Boris C Bernhardt1, Hosung Kim, Neda Bernasconi. 1. From the Neuroimaging of Epilepsy Laboratory, Department of Neurology and Brain Imaging Center, McGill University, Montreal Neurological Institute and Hospital, Montreal, Canada.
Abstract
OBJECTIVE: Evidence for disease progression in the mesiotemporal lobe is mainly derived from global volumetry of the hippocampus. In this study, we tracked progressive structural changes in the hippocampus, amygdala, and entorhinal cortex in drug-resistant temporal lobe epilepsy at a subregional level. Furthermore, we evaluated the relation between disease progression and surgical outcome. METHODS: We combined cross-sectional modeling of disease duration in a large cohort of patients (n = 134) and longitudinal analysis in a subset that delayed surgery (n = 31). To track subregional pathology, we applied surface-shape analysis techniques on manual mesiotemporal labels. RESULTS: Longitudinal and cross-sectional designs showed consistent patterns of progressive atrophy in hippocampal CA1, anterolateral entorhinal, and the amygdalar laterobasal group bilaterally. These regions also exhibited more marked age-related volume loss in patients compared with controls. We found a faster progression of hippocampal atrophy in patients with a seizure frequency ≥6 per month. High rates of contralateral entorhinal cortex atrophy predicted postsurgical seizure relapse. CONCLUSION: We observed progressive atrophy in hippocampal, amygdalar, and entorhinal subregions that frequently display neuronal loss on histology. The bilateral character of cumulative atrophy highlights the importance of early surgery. In patients who nevertheless delay this procedure, serial scanning may provide markers of surgical outcome.
OBJECTIVE: Evidence for disease progression in the mesiotemporal lobe is mainly derived from global volumetry of the hippocampus. In this study, we tracked progressive structural changes in the hippocampus, amygdala, and entorhinal cortex in drug-resistant temporal lobe epilepsy at a subregional level. Furthermore, we evaluated the relation between disease progression and surgical outcome. METHODS: We combined cross-sectional modeling of disease duration in a large cohort of patients (n = 134) and longitudinal analysis in a subset that delayed surgery (n = 31). To track subregional pathology, we applied surface-shape analysis techniques on manual mesiotemporal labels. RESULTS: Longitudinal and cross-sectional designs showed consistent patterns of progressive atrophy in hippocampal CA1, anterolateral entorhinal, and the amygdalar laterobasal group bilaterally. These regions also exhibited more marked age-related volume loss in patients compared with controls. We found a faster progression of hippocampal atrophy in patients with a seizure frequency ≥6 per month. High rates of contralateral entorhinal cortex atrophy predicted postsurgical seizure relapse. CONCLUSION: We observed progressive atrophy in hippocampal, amygdalar, and entorhinal subregions that frequently display neuronal loss on histology. The bilateral character of cumulative atrophy highlights the importance of early surgery. In patients who nevertheless delay this procedure, serial scanning may provide markers of surgical outcome.
Authors: D Fuerst; J Shah; W J Kupsky; R Johnson; A Shah; B Hayman-Abello; T Ergh; Q Poore; A Canady; C Watson Journal: Neurology Date: 2001-07-24 Impact factor: 9.910
Authors: F Cendes; F Andermann; P Gloor; I Lopes-Cendes; E Andermann; D Melanson; M Jones-Gotman; Y Robitaille; A Evans; T Peters Journal: Ann Neurol Date: 1993-12 Impact factor: 10.422
Authors: Camille Garcia-Ramos; Sam Bobholz; Kevin Dabbs; Bruce Hermann; Juho Joutsa; Juha O Rinne; Mira Karrasch; Vivek Prabhakaran; Shlomo Shinnar; Matti Sillanpää Journal: Hum Brain Mapp Date: 2017-04-03 Impact factor: 5.038
Authors: Kiran Khurshid; Andrew J D Crow; Petra E Rupert; Nancy L Minniti; Melissa A Carswell; Dawn J Mechanic-Hamilton; Vidyulata Kamath; Richard L Doty; Paul J Moberg; David R Roalf Journal: Neuropsychol Rev Date: 2019-05-29 Impact factor: 7.444
Authors: Boris C Bernhardt; Neda Bernasconi; Seok-Jun Hong; Sebastian Dery; Andrea Bernasconi Journal: Cereb Cortex Date: 2015-07-28 Impact factor: 5.357