Anaclara Prada Jardim1, Jeana Torres Corso2, Maria Teresa Fernandes Castilho Garcia2, Larissa Botelho Gaça2, Sandra Mara Comper2, Carmen Lúcia Penteado Lancellotti3, Ricardo Silva Centeno4, Henrique Carrete5, Esper Abrão Cavalheiro6, Carla Alessandra Scorza6, Elza Márcia Targas Yacubian2. 1. Clinical Neurology Sector, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo (UNIFESP), Rua Pedro de Toledo, 650 - Vila Clementino, CEP 04039-002, São Paulo, SP, Brazil. Electronic address: anaclarapjardim@gmail.com. 2. Clinical Neurology Sector, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo (UNIFESP), Rua Pedro de Toledo, 650 - Vila Clementino, CEP 04039-002, São Paulo, SP, Brazil. 3. Department of Pathological Sciences, Faculdade de Ciências Médicas da Santa Casa de São Paulo, Rua Dr. Cesáreo Motta Jr., 61 - Vila Buarque, CEP 01221-020, São Paulo, SP, Brazil. 4. Neurosurgery Sector, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 715, 6° andar - Vila Clementino, CEP 04024-002, São Paulo, SP, Brazil. 5. Diagnostic Imaging Sector, Department of Diagnostic Imaging, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 800 - Vila Clementino, CEP 04024-002, São Paulo, SP, Brazil. 6. Neuroscience Sector, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo (UNIFESP), Rua Pedro de Toledo, 669, 2° andar - Vila Clementino, CEP 04039-032, São Paulo, SP, Brazil.
Abstract
PURPOSE: To correlate hippocampal volumes obtained from brain structural imaging with histopathological patterns of hippocampal sclerosis (HS), in order to predict surgical outcome. METHODS: Patients with mesial temporal lobe epilepsy (MTLE) with HS were selected. Clinical data were assessed pre-operatively and surgical outcome in the first year post surgery. One block of mid hippocampal body was selected for HS classification according to ILAE criteria. NeuN-immunoreactive cell bodies were counted within hippocampal subfields, in four randomly visual fields, and cell densities were transformed into z-score values. FreeSurfer processing of 1.5T brain structural images was used for subcortical and cortical volumetric estimation of the ipsilateral hippocampus. Univariate analysis of variance and Pearson's correlation test were applied for statistical analyses. RESULTS: Sixty-two cases (31 female, 32 right HS) were included. ILAE type 1 HS was identified in 48 patients, type 2 in eight, type 3 in two, and four had no-HS. Better results regarding seizure control, i.e. ILAE 1, were achieved by patients with type 1 HS (58.3%). Patients with types 1 and 2 had smaller hippocampal volumes compared to those with no-HS (p<0.001 and p=0.004, respectively). Positive correlation was encountered between hippocampal volumes and CA1, CA3, CA4, and total estimated neuronal densities. CA2 was the only sector which did not correlate its neuronal density with hippocampal volume (p=0.390). CONCLUSION: This is the first study correlating hippocampal volume on MRI submitted to FreeSurfer processing with ILAE patterns of HS and neuronal loss within each hippocampal subfield, a fundamental finding to anticipate surgical prognosis for patients with drug-resistant MTLE and HS. Copyright Â
PURPOSE: To correlate hippocampal volumes obtained from brain structural imaging with histopathological patterns of hippocampal sclerosis (HS), in order to predict surgical outcome. METHODS:Patients with mesial temporal lobe epilepsy (MTLE) with HS were selected. Clinical data were assessed pre-operatively and surgical outcome in the first year post surgery. One block of mid hippocampal body was selected for HS classification according to ILAE criteria. NeuN-immunoreactive cell bodies were counted within hippocampal subfields, in four randomly visual fields, and cell densities were transformed into z-score values. FreeSurfer processing of 1.5T brain structural images was used for subcortical and cortical volumetric estimation of the ipsilateral hippocampus. Univariate analysis of variance and Pearson's correlation test were applied for statistical analyses. RESULTS: Sixty-two cases (31 female, 32 right HS) were included. ILAE type 1 HS was identified in 48 patients, type 2 in eight, type 3 in two, and four had no-HS. Better results regarding seizure control, i.e. ILAE 1, were achieved by patients with type 1 HS (58.3%). Patients with types 1 and 2 had smaller hippocampal volumes compared to those with no-HS (p<0.001 and p=0.004, respectively). Positive correlation was encountered between hippocampal volumes and CA1, CA3, CA4, and total estimated neuronal densities. CA2 was the only sector which did not correlate its neuronal density with hippocampal volume (p=0.390). CONCLUSION: This is the first study correlating hippocampal volume on MRI submitted to FreeSurfer processing with ILAE patterns of HS and neuronal loss within each hippocampal subfield, a fundamental finding to anticipate surgical prognosis for patients with drug-resistant MTLE and HS. Copyright Â
Authors: F Riederer; R Seiger; R Lanzenberger; E Pataraia; G Kasprian; L Michels; J Beiersdorf; S Kollias; T Czech; J Hainfellner; C Baumgartner Journal: AJNR Am J Neuroradiol Date: 2020-06 Impact factor: 3.825
Authors: Zachary A Cordner; Seva G Khambadkone; Gretha J Boersma; Lin Song; Tyler N Summers; Timothy H Moran; Kellie L K Tamashiro Journal: Exp Neurol Date: 2019-04-30 Impact factor: 5.330