OBJECTIVES: To investigate the use of whole brain voxel based morphometry (VBM) and stereological analysis to study brain morphology in patients with medically intractable temporal lobe epilepsy; and to determine the relation between side, duration, and age of onset of temporal lobe epilepsy, history of childhood febrile convulsions, and grey matter structure. METHODS: Three dimensional magnetic resonance images were obtained from 58 patients with left sided seizure onset (LSSO) and 58 patients with right sided seizure onset (RSSO), defined using EEG and foramen ovale recordings in the course of presurgical evaluation for temporal lobectomy. Fifty eight normal controls formed a comparison group. VBM was used to characterise whole brain grey matter concentration, while the Cavalieri method of modern design stereology in conjunction with point counting was used to estimate hippocampal and amygdala volume. Age and sex were used as confounding covariates in analyses. RESULTS: LSSO and RSSO patients showed significant reductions in volume (using stereology) and grey matter concentration (using VBM) of the hippocampus, but not of the amygdala, in the presumed epileptogenic zone when compared with controls, but hippocampal (and amygdala) volume and grey matter concentration were not related to duration or age of onset of epilepsy. LSSO and RSSO patients with a history of childhood febrile convulsions had reduced hippocampal volumes in the presumed epileptogenic zone compared with patients without such a history. Left amygdala volume was also reduced in LSSO patients with a history of childhood convulsions. VBM results indicated bilateral thalamic, prefrontal, and cerebellar GMC reduction in patients, which correlated with duration and age of onset of epilepsy. CONCLUSIONS: Hippocampal sclerosis is not necessarily the consequence of recurrent temporal lobe seizures. A major cause of hippocampal sclerosis appears to be an early aberrant neurological insult, such as childhood febrile seizures. Secondary brain abnormalities exist in regions outside the presumed epileptogenic zone and may result from recurrent seizures.
OBJECTIVES: To investigate the use of whole brain voxel based morphometry (VBM) and stereological analysis to study brain morphology in patients with medically intractable temporal lobe epilepsy; and to determine the relation between side, duration, and age of onset of temporal lobe epilepsy, history of childhood febrile convulsions, and grey matter structure. METHODS: Three dimensional magnetic resonance images were obtained from 58 patients with left sided seizure onset (LSSO) and 58 patients with right sided seizure onset (RSSO), defined using EEG and foramen ovale recordings in the course of presurgical evaluation for temporal lobectomy. Fifty eight normal controls formed a comparison group. VBM was used to characterise whole brain grey matter concentration, while the Cavalieri method of modern design stereology in conjunction with point counting was used to estimate hippocampal and amygdala volume. Age and sex were used as confounding covariates in analyses. RESULTS: LSSO and RSSO patients showed significant reductions in volume (using stereology) and grey matter concentration (using VBM) of the hippocampus, but not of the amygdala, in the presumed epileptogenic zone when compared with controls, but hippocampal (and amygdala) volume and grey matter concentration were not related to duration or age of onset of epilepsy. LSSO and RSSO patients with a history of childhood febrile convulsions had reduced hippocampal volumes in the presumed epileptogenic zone compared with patients without such a history. Left amygdala volume was also reduced in LSSO patients with a history of childhood convulsions. VBM results indicated bilateral thalamic, prefrontal, and cerebellar GMC reduction in patients, which correlated with duration and age of onset of epilepsy. CONCLUSIONS:Hippocampal sclerosis is not necessarily the consequence of recurrent temporal lobe seizures. A major cause of hippocampal sclerosis appears to be an early aberrant neurological insult, such as childhood febrile seizures. Secondary brain abnormalities exist in regions outside the presumed epileptogenic zone and may result from recurrent seizures.
Authors: F G Woermann; L T van Elst; M J Koepp; S L Free; P J Thompson; M R Trimble; J S Duncan Journal: J Neurol Neurosurg Psychiatry Date: 2000-02 Impact factor: 10.154
Authors: N Bernasconi; A Bernasconi; Z Caramanos; F Dubeau; J Richardson; F Andermann; D L Arnold Journal: Neurology Date: 2001-05-22 Impact factor: 9.910
Authors: Bruce Hermann; Michael Seidenberg; Mark Sager; Cynthia Carlsson; Barry Gidal; Raj Sheth; Paul Rutecki; Sanjay Asthana Journal: Epilepsia Date: 2007-11-21 Impact factor: 5.864
Authors: Simon Sean Keller; John Robin Highley; Marta Garcia-Finana; Vanessa Sluming; Roozbeh Rezaie; Neil Roberts Journal: J Anat Date: 2007-08-29 Impact factor: 2.610
Authors: P R B Diniz; T R Velasco; C E G Salmon; A C Sakamoto; J P Leite; A C Santos Journal: AJNR Am J Neuroradiol Date: 2011-09-01 Impact factor: 3.825
Authors: Andrey Finegersh; Christina Avedissian; Sadat Shamim; Irene Dustin; Paul M Thompson; William H Theodore Journal: Epilepsia Date: 2011-01-26 Impact factor: 5.864
Authors: Sofia H Eriksson; Maria Thom; Mark R Symms; Niels K Focke; Lillian Martinian; Sanjay M Sisodiya; John S Duncan Journal: Hum Brain Mapp Date: 2009-10 Impact factor: 5.038
Authors: S H Eriksson; S L Free; M Thom; M R Symms; L Martinian; J S Duncan; S M Sisodiya Journal: J Neurosci Methods Date: 2009-05-09 Impact factor: 2.390