| | - Paul M. Thompson
- Imaging Genetics Center Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California Los Angeles California USA
| | - Neda Jahanshad
- Imaging Genetics Center Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California Los Angeles California USA
| | - Lianne Schmaal
- Orygen Parkville Australia
- Centre for Youth Mental Health The University of Melbourne Melbourne Australia
| |
Collapse
|
18
|
Canjels LP, Backes WH, van Veenendaal TM, Vlooswijk MC, Hofman PA, Aldenkamp AP, Rouhl RP, Jansen JF. Volumetric and Functional Activity Lateralization in Healthy Subjects and Patients with Focal Epilepsy: Initial Findings in a 7T MRI Study. J Neuroimaging 2020; 30:666-673. [PMID: 32472965 PMCID: PMC7586826 DOI: 10.1111/jon.12739] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/20/2020] [Accepted: 05/20/2020] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND AND PURPOSE In 30% of the patients with focal epilepsy, an epileptogenic lesion cannot be visually detected with structural MRI. Ultra-high field MRI may be able to identify subtle pathology related to the epileptic focus. We set out to assess 7T MRI-derived volumetric and functional activity lateralization of the hippocampus, hippocampal subfields, temporal and frontal lobe in healthy subjects and MRI-negative patients with focal epilepsy. METHODS Twenty controls and 10 patients with MRI-negative temporal or frontal lobe epilepsy (TLE and FLE, respectively) underwent a 7T MRI exam. T1 -weigthed imaging and resting-state fMRI was performed. T1 -weighted images were segmented to yield volumes, while from fMRI data, the fractional amplitude of low frequency fluctuations was calculated. Subsequently, volumetric and functional lateralization was calculated from left-right asymmetry. RESULTS In controls, volumetric lateralization was symmetric, with a slight asymmetry of the hippocampus and subiculum, while functional lateralization consistently showed symmetry. Contrarily, in epilepsy patients, regions were less symmetric. In TLE patients with known focus, volumetric lateralization in the hippocampus and hippocampal subfields was indicative of smaller ipsilateral volumes. These patients also showed clear functional lateralization, though not consistently ipsilateral or contralateral to the epileptic focus. TLE patients with unknown focus showed an obvious volumetric lateralization, facilitating the localization of the epileptic focus. Lateralization results in the FLE patients were less consistent with the epileptic focus. CONCLUSION MRI-derived volume and fluctuation amplitude are highly symmetric in controls, whereas in TLE, volumetric and functional lateralization effects were observed. This highlights the potential of the technique.
Collapse
Affiliation(s)
- Lisanne P.W. Canjels
- Departments of Radiology and Nuclear MedicineMaastricht University Medical CenterMaastrichtThe Netherlands
- School for Mental Health and NeuroscienceMaastricht UniversityMaastrichtThe Netherlands
- Department of Electrical EngineeringEindhoven University of TechnologyEindhovenThe Netherlands
| | - Walter H. Backes
- Departments of Radiology and Nuclear MedicineMaastricht University Medical CenterMaastrichtThe Netherlands
- School for Mental Health and NeuroscienceMaastricht UniversityMaastrichtThe Netherlands
- School for Cardiovascular DisordersMaastricht UniversityMaastrichtThe Netherlands
| | - Tamar M. van Veenendaal
- Departments of Radiology and Nuclear MedicineMaastricht University Medical CenterMaastrichtThe Netherlands
- School for Mental Health and NeuroscienceMaastricht UniversityMaastrichtThe Netherlands
| | - Marielle C.G. Vlooswijk
- School for Mental Health and NeuroscienceMaastricht UniversityMaastrichtThe Netherlands
- Department of NeurologyMaastricht University Medical CenterMaastrichtThe Netherlands
- Academic Center for Epileptology Kempenhaeghe/Maastricht UMC+MaastrichtThe Netherlands
| | - Paul A.M. Hofman
- Departments of Radiology and Nuclear MedicineMaastricht University Medical CenterMaastrichtThe Netherlands
| | - Albert P. Aldenkamp
- School for Mental Health and NeuroscienceMaastricht UniversityMaastrichtThe Netherlands
- Department of Electrical EngineeringEindhoven University of TechnologyEindhovenThe Netherlands
- Department of NeurologyMaastricht University Medical CenterMaastrichtThe Netherlands
- Academic Center for Epileptology Kempenhaeghe/Maastricht UMC+MaastrichtThe Netherlands
| | - Rob P.W. Rouhl
- School for Mental Health and NeuroscienceMaastricht UniversityMaastrichtThe Netherlands
- Department of NeurologyMaastricht University Medical CenterMaastrichtThe Netherlands
- Academic Center for Epileptology Kempenhaeghe/Maastricht UMC+MaastrichtThe Netherlands
| | - Jacobus F.A. Jansen
- Departments of Radiology and Nuclear MedicineMaastricht University Medical CenterMaastrichtThe Netherlands
- School for Mental Health and NeuroscienceMaastricht UniversityMaastrichtThe Netherlands
- Department of Electrical EngineeringEindhoven University of TechnologyEindhovenThe Netherlands
| |
Collapse
|
19
|
Ke J, Foley LM, Hitchens TK, Richardson RM, Modo M. Ex vivo mesoscopic diffusion MRI correlates with seizure frequency in patients with uncontrolled mesial temporal lobe epilepsy. Hum Brain Mapp 2020; 41:4529-4548. [PMID: 32691978 PMCID: PMC7555080 DOI: 10.1002/hbm.25139] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 06/08/2020] [Accepted: 07/05/2020] [Indexed: 12/28/2022] Open
Abstract
The role of hippocampal connectivity in mesial temporal lobe epilepsy (mTLE) remains poorly understood. The use of ex vivo hippocampal samples excised from patients with mTLE affords mesoscale diffusion magnetic resonance imaging (MRI) to identify individual cell layers, such as the pyramidal (PCL) and granule cell layers (GCL), which are thought to be impacted by seizure activity. Diffusion tensor imaging (DTI) of control (n = 3) and mTLE (n = 7) hippocampi on an 11.7 T MRI scanner allowed us to reveal intra‐hippocampal connectivity and evaluate how epilepsy affected mean (MD), axial (AD), and radial diffusivity (RD), as well as fractional anisotropy (FA). Regional measurements indicated a volume loss in the PCL of the cornu ammonis (CA) 1 subfield in mTLE patients compared to controls, which provided anatomical context. Diffusion measurements, as well as streamline density, were generally higher in mTLE patients compared to controls, potentially reflecting differences due to tissue fixation. mTLE measurements were more variable than controls. This variability was associated with disease severity, as indicated by a strong correlation (r = 0.87) between FA in the stratum radiatum and the frequency of seizures in patients. MD and RD of the PCL in subfields CA3 and CA4 also correlated strongly with disease severity. No correlation of MR measures with disease duration was evident. These results reveal the potential of mesoscale diffusion MRI to examine layer‐specific diffusion changes and connectivity to determine how these relate to clinical measures. Improving the visualization of intra‐hippocampal connectivity will advance the development of novel hypotheses about seizure networks.
Collapse
Affiliation(s)
- Justin Ke
- Department of Radiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Lesley M Foley
- Animal Imaging Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - T Kevin Hitchens
- Animal Imaging Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Neurobiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - R Mark Richardson
- Centre for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Neurological Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Michel Modo
- Department of Radiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Centre for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,McGowan Institute for Regenerative Medicine, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
20
|
Masaki H, Watanabe K, Kakeda S, Ide S, Sugimoto K, Ueda I, Hamamura T, Hisanaga S, Toyota T, Akamatsu N, Shimajiri S, Yamamoto J, Nishizawa S, Adachi H, Korogi Y. Hippocampal sclerosis without visually detectable hippocampal MRI abnormalities: automated subfield volumetric analysis. Jpn J Radiol 2020; 38:1020-1027. [PMID: 32653988 DOI: 10.1007/s11604-020-01019-y] [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: 03/03/2020] [Accepted: 06/19/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE This study aims to investigate hippocampal subfield volumes in patients with hippocampal sclerosis (HS) without visually detectable MRI abnormalities and to determine the diagnostic accuracy using hippocampal subfield volumes. MATERIALS AND METHODS We examined 46 patients with unilateral HS who had a histopathological diagnosis, and 54 controls. The patients were divided into two groups; visually detectable HS (n = 26) and undetectable HS (n = 20) on MRI. The volumes of hippocampal subfield using FreeSurfer were compared among the three groups. Diagnostic accuracy was calculated as the AUC of ROC using cutoff values for each individual subfield. RESULTS Compared with the controls, visually detectable HS showed significantly reduced volumes of all the hippocampal subfields and entire hippocampus, whereas visually undetectable HS showed significant atrophy only in the CA3 and hippocampus-amygdala-transition-area. To diagnose visually undetectable HS, the CA3 volumes had AUC of 0.719, which was higher than AUC of 0.614 based on the entire hippocampal volumes. CONCLUSION Visually undetectable HS demonstrated volume reductions in the CA3. Further, the CA3 volumes was more useful to diagnose visually undetectable HS compared with the entire hippocampal volumes.
Collapse
Affiliation(s)
- Hiromi Masaki
- Department of Radiology, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan
| | - Keita Watanabe
- Department of Radiology, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan. .,Open Innovation Institute, Kyoto University, Kyoto, Japan.
| | - Shingo Kakeda
- Department of Radiology, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.,Department of Diagnostic Radiology, Hirosaki University Graduate School of Medicine Radiology, Aomori, Japan
| | - Satoru Ide
- Department of Radiology, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan
| | - Kohichiro Sugimoto
- Department of Radiology, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan
| | - Issei Ueda
- Department of Radiology, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan
| | - Toshihiko Hamamura
- Department of Radiology, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan
| | - Sachi Hisanaga
- Department of Radiology, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan
| | - Tomoko Toyota
- Department of Neurology, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
| | - Naoki Akamatsu
- Department of Neurology, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan.,Department of Neurology, School of Medicine, International University of Health and Welfare, Otawara, Japan
| | - Shohei Shimajiri
- Department of Pathology and Cell Biology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Junkoh Yamamoto
- Department of Neurosurgery, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Shigeru Nishizawa
- Department of Neurosurgery, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Hiroaki Adachi
- Department of Neurology, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
| | - Yukunori Korogi
- Department of Radiology, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan
| |
Collapse
|
21
|
Jiang H, Guo Y. Multi-class multimodal semantic segmentation with an improved 3D fully convolutional networks. Neurocomputing 2020. [DOI: 10.1016/j.neucom.2018.11.103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
|
22
|
Differential annualized rates of hippocampal subfields atrophy in aging and future Alzheimer's clinical syndrome. Neurobiol Aging 2020; 90:75-83. [PMID: 32107063 DOI: 10.1016/j.neurobiolaging.2020.01.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 01/22/2020] [Accepted: 01/26/2020] [Indexed: 01/22/2023]
Abstract
Several studies have investigated the differential vulnerability of hippocampal subfields during aging and Alzheimer's disease (AD). Results were often contradictory, mainly because these works were based on concatenations of cross-sectional measures in cohorts with different ages or stages of AD, in the absence of a longitudinal design. Here, we investigated 327 participants from a population-based cohort of nondemented older adults with a 14-year clinical follow-up. MRI at baseline and 4 years later were assessed to measure the annualized rates of hippocampal subfields atrophy in each participant using an automatic segmentation pipeline with subsequent quality control. On the one hand, CA4 dentate gyrus was significantly more affected than the other subfields in the whole population (CA1-3: -0.68%/year; subiculum: -0.99%/year; and CA4-DG: -1.39%/year; p < 0.0001). On the other hand, the annualized rate of CA1-3 atrophy was associated with an increased risk of developing Alzheimer's clinical syndrome over time, independently of age, gender, educational level, and ApoE4 genotype (HR = 2.0; CI 95% 1.4-3.0). These results illustrate the natural history of hippocampal subfields atrophy during aging and AD by showing that the dentate gyrus is the most vulnerable subfield to the effects of aging while the cornu-ammonis is the primary target of AD pathophysiological processes, years before symptom onset.
Collapse
|
23
|
Lee HJ, Park KM. Intrinsic hippocampal and thalamic networks in temporal lobe epilepsy with hippocampal sclerosis according to drug response. Seizure 2020; 76:32-38. [PMID: 31986443 DOI: 10.1016/j.seizure.2020.01.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 12/31/2019] [Accepted: 01/15/2020] [Indexed: 12/25/2022] Open
Abstract
PURPOSE The aim of this study was to investigate whether intrinsic hippocampal or thalamic networks in patients with temporal lobe epilepsy (TLE) with hippocampal sclerosis (HS) were different according to antiepileptic drug (AED) response. METHODS We enrolled 80 patients with TLE with HS and 40 healthy controls. Of the patients with TLE with HS, 43 were classified as a drug-resistant epilepsy (DRE) group, whereas 37 patients were enrolled as a drug-controlled epilepsy (DCE) group. We investigated the structural connectivity of the global brain, intrinsic hippocampal, and intrinsic thalamic networks based on structural volumes in the patients with DRE and DCE, and analyzed the differences between them. RESULTS There were significant alterations of the intrinsic hippocampal network compared with healthy controls. The average degree and the global efficiency were decreased, whereas the characteristic path length was increased in the patients with DRE compared with those in healthy controls. In the patients with DCE, only the small-worldness index was decreased compared with healthy controls. Compared to the patients with DCE, the mean clustering coefficient was increased in the patients with DRE. CONCLUSION We found that the intrinsic hippocampal network in patients with TLE with HS was different according to AED response. The patients with DRE had more severe disruptions of the intrinsic hippocampal network than those with DCE compared with healthy controls. These findings suggested that the hippocampal network might be related to AED response and could be a new biomarker of medical outcome in patients with TLE with HS.
Collapse
Affiliation(s)
- Ho-Joon Lee
- Department of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - Kang Min Park
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
| |
Collapse
|
24
|
Vos SB, Winston GP, Goodkin O, Pemberton HG, Barkhof F, Prados F, Galovic M, Koepp M, Ourselin S, Cardoso MJ, Duncan JS. Hippocampal profiling: Localized magnetic resonance imaging volumetry and T2 relaxometry for hippocampal sclerosis. Epilepsia 2019; 61:297-309. [PMID: 31872873 PMCID: PMC7065164 DOI: 10.1111/epi.16416] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 12/02/2019] [Accepted: 12/02/2019] [Indexed: 12/13/2022]
Abstract
Objective Hippocampal sclerosis (HS) is the most common cause of drug‐resistant temporal lobe epilepsy, and its accurate detection is important to guide epilepsy surgery. Radiological features of HS include hippocampal volume loss and increased T2 signal, which can both be quantified to help improve detection. In this work, we extend these quantitative methods to generate cross‐sectional area and T2 profiles along the hippocampal long axis to improve the localization of hippocampal abnormalities. Methods T1‐weighted and T2 relaxometry data from 69 HS patients (32 left, 32 right, 5 bilateral) and 111 healthy controls were acquired on a 3‐T magnetic resonance imaging (MRI) scanner. Automated hippocampal segmentation and T2 relaxometry were performed and used to calculate whole‐hippocampal volumes and to estimate quantitative T2 (qT2) values. By generating a group template from the controls, and aligning this so that the hippocampal long axes were along the anterior‐posterior axis, we were able to calculate hippocampal cross‐sectional area and qT2 by a slicewise method to localize any volume loss or T2 hyperintensity. Individual patient profiles were compared with normative data generated from the healthy controls. Results Profiling of hippocampal volumetric and qT2 data could be performed automatically and reproducibly. HS patients commonly showed widespread decreases in volume and increases in T2 along the length of the affected hippocampus, and focal changes may also be identified. Patterns of atrophy and T2 increase in the left hippocampus were similar between left, right, and bilateral HS. These profiles have potential to distinguish between sclerosis affecting volume and qT2 in the whole or parts of the hippocampus, and may aid the radiological diagnosis in uncertain cases or cases with subtle or focal abnormalities where standard whole‐hippocampal measurements yield normal values. Significance Hippocampal profiling of volumetry and qT2 values can help spatially localize hippocampal MRI abnormalities and work toward improved sensitivity of subtle focal lesions.
Collapse
Affiliation(s)
- Sjoerd B Vos
- Centre for Medical Image Computing, University College London, London, UK.,Epilepsy Society MRI Unit, Chalfont St Peter, UK.,Department of Clinical and Experimental Epilepsy, University College London, London, UK.,Neuroradiological Academic Unit, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Gavin P Winston
- Epilepsy Society MRI Unit, Chalfont St Peter, UK.,Department of Clinical and Experimental Epilepsy, University College London, London, UK.,Division of Neurology, Department of Medicine, Queen's University, Kingston, Canada
| | - Olivia Goodkin
- Centre for Medical Image Computing, University College London, London, UK.,Neuroradiological Academic Unit, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Hugh G Pemberton
- Centre for Medical Image Computing, University College London, London, UK.,Neuroradiological Academic Unit, UCL Queen Square Institute of Neurology, University College London, London, UK.,Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Frederik Barkhof
- Centre for Medical Image Computing, University College London, London, UK.,Neuroradiological Academic Unit, UCL Queen Square Institute of Neurology, University College London, London, UK.,Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, National Health Service Foundation Trust, London, UK.,Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, Faculty of Brain Sciences, UCL Queen Square Institute of Neurology, University College London, London, UK.,Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands
| | - Ferran Prados
- Centre for Medical Image Computing, University College London, London, UK.,Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, Faculty of Brain Sciences, UCL Queen Square Institute of Neurology, University College London, London, UK.,eHealth Center, Open University of Catalonia, Barcelona, Spain
| | - Marian Galovic
- Epilepsy Society MRI Unit, Chalfont St Peter, UK.,Department of Clinical and Experimental Epilepsy, University College London, London, UK.,Department of Neurology, University Hospital Zurich, Zurich, Switzerland
| | - Matthias Koepp
- Epilepsy Society MRI Unit, Chalfont St Peter, UK.,Department of Clinical and Experimental Epilepsy, University College London, London, UK
| | - Sebastien Ourselin
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - M Jorge Cardoso
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - John S Duncan
- Epilepsy Society MRI Unit, Chalfont St Peter, UK.,Department of Clinical and Experimental Epilepsy, University College London, London, UK
| |
Collapse
|
25
|
Avakyan GN, Blinov DV, Alikhanov AA, Perepelova EM, Perepelov VA, Burd SG, Lebedeva AV, Avakyan GG. Recommendations of the Russian League Against Epilepsy (RLAE) on the use of magnetic resonance imaging in the diagnosis of epilepsy. ACTA ACUST UNITED AC 2019. [DOI: 10.17749/2077-8333.2019.11.3.208-232] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Introduction. The MRI method has revolutionized the diagnosis of epilepsy. However, the widespread adoption of MRI in clinical practice is slowed by an insufficient number of high-field MRI scanners, a shortage of trained specialists, and the lack of standard examination protocols. The aim of this article is to present the Recommendations of the Russian League Against Epilepsy (RLAE) on the use of magnetic resonance imaging in the diagnosis of epilepsy.Materials and methods. As a structural element of the International League Against Epilepsy (ILAE), the RLAE considers it important to adapt the Protocol developed by ILAE for specialists in Russia and EAEU countries. The working group analyzed and generalized the clinical practice existing in the Russian Federation, the Republic of Kazakhstan, the Republic of Belarus and the Republic of Uzbekistan. These recommendations are intended for doctors in specialized centers of epilepsy surgery, and for doctors in general medical centers. The recommendations are applicable primarily to adult patients, but the general principles are relevant to children as well.Results. In all patients with convulsive seizures shortly after the first seizure, or patients diagnosed with epilepsy who have an unexplained increase in the frequency of seizures, rapid decrease in cognitive functions or the appearance / worsening of neuropsychiatric symptoms, the RLAE recommends using a unified MR protocol for the neuroimaging of structural sequences in epilepsy with three-dimensional pulse sequences T1 and T2 FLAIR with isotropic voxel 1 × 1 × 1 mm3 and two-dimensional T2- weighted pulse sequences with a pixel size of 1 × 1 mm2 or less. The MRI examination should be combined with EEG or EEG-video monitoring. Using this protocol allows one to set a unified standard for examining patients with epilepsy in order to detect (with high sensitivity) brain lesions playing a key role in the occurrence of seizures. Here, all 13 recommendations are presented.Conclusion. Implementation of these recommendations in clinical practice will improve the access to high-tech medical care and optimize health care costs.
Collapse
Affiliation(s)
- G. N. Avakyan
- Pirogov Russian National Research Medical University
| | - D. V. Blinov
- Institute for Preventive and Social Medicine;
Moscow Haass Medical – Social Institute;
Lapino Clinic Hospital, MD Medical Group
| | | | | | | | - S. G. Burd
- Pirogov Russian National Research Medical University
| | | | - G. G. Avakyan
- Pirogov Russian National Research Medical University
| |
Collapse
|
26
|
Hirano M, Itoh T, Fujimura H, Inoue K, Samukawa M, Nose K, Sakamoto H, Maekura S, Ueno S, Satou T, Nishioka T, Kusunoki S, Nakamura Y. Pathological Findings in Male Patients With Anti-N-methyl-d-Aspartate Receptor Encephalitis. J Neuropathol Exp Neurol 2019; 78:735-741. [PMID: 31282957 DOI: 10.1093/jnen/nlz052] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis is the most common type of autoimmune encephalitis. The disease predominantly affects women (1:5-1:10), with only 3 reports of autopsy findings in women being published to date. The present study reports findings from the first autopsy performed on a man with anti-NMDAR encephalitis. The patient had some scattered lesions in the limbic system with neuronal loss, gliosis, and microglial activation. The temporal and frontal cortices showed additional patchy demyelination. T-lymphocyte infiltration was detectable in the fusiform gyrus lesion. These findings were partly similar to those reported in female patients. Although clinical differences based on the sex of the patient are reported for this disease, the observed pathological similarities potentially help to establish common therapeutic strategies for all patients. Severe testicular damage was additionally observed in the male patient in this study. Biopsy-proven severe testicular damage was also confirmed in another, previously fertile man who became azoospermic. Moreover, serum follicle-stimulating hormone levels, which often increased in response to disturbed spermatogenesis, were elevated, and testosterone/luteinizing hormone ratio reflecting Leydig cell function was low in all 5 male patients in this study. Overall, these findings suggest similar brain pathology in patients of both sexes and severe testicular damage in male patients.
Collapse
Affiliation(s)
- Makito Hirano
- Department of Neurology
- Department of Neurology, Sakai Hospital
| | - Tatsuki Itoh
- Department of Pathology, Faculty of Medicine, Kindai University
| | | | - Kimiko Inoue
- Department of Neurology, Toneyama National Hospital
| | - Makoto Samukawa
- Department of Neurology
- Department of Neurology, Sakai Hospital
| | | | | | - Shunji Maekura
- Department of Pathology, Sakai Hospital, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Shuichi Ueno
- Department of Neurology
- Department of Neurology, Sakai Hospital
| | - Takao Satou
- Department of Pathology, Faculty of Medicine, Kindai University
| | | | | | | |
Collapse
|
27
|
Kraus C, Seiger R, Pfabigan DM, Sladky R, Tik M, Paul K, Woletz M, Gryglewski G, Vanicek T, Komorowski A, Kasper S, Lamm C, Windischberger C, Lanzenberger R. Hippocampal Subfields in Acute and Remitted Depression-an Ultra-High Field Magnetic Resonance Imaging Study. Int J Neuropsychopharmacol 2019; 22:513-522. [PMID: 31175352 PMCID: PMC6672627 DOI: 10.1093/ijnp/pyz030] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 04/29/2019] [Accepted: 06/05/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Studies investigating hippocampal volume changes after treatment with serotonergic antidepressants in patients with major depressive disorder yielded inconsistent results, and effects on hippocampal subfields are unclear. METHODS To detail treatment effects on total hippocampal and subfield volumes, we conducted an open-label study with escitalopram followed by venlafaxine upon nonresponse in 20 unmedicated patients with major depressive disorder. Before and after 12 weeks treatment, we measured total hippocampal formation volumes and subfield volumes with ultra-high field (7 Tesla), T1-weighted, structural magnetic resonance imaging, and FreeSurfer. Twenty-eight remitted patients and 22 healthy subjects were included as controls. We hypothesized to detect increased volumes after treatment in major depressive disorder. RESULTS We did not detect treatment-related changes of total hippocampal or subfield volumes in patients with major depressive disorder. Secondary results indicated that the control group of untreated, stable remitted patients, compared with healthy controls, had larger volumes of the right hippocampal-amygdaloid transition area and right fissure at both measurement time points. Depressed patients exhibited larger volumes of the right subiculum compared with healthy controls at MRI-2. Exploratory data analyses indicated lower baseline volumes in the subgroup of remitting (n = 10) vs nonremitting (n = 10) acute patients. CONCLUSIONS The results demonstrate that monoaminergic antidepressant treatment in major depressive disorder patients was not associated with volume changes in hippocampal subfields. Studies with larger sample sizes to detect smaller effects as well as other imaging modalities are needed to further assess the impact of antidepressant treatment on hippocampal subfields.
Collapse
Affiliation(s)
- Christoph Kraus
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | - Rene Seiger
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | - Daniela M Pfabigan
- Department of Basic Psychological Research and Research Methods, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Ronald Sladky
- Department of Basic Psychological Research and Research Methods, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Martin Tik
- MR Centre of Excellence, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Austria
| | - Katharina Paul
- Department of Basic Psychological Research and Research Methods, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Michael Woletz
- MR Centre of Excellence, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Austria
| | - Gregor Gryglewski
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | - Thomas Vanicek
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | - Arkadiusz Komorowski
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | - Siegfried Kasper
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | - Claus Lamm
- Department of Basic Psychological Research and Research Methods, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Christian Windischberger
- MR Centre of Excellence, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Austria
| | - Rupert Lanzenberger
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| |
Collapse
|
28
|
Yoo JG, Jakabek D, Ljung H, Velakoulis D, van Westen D, Looi JCL, Källén K. MRI morphology of the hippocampus in drug-resistant temporal lobe epilepsy: Shape inflation of left hippocampus and correlation of right-sided hippocampal volume and shape with visuospatial function in patients with right-sided TLE. J Clin Neurosci 2019; 67:68-74. [PMID: 31221579 DOI: 10.1016/j.jocn.2019.06.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 06/10/2019] [Indexed: 11/27/2022]
Abstract
We sought to quantify the morphology in vivo of hippocampi in patients with drug resistant temporal lobe epilepsy (TLE) via magnetic resonance imaging (MRI), prior to temporal lobe resection, and the correlation of surface-based shape analysis of morphology and clinical cognitive function. Thirty patients with drug-resistant TLE and twenty healthy controls underwent clinical neuropsychological testing, and brain MRI at Lund University Hospital prior to hippocampal resection. A neuroradiologist categorised radiological findings into normal hippocampus, subtle changes or definite hippocampal sclerosis. We manually segmented MRI of the hippocampus of participants using ANALYZE 11.0 software; and analysed hippocampal shape using SPHARM-PDM software. For radiologist visual-ratings of definite left hippocampal sclerosis in those with left-sided TLE, hippocampal volumes were significantly smaller compared to normal controls. In right-sided TLE we found contralateral shape inflation of the left hippocampus, partially confirming previous shape analytic studies of the hippocampus in TLE. We found significant correlation of volume and surface deflation of the right hippocampus in right-sided TLE with reduced performance on the two right-lateralised visuospatial memory tests, the Rey Complex Figure Test (Immediate and Delayed recall) and the Recognition Memory Test for faces. Decreased hippocampal volume was correlated with poorer performance on these tasks. The morphology of the hippocampus can be quantified via neuroimaging shape analysis in TLE. Contralateral shape inflation of the left hippocampus in right-sided TLE is intriguing, and may result from functional compensation and/or abnormal tissue. In right-sided TLE, hippocampal structural integrity, quantified as hippocampal shape, is correlated with lateralised visuospatial function.
Collapse
Affiliation(s)
- Jae-Gon Yoo
- Academic Unit of Psychiatry and Addiction Medicine, Australian National University Medical School, Canberra Hospital, ACT, Australia
| | - David Jakabek
- Graduate School of Medicine, University of Wollongong, Wollongong, NSW, Australia
| | - Hanna Ljung
- Skåne University Hospital, Department of Neurology and Rehabilitation Medicine, Lund, Sweden
| | - Dennis Velakoulis
- Neuropsychiatry Unit, Royal Melbourne Hospital, Department of Psychiatry, University of Melbourne Medical School, Melbourne, Victoria, Australia
| | - Danielle van Westen
- Diagnostic Radiology, Department of Clinical Sciences, Lund University, Lund, Sweden; Image and Function, Skane University Hospital, Lund, Sweden
| | - Jeffrey C L Looi
- Academic Unit of Psychiatry and Addiction Medicine, Australian National University Medical School, Canberra Hospital, ACT, Australia; Neuropsychiatry Unit, Royal Melbourne Hospital, Department of Psychiatry, University of Melbourne Medical School, Melbourne, Victoria, Australia.
| | - Kristina Källén
- Division of Clinical Sciences, Helsingborg, Sweden & Department of Clinical Sciences, Lund, Sweden; Neurology, Lund, Sweden & Faculty of Medicine, Lund University, Lund, Sweden
| |
Collapse
|
29
|
Ogawa M, Sone D, Beheshti I, Maikusa N, Okita K, Takano H, Matsuda H. Association between subfield volumes of the medial temporal lobe and cognitive assessments. Heliyon 2019; 5:e01828. [PMID: 31194147 PMCID: PMC6551380 DOI: 10.1016/j.heliyon.2019.e01828] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 04/01/2019] [Accepted: 05/23/2019] [Indexed: 12/23/2022] Open
Abstract
Cognitive assessments and neuroimaging are routinely combined in clinical practice to diagnose dementia represented by Alzheimer's disease (AD). The Montreal Cognitive Assessment (MoCA) is reported to be more suitable than the Mini-Mental State Examination (MMSE) for screening mild cognitive impairment (MCI) and mild AD. On the other hand, attention to the subfield volumes of the medial temporal lobe has recently been considered important for the differential diagnosis and early detection of AD. The aim of this study was to uncover which specific hippocampal subfields and adjacent extrahippocampal structures contribute to deficits in cognitive assessment scores in patients with MCI and AD. We recruited from our institute 31 Japanese patients—14 with amnestic MCI and 17 with probable AD, with a clinical dementia rating (CDR) of 0.5 and 1, respectively—and 50 healthy elderly individuals with a CDR of 0. All participants underwent magnetic resonance imaging and cognitive assessments with the MMSE, Wechsler Memory Scale-Revised Logical Memory I and II, and Japanese version of the MoCA (MoCA-J). With adjustment for age and sex, we performed partial correlation analysis of the cognitive assessment scores with the subfield volumes of the medial temporal lobe measured by software-mediated automatic segmentation of hippocampal subfields using high-resolution T1-and T2-weighted images. Compared with normal controls, patients with MCI and AD showed subfield volume reductions in cornu ammonis (CA) 1, CA2, Brodmann area (BA) 35, BA36, the dentate gyrus (DG), the subiculum, and the entorhinal cortex (ERC). All participants showed high correlation coefficients (above 0.6) between cognitive assessment scores and subfield volumes in CA1, the DG, the subiculum, the ERC, and BA36. In patients with MCI and AD, the MoCA-J showed higher correlations than the MMSE with subfield volumes in CA1, the DG, the subiculum, and the ERC. These results suggest that the combination of the in vivo analysis of subfield morphometry of the medial temporal lobe with the MoCA-J paradigm provides important insights into whether changes within specific subfields are related to the cognitive profile in MCI and AD.
Collapse
Affiliation(s)
- Masayo Ogawa
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Daichi Sone
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Iman Beheshti
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Norihide Maikusa
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Kyoji Okita
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Harumasa Takano
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Hiroshi Matsuda
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| |
Collapse
|
30
|
Automated Volumetry of Medial Temporal Lobe Subregions in Mild Cognitive Impairment and Alzheimer Disease. Alzheimer Dis Assoc Disord 2019; 33:206-211. [PMID: 31135455 DOI: 10.1097/wad.0000000000000318] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE Hippocampal subfield volumetry should be more useful than whole hippocampal (WH) volumetry for diagnosing Alzheimer disease (AD). This study sought to confirm this. METHODS We investigated cognitively normal (CN) participants and patients with mild cognitive impairment (MCI) or AD using high-resolution T2-weighted and 3-dimensional T1-weighted magnetic resonance imaging. Using medial temporal subregion volumetry, we investigated discriminative power for MCI and AD versus CN. PATIENTS We recruited 30 CN participants, 30 amnestic MCI patients, and 49 AD patients between April 2015 and October 2016. RESULTS For AD, discriminative power of the combined volumes of the subiculum, entorhinal cortex, and cornu ammonis 1 was highest [area under the curve (AUC)=0.915; 85.7% sensitivity, 86.7% specificity, 86.1% accuracy], and was significantly higher than that of the WH volume (AUC=0.887; 90.0% sensitivity, 75.5% specificity, 84.5% accuracy) (P=0.019). For MCI, discriminative power of the subiculum volume was highest (AUC=0.747; 80.0% sensitivity, 73.3% specificity, 76.7% accuracy), but was only slightly higher than that of the WH volume (AUC=0.730; 56.7% sensitivity, 90.0% specificity, 73.3% accuracy). CONCLUSIONS Using the combined volumes of the subiculum, entorhinal cortex, and cornu ammonis 1 may enable greater diagnostic accuracy compared with the WH volume or any single subfield in AD patients.
Collapse
|
31
|
Bernasconi A, Cendes F, Theodore WH, Gill RS, Koepp MJ, Hogan RE, Jackson GD, Federico P, Labate A, Vaudano AE, Blümcke I, Ryvlin P, Bernasconi N. Recommendations for the use of structural magnetic resonance imaging in the care of patients with epilepsy: A consensus report from the International League Against Epilepsy Neuroimaging Task Force. Epilepsia 2019; 60:1054-1068. [PMID: 31135062 DOI: 10.1111/epi.15612] [Citation(s) in RCA: 118] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 04/23/2019] [Accepted: 04/24/2019] [Indexed: 01/01/2023]
Abstract
Structural magnetic resonance imaging (MRI) is of fundamental importance to the diagnosis and treatment of epilepsy, particularly when surgery is being considered. Despite previous recommendations and guidelines, practices for the use of MRI are variable worldwide and may not harness the full potential of recent technological advances for the benefit of people with epilepsy. The International League Against Epilepsy Diagnostic Methods Commission has thus charged the 2013-2017 Neuroimaging Task Force to develop a set of recommendations addressing the following questions: (1) Who should have an MRI? (2) What are the minimum requirements for an MRI epilepsy protocol? (3) How should magnetic resonance (MR) images be evaluated? (4) How to optimize lesion detection? These recommendations target clinicians in established epilepsy centers and neurologists in general/district hospitals. They endorse routine structural imaging in new onset generalized and focal epilepsy alike and describe the range of situations when detailed assessment is indicated. The Neuroimaging Task Force identified a set of sequences, with three-dimensional acquisitions at its core, the harmonized neuroimaging of epilepsy structural sequences-HARNESS-MRI protocol. As these sequences are available on most MR scanners, the HARNESS-MRI protocol is generalizable, regardless of the clinical setting and country. The Neuroimaging Task Force also endorses the use of computer-aided image postprocessing methods to provide an objective account of an individual's brain anatomy and pathology. By discussing the breadth and depth of scope of MRI, this report emphasizes the unique role of this noninvasive investigation in the care of people with epilepsy.
Collapse
Affiliation(s)
- Andrea Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Fernando Cendes
- Department of Neurology, University of Campinas, Campinas, Brazil
| | - William H Theodore
- Clinical Epilepsy Section, National Institutes of Health, Bethesda, Maryland
| | - Ravnoor S Gill
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | | | - Robert Edward Hogan
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri
| | - Graeme D Jackson
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, Victoria, Australia
| | - Paolo Federico
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Angelo Labate
- Institute of Neurology, University of Catanzaro, Catanzaro, Italy
| | - Anna Elisabetta Vaudano
- Neurology Unit, Azienda Ospedaliero Universitaria, University of Modena and Reggio Emilia, Modena, Italy
| | - Ingmar Blümcke
- Department of Neuropathology, University Hospital Erlangen, Erlangen, Germany
| | - Philippe Ryvlin
- Clinical Neurosciences, Lausanne University Hospital, Lausanne, Switzerland
| | - Neda Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| |
Collapse
|
32
|
Aanes S, Bjuland KJ, Sripada K, Sølsnes AE, Grunewaldt KH, Håberg A, Løhaugen GC, Skranes J. Reduced hippocampal subfield volumes and memory function in school-aged children born preterm with very low birthweight (VLBW). Neuroimage Clin 2019; 23:101857. [PMID: 31136968 PMCID: PMC6536855 DOI: 10.1016/j.nicl.2019.101857] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 05/07/2019] [Accepted: 05/09/2019] [Indexed: 01/31/2023]
Abstract
BACKGROUND The hippocampus, an essential structure for learning and memory, has a reduced volume in preterm born (gestational age < 37 weeks) individuals with very low birth weight (VLBW: birth weight < 1500 g), which may affect memory function. However, the hippocampus is a complex structure with distinct subfields related to specific memory functions. These subfields are differentially affected by a variety of neuropathological conditions, but it remains unclear how these subfields may be affected by medical complications following preterm birth which may cause aberrant brain development, and the consequences of this on learning and memory function in children with VLBW. METHODS Children born preterm with VLBW (n = 34) and term-born controls from the Norwegian Mother and Child Cohort Study (MoBa) (n = 104) underwent structural MRI and a neuropsychological assessment of memory function at primary school age. FreeSurfer 6.0 was used to analyze the volumes of hippocampal subfields which were compared between groups, as was memory performance. Correlations between abnormal hippocampal subfields and memory performance were explored in the VLBW group. RESULTS All absolute hippocampal subfield volumes were lower in the children with VLBW compared to MoBa term-born controls, and the volumes of the left and right dentate gyrus and the right subiculum remained significantly lower after correcting for total intracranial volume. The VLBW group had inferior working memory performance and the score on the subtest Spatial Span backwards was positively correlated to the volume of the right dentate gyrus. CONCLUSIONS Hippocampal subfield volumes seem to be differently affected by early brain development related to preterm birth. The dentate gyrus appears particularly susceptible to adverse effects of preterm birth. Reduced working memory function among children with VLBW was associated with smaller volume of right dentate gyrus. This finding demonstrates alterations in hippocampal structure-function relationships associated with early brain development related to preterm birth.
Collapse
Affiliation(s)
- Synne Aanes
- Department of Clinical and Molecular Medicine, Norwegian University of Science & Technology, Trondheim, Norway.
| | | | - Kam Sripada
- Department of Clinical and Molecular Medicine, Norwegian University of Science & Technology, Trondheim, Norway
| | - Anne Elisabeth Sølsnes
- Department of Clinical and Molecular Medicine, Norwegian University of Science & Technology, Trondheim, Norway
| | - Kristine H Grunewaldt
- Department of Clinical and Molecular Medicine, Norwegian University of Science & Technology, Trondheim, Norway; Department of Pediatrics, St Olav University Hospital, Trondheim, Norway
| | - Asta Håberg
- Department of Neuromedicine and Movement Science, Norwegian University of Science & Technology, Trondheim, Norway
| | - Gro C Løhaugen
- Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
| | - Jon Skranes
- Department of Clinical and Molecular Medicine, Norwegian University of Science & Technology, Trondheim, Norway; Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
| |
Collapse
|
33
|
Zahr NM, Pohl KM, Saranathan M, Sullivan EV, Pfefferbaum A. Hippocampal subfield CA2+3 exhibits accelerated aging in Alcohol Use Disorder: A preliminary study. NEUROIMAGE-CLINICAL 2019; 22:101764. [PMID: 30904825 PMCID: PMC6434095 DOI: 10.1016/j.nicl.2019.101764] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 12/21/2018] [Accepted: 03/10/2019] [Indexed: 12/31/2022]
Abstract
The profile of brain structural dysmorphology of individuals with Alcohol Use Disorders (AUD) involves disruption of the limbic system. In vivo imaging studies report hippocampal volume loss in AUD relative to controls, but only recently has it been possible to articulate different regions of this complex structure. Volumetric analysis of hippocampal regions rather than total hippocampal volume may augment differentiation of disease processes. For example, damage to hippocampal subfield cornu ammonis 1 (CA1) is often reported in Alzheimer's disease (AD), whereas deficits in CA4/dentate gyrus are described in response to stress and trauma. Two previous studies explored the effects of chronic alcohol use on hippocampal subfields: one reported smaller volume of the CA2+3 in alcohol-dependent subjects relative to controls, associated with years of alcohol consumption; the other, smaller volumes of presubiculum, subiculum, and fimbria in alcohol-dependent relative to control men. The current study, conducted in 24 adults with DSM5-diagnosed AUD (7 women, 53.7 ± 8.8) and 20 controls (7 women, 54.1 ± 9.3), is the first to use FreeSurfer 6.0, which provides state-of-the art hippocampal parcellation, to explore the sensitivity of hippocampal sufields to alcoholism. T1- and T2- images were collected on a GE MR750 system with a 32-channel Nova head coil. FreeSurfer 6.0 hippocampal subfield analysis produced 12 subfields: parasubiculum; presubiculum; subiculum; CA1; CA2+3; CA4; GC-ML-DG (Granule Cell (GC) and Molecular Layer (ML) of the Dentate Gyrus (DG)); molecular layer; hippocampus-amygdala-transition-area (HATA); fimbria; hippocampal tail; hippocampal fissure; and whole volume for left and right hippocampi. A comprehensive battery of neuropsychological tests comprising attention, memory and learning, visuospatial abilities, and executive functions was administered. Multiple regression analyses of raw volumetric data for each subfields by group, age, sex, hemisphere, and supratentorial volume (svol) showed significant effects of svol (p < .04) on nearly all structures (excluding tail and fissure). Volumes corrected for svol showed effects of age (fimbria, fissure) and group (subiculum, CA1, CA4, GC-ML-DG, HATA, fimbria); CA2+3 showed a diagnosis-by-age interaction indicating older AUD individuals had a smaller volume than would be expected for their age. There were no selective relations between hippocampal subfields and performance on neuropsychological tests, likely due to lack of statistical power. The current results concur with the previous study identifying CA2+3 as sensitive to alcoholism, extend them by identifying an alcoholism-age interaction, and suggest an imaging phenotype distinguishing AUD from AD and stress/trauma. Whether alcohol use disorders (AUD) compromise hippocampal volume is disputed. A 32-channel head coil acquired high-resolution images. The hippocampus was segmented using FreeSurfer 6.0. Several subregions showed volume deficits in AUD relative to healthy controls. Cornu Ammonis 2+3 showed a alcoholism-by-age interaction.
Collapse
Affiliation(s)
- Natalie M Zahr
- Neuroscience Program, SRI International, 333 Ravenswood Ave., Menlo Park, CA 94025, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd., Stanford, CA 94305, USA.
| | - Kilian M Pohl
- Neuroscience Program, SRI International, 333 Ravenswood Ave., Menlo Park, CA 94025, USA
| | - Manojkumar Saranathan
- Department of Medical Imaging, University of Arizona College of Medicine, 1501 N. Campbell Ave., Tucson, AZ 85724, USA
| | - Edith V Sullivan
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd., Stanford, CA 94305, USA
| | - Adolf Pfefferbaum
- Neuroscience Program, SRI International, 333 Ravenswood Ave., Menlo Park, CA 94025, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd., Stanford, CA 94305, USA
| |
Collapse
|
34
|
Shah P, Bassett DS, Wisse LEM, Detre JA, Stein JM, Yushkevich PA, Shinohara RT, Elliott MA, Das SR, Davis KA. Structural and functional asymmetry of medial temporal subregions in unilateral temporal lobe epilepsy: A 7T MRI study. Hum Brain Mapp 2019; 40:2390-2398. [PMID: 30666753 DOI: 10.1002/hbm.24530] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 01/11/2019] [Indexed: 12/24/2022] Open
Abstract
Mesial temporal lobe epilepsy (TLE) is a common neurological disorder affecting the hippocampus and surrounding medial temporal lobe (MTL). Although prior studies have analyzed whole-brain network distortions in TLE patients, the functional network architecture of the MTL at the subregion level has not been examined. In this study, we utilized high-resolution 7T T2-weighted magnetic resonance imaging (MRI) and resting-state BOLD-fMRI to characterize volumetric asymmetry and functional network asymmetry of MTL subregions in unilateral medically refractory TLE patients and healthy controls. We subdivided the TLE group into mesial temporal sclerosis patients (TLE-MTS) and MRI-negative nonlesional patients (TLE-NL). Using an automated multi-atlas segmentation pipeline, we delineated 10 MTL subregions per hemisphere for each subject. We found significantly different patterns of volumetric asymmetry between the two groups, with TLE-MTS exhibiting volumetric asymmetry corresponding to decreased volumes ipsilaterally in all hippocampal subfields, and TLE-NL exhibiting no significant volumetric asymmetries other than a mild decrease in whole-hippocampal volume ipsilaterally. We also found significantly different patterns of functional network asymmetry in the CA1 subfield and whole hippocampus, with TLE-NL patients exhibiting asymmetry corresponding to increased connectivity ipsilaterally and TLE-MTS patients exhibiting asymmetry corresponding to decreased connectivity ipsilaterally. Our findings provide initial evidence that functional neuroimaging-based network properties within the MTL can distinguish between TLE subtypes. High-resolution MRI has potential to improve localization of underlying brain network disruptions in TLE patients who are candidates for surgical resection.
Collapse
Affiliation(s)
- Preya Shah
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, Pennsylvania.,Center for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Danielle S Bassett
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Electrical and Systems Engineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Physics and Astronomy, College of Arts and Sciences, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Laura E M Wisse
- Penn Image Computing and Science Laboratory, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - John A Detre
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Center for Functional Neuroimaging, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Joel M Stein
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Paul A Yushkevich
- Penn Image Computing and Science Laboratory, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Russell T Shinohara
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Mark A Elliott
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Sandhitsu R Das
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Penn Image Computing and Science Laboratory, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kathryn A Davis
- Center for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| |
Collapse
|
35
|
Peixoto-Santos JE, de Carvalho LED, Kandratavicius L, Diniz PRB, Scandiuzzi RC, Coras R, Blümcke I, Assirati JA, Carlotti CG, Matias CCMS, Salmon CEG, Dos Santos AC, Velasco TR, Moraes MFD, Leite JP. Manual Hippocampal Subfield Segmentation Using High-Field MRI: Impact of Different Subfields in Hippocampal Volume Loss of Temporal Lobe Epilepsy Patients. Front Neurol 2018; 9:927. [PMID: 30524352 PMCID: PMC6256705 DOI: 10.3389/fneur.2018.00927] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 10/12/2018] [Indexed: 11/17/2022] Open
Abstract
In patients with temporal lobe epilepsy (TLE), presurgical magnetic resonance imaging (MRI) often reveals hippocampal atrophy, while neuropathological assessment indicates the different types of hippocampal sclerosis (HS). Different HS types are not discriminated in MRI so far. We aimed to define the volume of each hippocampal subfield on MRI manually and to compare automatic and manual segmentations for the discrimination of HS types. The T2-weighted images from 14 formalin-fixed age-matched control hippocampi were obtained with 4.7T MRI to evaluate the volume of each subfield at the anatomical level of the hippocampal head, body, and tail. Formalin-fixed coronal sections at the level of the body of 14 control cases, as well as tissue samples from 24 TLE patients, were imaged with a similar high-resolution sequence at 3T. Presurgical three-dimensional (3D) T1-weighted images from TLE went through a FreeSurfer 6.0 hippocampal subfield automatic assessment. The manual delineation with the 4.7T MRI was identified using Luxol Fast Blue stained 10-μm-thin microscopy slides, collected at every millimeter. An additional section at the level of the body from controls and TLE cases was submitted to NeuN immunohistochemistry for neuronal density estimation. All TLE cases were classified according to the International League Against Epilepsy's (ILAE's) HS classification. Manual volumetry in controls revealed that the dentate gyrus (DG)+CA4 region, CA1, and subiculum accounted for almost 90% of the hippocampal volume. The manual 3T volumetry showed that all TLE patients with type 1 HS (TLE-HS1) had lower volumes for DG+CA4, CA2, and CA1, whereas those TLE patients with HS type 2 (TLE-HS2) had lower volumes only in CA1 (p ≤ 0.038). Neuronal cell densities always decreased in CA4, CA3, CA2, and CA1 of TLE-HS1 but only in CA1 of TLE-HS2 (p ≤ 0.003). In addition, TLE-HS2 had a higher volume (p = 0.016) and higher neuronal density (p < 0.001) than the TLE-HS1 in DG + CA4. Automatic segmentation failed to match the manual or histological findings and was unable to differentiate TLE-HS1 from TLE-HS2. Total hippocampal volume correlated with DG+CA4 and CA1 volumes and neuronal density. For the first time, we also identified subfield-specific pathology patterns in the manual evaluation of volumetric MRI scans, showing the importance of manual segmentation to assess subfield-specific pathology patterns.
Collapse
Affiliation(s)
- Jose Eduardo Peixoto-Santos
- Department of Neurosciences and Behavioral Sciences, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil.,Neuropathology Institute, University Hospitals Erlangen and Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | | | - Ludmyla Kandratavicius
- Department of Neurosciences and Behavioral Sciences, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil
| | | | - Renata Caldo Scandiuzzi
- Department of Neurosciences and Behavioral Sciences, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Roland Coras
- Neuropathology Institute, University Hospitals Erlangen and Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Ingmar Blümcke
- Neuropathology Institute, University Hospitals Erlangen and Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Joao Alberto Assirati
- Department of Surgery and Anatomy, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Carlos Gilberto Carlotti
- Department of Surgery and Anatomy, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil
| | | | - Carlos Ernesto Garrido Salmon
- Department of Physics and Mathematics, Faculty of Philosophy, Science and Languages of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Antonio Carlos Dos Santos
- Department of Internal Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Tonicarlo R Velasco
- Department of Neurosciences and Behavioral Sciences, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Marcio Flavio D Moraes
- Department of Physiology and Biophysics, Center for Technology and Research in Magneto-Resonance, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Joao Pereira Leite
- Department of Neurosciences and Behavioral Sciences, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil
| |
Collapse
|
36
|
Rutland JW, Feldman RE, Delman BN, Panov F, Fields MC, Marcuse LV, Hof PR, Lin HM, Balchandani P. Subfield-specific tractography of the hippocampus in epilepsy patients at 7 Tesla. Seizure 2018; 62:3-10. [PMID: 30245458 PMCID: PMC6221989 DOI: 10.1016/j.seizure.2018.09.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 08/29/2018] [Accepted: 09/12/2018] [Indexed: 10/28/2022] Open
Abstract
PURPOSE MRI-negative epilepsy patients could benefit from advanced imaging techniques such as high-resolution diffusion magnetic resonance imaging (dMRI). Our aim was to perform hippocampal subfield-specific tractography and quantify connectivity of the subfields in MRI-negative patients. Abnormal connectivity of the hippocampal subfields may help inform seizure focus hypothesis and provide information to guide surgical intervention. METHODS Hippocampal structural imaging and dMRI was acquired in 25 drug resistant MRI-negative patients and 25 healthy volunteers. The hippocampi of each subject was segmented on high-resolution structural images and dMRI-based probabilistic tractography was performed in each subfield. The degrees of connectivity and fiber densities of the hippocampal subfields were quantified and compared between epilepsy patients and healthy volunteers. RESULTS We were able to perform subfield-specific hippocampal tractography in each subject that participated in this study. These methods identified some hippocampal subfields that are abnormally connected in MRI-negative patients. In particular patients suspected of left temporal seizure focus exhibited increased connectivity of certain ipsilateral subfields, especially the subiculum, presubiculum, and parasubiculum, and reduced connectivity of some contralateral subfields, such as CA1 and subiculum. CONCLUSIONS Our data suggest that the hippocampal subfields are connected in distinct ways in different types of epilepsy. These results may provide important information that could help inform seizure focus hypothesis and in the surgical treatment of MRI-negative patients. These observations suggest that high-resolution dMRI-based tractography of the hippocampal subfields can detect subtle abnormalities in otherwise normal-appearing MRI-negative patients.
Collapse
Affiliation(s)
- John W Rutland
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
| | - Rebecca E Feldman
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Bradley N Delman
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Fedor Panov
- Department of Neurosurgery, Mount Sinai Hospital, New York, NY, United States
| | - Madeline C Fields
- Department of Neurology, Mount Sinai Hospital, New York, NY, United States
| | - Lara V Marcuse
- Department of Neurology, Mount Sinai Hospital, New York, NY, United States
| | - Patrick R Hof
- Department of Neuroscience, Mount Sinai Hospital, New York, NY, United States
| | - Hung-Mo Lin
- Department of Population Health Science and Policy, Mount Sinai Hospital, New York, NY, United States
| | - Priti Balchandani
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| |
Collapse
|
37
|
Hadar PN, Kini LG, Coto C, Piskin V, Callans LE, Chen SH, Stein JM, Das SR, Yushkevich PA, Davis KA. Clinical validation of automated hippocampal segmentation in temporal lobe epilepsy. Neuroimage Clin 2018; 20:1139-1147. [PMID: 30380521 PMCID: PMC6205355 DOI: 10.1016/j.nicl.2018.09.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 09/16/2018] [Accepted: 09/29/2018] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To provide a multi-atlas framework for automated hippocampus segmentation in temporal lobe epilepsy (TLE) and clinically validate the results with respect to surgical lateralization and post-surgical outcome. METHODS We retrospectively identified 47 TLE patients who underwent surgical resection and 12 healthy controls. T1-weighted 3 T MRI scans were acquired for all subjects, and patients were identified by a neuroradiologist with regards to lateralization and degree of hippocampal sclerosis (HS). Automated segmentation was implemented through the Joint Label Fusion/Corrective Learning (JLF/CL) method. Gold standard lateralization was determined from the surgically resected side in Engel I (seizure-free) patients at the two-year timepoint. ROC curves were used to identify appropriate thresholds for hippocampal asymmetry ratios, which were then used to analyze JLF/CL lateralization. RESULTS The optimal template atlas based on subject images with varying appearances, from normal-appearing to severe HS, was demonstrated to be composed entirely of normal-appearing subjects, with good agreement between automated and manual segmentations. In applying this atlas to 26 surgically resected seizure-free patients at a two-year timepoint, JLF/CL lateralized seizure onset 92% of the time. In comparison, neuroradiology reads lateralized 65% of patients, but correctly lateralized seizure onset in these patients 100% of the time. When compared to lateralized neuroradiology reads, JLF/CL was in agreement and correctly lateralized all 17 patients. When compared to nonlateralized radiology reads, JLF/CL correctly lateralized 78% of the nine patients. SIGNIFICANCE While a neuroradiologist's interpretation of MR imaging is a key, albeit imperfect, diagnostic tool for seizure localization in medically-refractory TLE patients, automated hippocampal segmentation may provide more efficient and accurate epileptic foci localization. These promising findings demonstrate the clinical utility of automated segmentation in the TLE MR imaging pipeline prior to surgical resection, and suggest that further investigation into JLF/CL-assisted MRI reading could improve clinical outcomes. Our JLF/CL software is publicly available at https://www.nitrc.org/projects/ashs/.
Collapse
Affiliation(s)
- Peter N Hadar
- Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Lohith G Kini
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Carlos Coto
- Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Virginie Piskin
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, United States; Penn Image Computing and Science Lab, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Lauren E Callans
- Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Stephanie H Chen
- Department of Neurology, University of Maryland, Baltimore, MD 21201, United States
| | - Joel M Stein
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Sandhitsu R Das
- Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, United States; Penn Image Computing and Science Lab, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Paul A Yushkevich
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, United States; Penn Image Computing and Science Lab, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Kathryn A Davis
- Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, United States.
| |
Collapse
|
38
|
Granados Sánchez A, Orejuela Zapata J. Hippocampal sclerosis: Volumetric evaluation of the substructures of the hippocampus by magnetic resonance imaging. RADIOLOGIA 2018. [DOI: 10.1016/j.rxeng.2018.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
39
|
Quantitative volume-based morphometry in focal cortical dysplasia: A pilot study for lesion localization at the individual level. Eur J Radiol 2018; 105:240-245. [DOI: 10.1016/j.ejrad.2018.06.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 06/16/2018] [Accepted: 06/21/2018] [Indexed: 12/27/2022]
|
40
|
Lee DH, Lee DW, Kwon JI, Woo CW, Kim ST, Lee JS, Choi CG, Kim KW, Kim JK, Woo DC. In Vivo Mapping and Quantification of Creatine Using Chemical Exchange Saturation Transfer Imaging in Rat Models of Epileptic Seizure. Mol Imaging Biol 2018; 21:232-239. [DOI: 10.1007/s11307-018-1243-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
|
41
|
Granados Sánchez AM, Orejuela Zapata JF. Hippocampal sclerosis: volumetric evaluation of the substructures of the hippocampus by magnetic resonance imaging. RADIOLOGIA 2018; 60:404-412. [PMID: 29807677 DOI: 10.1016/j.rx.2018.03.007] [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: 06/27/2017] [Revised: 02/05/2018] [Accepted: 03/29/2018] [Indexed: 10/16/2022]
Abstract
OBJECTIVE The pathological classification of hippocampal sclerosis is based on the loss of neurons in the substructures of the hippocampus. This study aimed to evaluate these substructures in patients with hippocampal sclerosis by magnetic resonance imaging and to compare the usefulness of this morphological analysis compared to that of volumetric analysis of the entire hippocampus. MATERIAL AND METHODS We included 25 controls and 25 patients with hippocampal sclerosis whose diagnosis was extracted from the institutional epilepsy board. We used FreeSurfer to process the studies and obtain the volumetric data. We evaluated overall volume and volume by substructure: fimbria, subiculum, presubiculum, hippocampal sulcus, CA1, CA2-CA3, CA4, and dentate gyrus (DG). We considered p < 0.05 statistically significant. RESULTS We observed statistically significant decreases in the volume of the hippocampus ipsilateral to the epileptogenic focus in 19 (76.0%) of the 25 cases. With the exception of the hippocampal sulcus, we observed a decrease in all ipsilateral hippocampal substructures in patients with right hippocampal sclerosis (CA1, p=0.0223; CA2-CA3, p=0.0066; CA4-GD, p=0.0066; fimbria, p=0.0046; presubiculum, p=0.0087; subiculum, p=0.0017) and in those with left hippocampal sclerosis (CA1, p<0.0001; CA2-CA3, p<0. 0001; CA4-GD, p<0. 0001; fimbria, p=0.0183; presubiculum, p<0. 0001; subiculum, p<0. 0001). In four patients with left hippocampal sclerosis, none of the substructures had statistically significant alterations, although a trend toward atrophy was observed, mainly in CA2-CA3 and CA4-GD. CONCLUSION The findings suggest that it can be useful to assess the substructures of the hippocampus to improve the performance of diagnostic imaging in patients with hippocampal sclerosis.
Collapse
Affiliation(s)
- A M Granados Sánchez
- Departamento de Imágenes Diagnósticas, Fundación Valle de Lili; Universidad ICESI, Cali, Colombia
| | - J F Orejuela Zapata
- Departamento de Imágenes Diagnósticas, Fundación Valle de Lili; Universidad ICESI, Cali, Colombia.
| |
Collapse
|
42
|
Yang PF, Pei JS, Jia YZ, Lin Q, Xiao H, Zhang TT, Zhong ZH. Surgical Management and Long-Term Seizure Outcome After Surgery for Temporal Lobe Epilepsy Associated with Cerebral Cavernous Malformations. World Neurosurg 2017; 110:e659-e670. [PMID: 29175574 DOI: 10.1016/j.wneu.2017.11.067] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Revised: 11/11/2017] [Accepted: 11/14/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Operative strategies for cerebral cavernous malformation (CCM)-associated temporal lobe epilepsy and timing of surgical intervention continue to be debated. This study aimed to establish an algorithm to evaluate the efficacy of surgical intervention strategies, to maximize positive surgical outcomes and minimize postsurgical neurologic deficits. METHODS 47 patients having undergone operation for CCM-associated temporal lobe epilepsy were retrospectively reviewed. They had received a diagnostic series for seizure localization, including long-term video electroencephalography (vEEG), high-resolution magnetic resonance imaging (MRI), and positron emission tomography-computed tomography (PET-CT). In patients with mesial temporal lobe CCMs, the involved structures (amygdala, hippocampus, or parahippocampal gyrus) were resected in addition to the lesions. Patients with neocortical epileptogenic CCM underwent extended lesionectomy guided by intraoperative electrocorticography; further performance of amygdalohippocampectomy depended on the extent of hippocampal epileptogenicity. RESULTS The study cohort contained 28 patients with drug-resistant epilepsy (DRE), 12 with chronic epilepsy (CE), and 7 with sporadic seizure (SS). Normal temporal lobe metabolism was seen in 7/7 patients of the SS group. Hypometabolism was found in all patients with chronic disease except for those with posterior inferior and middle temporal gyrus cavernous malformations (CMs). Of the 31 patients with superficial neocortical CCM, 7 had normal PET without hippocampal sclerosis, 14 had ipsilateral temporal lobe hypometabolism without hippocampal sclerosis, and 10 had obvious hippocampal sclerosis and hypometabolism. Seizure freedom in DRE, CE, and SS was 82.1%, 75%, and 100%, respectively. A significant difference was found between lesion laterality and postoperative seizure control; the rate was lower in left-sided cases because of less aggressive resection. CONCLUSIONS Our study demonstrates that the data from the presurgical evaluation, particularly regarding CM location, responsiveness to antiepileptic drugs, and temporal lobe metabolism, are crucial parameters for choosing surgical approaches to CCM-associated temporal lobe epilepsy. By this operative strategy, patients may receive maximized seizure control and minimized postsurgical neurologic sequelae.
Collapse
Affiliation(s)
- Peng-Fan Yang
- Department of Neurosurgery, Fuzhou General Hospital, Fujian Medical University, Fuzhou, China.
| | - Jia-Sheng Pei
- Department of Neurosurgery, Fuzhou General Hospital, Fujian Medical University, Fuzhou, China
| | - Yan-Zeng Jia
- Department of Epileptology, Fuzhou General Hospital, Fujian Medical University, Fuzhou, China
| | - Qiao Lin
- Department of Epileptology, Fuzhou General Hospital, Fujian Medical University, Fuzhou, China
| | - Hui Xiao
- Department of Medical Imaging, Fuzhou General Hospital, Fujian Medical University, Fuzhou, China
| | - Ting-Ting Zhang
- Department of Pathology, Fuzhou General Hospital, Fujian Medical University, Fuzhou, China
| | - Zhong-Hui Zhong
- Department of Epileptology, Fuzhou General Hospital, Fujian Medical University, Fuzhou, China
| |
Collapse
|
43
|
Discrete pre-processing step effects in registration-based pipelines, a preliminary volumetric study on T1-weighted images. PLoS One 2017; 12:e0186071. [PMID: 29023597 PMCID: PMC5638331 DOI: 10.1371/journal.pone.0186071] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 09/25/2017] [Indexed: 01/18/2023] Open
Abstract
Pre-processing MRI scans prior to performing volumetric analyses is common practice in MRI studies. As pre-processing steps adjust the voxel intensities, the space in which the scan exists, and the amount of data in the scan, it is possible that the steps have an effect on the volumetric output. To date, studies have compared between and not within pipelines, and so the impact of each step is unknown. This study aims to quantify the effects of pre-processing steps on volumetric measures in T1-weighted scans within a single pipeline. It was our hypothesis that pre-processing steps would significantly impact ROI volume estimations. One hundred fifteen participants from the OASIS dataset were used, where each participant contributed three scans. All scans were then pre-processed using a step-wise pipeline. Bilateral hippocampus, putamen, and middle temporal gyrus volume estimations were assessed following each successive step, and all data were processed by the same pipeline 5 times. Repeated-measures analyses tested for a main effects of pipeline step, scan-rescan (for MRI scanner consistency) and repeated pipeline runs (for algorithmic consistency). A main effect of pipeline step was detected, and interestingly an interaction between pipeline step and ROI exists. No effect for either scan-rescan or repeated pipeline run was detected. We then supply a correction for noise in the data resulting from pre-processing.
Collapse
|
44
|
Abstract
In recent years, the field of neuroimaging has undergone dramatic development. Specifically, of importance for clinicians and researchers managing patients with epilepsies, new methods of brain imaging in search of the seizure-producing abnormalities have been implemented, and older methods have undergone additional refinement. Methodology to predict seizure freedom and cognitive outcome has also rapidly progressed. In general, the image data processing methods are very different and more complicated than even a decade ago. In this review, we identify the recent developments in neuroimaging that are aimed at improved management of epilepsy patients. Advances in structural imaging, diffusion imaging, fMRI, structural and functional connectivity, hybrid imaging methods, quantitative neuroimaging, and machine-learning are discussed. We also briefly summarize the potential new developments that may shape the field of neuroimaging in the near future and may advance not only our understanding of epileptic networks as the source of treatment-resistant seizures but also better define the areas that need to be treated in order to provide the patients with better long-term outcomes.
Collapse
|
45
|
Sone D, Imabayashi E, Maikusa N, Okamura N, Furumoto S, Kudo Y, Ogawa M, Takano H, Yokoi Y, Sakata M, Tsukamoto T, Kato K, Matsuda H. Regional tau deposition and subregion atrophy of medial temporal structures in early Alzheimer's disease: A combined positron emission tomography/magnetic resonance imaging study. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2017; 9:35-40. [PMID: 28856235 PMCID: PMC5562105 DOI: 10.1016/j.dadm.2017.07.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Introduction Molecular imaging and selective hippocampal subfield atrophy are a focus of recent Alzheimer's disease (AD) research. Here, we investigated correlations between molecular imaging and hippocampal subfields in early AD. Methods We investigated 18 patients with early AD and 18 healthy control subjects using 11C-Pittsburgh compound-B (PIB) positron emission tomography (PET) and 18F-THK5351 PET and automatic segmentation of hippocampal subfields with high-resolution T2-weighted magnetic resonance imaging. The PET images were normalized and underwent voxelwise regression analysis with each subregion volumes using SPM12. Results As for 18F-THK5351 PET, the bilateral perirhinal cortex volumes were significantly associated with the ipsilateral or bilateral temporal lobar uptakes, whereas hippocampal subfields showed no correlations. 11C-PIB PET showed relatively broad negative correlation with the right cornu ammonis 3 volumes. Discussion Regional tau deposition was correlated with extrahippocampal subregional atrophy and not with hippocampal subfields, possibly reflecting different underlying mechanisms of atrophy in early AD. Amyloid might be associated with right cornu ammonis 3 atrophy. Molecular imaging and hippocampal subfield are hot topics of Alzheimer's disease. We investigated 18 patients with early Alzheimer's disease by amyloid/tau imaging. Bilateral perirhinal cortices were significantly correlated with tau deposition. Hippocampal subfields showed no significant correlations with tau deposition. Amyloid deposition showed a correlation with right CA3 volumes.
Collapse
Affiliation(s)
- Daichi Sone
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Tokyo, Japan.,Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Etsuko Imabayashi
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Norihide Maikusa
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Nobuyuki Okamura
- Division of Pharmacology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan.,Division of Neuro-imaging, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Shozo Furumoto
- Division of Radiopharmaceutical Chemistry, Cyclotron and Radioisotope Center, Tohoku University, Sendai, Japan
| | - Yukitsuka Kudo
- Division of Neuro-imaging, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Masayo Ogawa
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Harumasa Takano
- Department of Psychiatry, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yuma Yokoi
- Department of Psychiatry, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Masuhiro Sakata
- Department of Psychiatry, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Tadashi Tsukamoto
- Department of Neurology, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Koichi Kato
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Hiroshi Matsuda
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Tokyo, Japan
| |
Collapse
|
46
|
Györfi O, Nagy H, Bokor M, Moustafa AA, Rosenzweig I, Kelemen O, Kéri S. Reduced CA2-CA3 Hippocampal Subfield Volume Is Related to Depression and Normalized by l-DOPA in Newly Diagnosed Parkinson's Disease. Front Neurol 2017; 8:84. [PMID: 28367136 PMCID: PMC5355434 DOI: 10.3389/fneur.2017.00084] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 02/24/2017] [Indexed: 11/24/2022] Open
Abstract
Hippocampal dysfunctions may play an important role in the non-motor aspects of Parkinson’s disease (PD), including depressive and cognitive symptoms. Fine structural alterations of the hippocampus and their relationship with symptoms and medication effects are unknown in newly diagnosed PD. We measured the volume of hippocampal subfields in 35 drug-naïve, newly diagnosed PD patients without cognitive impairment and 30 matched healthy control individuals. Assessments were performed when the patients did not receive medications and after a 24-week period of l-DOPA treatment. We obtained a T1-weighted 3D magnetization-prepared rapid acquisition gradient echo image at each assessment. FreeSurfer v6.0 was used for image analysis. Results revealed a selectively decreased CA2–CA3 volume in non-medicated PD patients, which was normalized after the 24-week treatment period. Higher depressive symptoms were associated with smaller CA2–CA3 volumes. These results indicate that the CA2–CA3 subfield is structurally affected in the earliest stage of PD in the absence of cognitive impairment. This structural anomaly, normalized by l-DOPA, is related to depressive non-motor symptoms.
Collapse
Affiliation(s)
- Orsolya Györfi
- Department of Neurology, Nyírö Gyula Hospital, National Institute of Psychiatry and Addictions , Budapest , Hungary
| | - Helga Nagy
- National Institute for Medical Rehabilitation, Budapest, Hungary; Department of Neurology, Semmelweis University, Budapest, Hungary
| | - Magdolna Bokor
- Department of Neurology, Nyírö Gyula Hospital, National Institute of Psychiatry and Addictions , Budapest , Hungary
| | - Ahmed A Moustafa
- School of Social Sciences and Psychology, Western Sydney University, Sydney, NSW, Australia; Marcs Institute for Brain and Behavior, Western Sydney University, Sydney, NSW, Australia
| | - Ivana Rosenzweig
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, IOPPN, King's College and Imperial College London, London, UK; Sleep Disorders Centre, Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Oguz Kelemen
- Faculty of Medicine, Department of Behavioral Sciences, University of Szeged , Szeged , Hungary
| | - Szabolcs Kéri
- Department of Neurology, Nyírö Gyula Hospital, National Institute of Psychiatry and Addictions, Budapest, Hungary; Department of Cognitive Science, Budapest University of Technology and Economics, Budapest, Hungary; Faculty of Medicine, Department of Physiology, University of Szeged, Szeged, Hungary
| |
Collapse
|