Yue-Loong Hsin1, Tomor Harnod2, Cheng-Siu Chang3, Syu-Jyun Peng4. 1. Department of Neurology, Chung Shan Medical University and Chung Shan Medical University Hospital, No. 110, Sec. 1, Jianguo N. Rd., South Dist., Taichung City 40201, Taiwan. Electronic address: hsin.yloong@msa.hinet.net. 2. Department of Neurosurgery, Buddhist Tzu Chi General Hospital, No.707, Sec. 3, Zhongyang Rd., Hualien City, Hualien County 97002, Taiwan. Electronic address: tomorha@yahoo.com.tw. 3. Department of Neurosurgery, Chung Shan Medical University and Chung Shan Medical University Hospital, No. 110, Sec. 1, Jianguo N. Rd., South Dist., Taichung City 40201, Taiwan. Electronic address: chengsiu.chang@gmail.com. 4. Institute of Electronics, National Chiao Tung University, 1001 University Rd., Hsinchu City 300, Taiwan; Biomedical Electronics Translational Research Center, National Chiao Tung University, 1001 University Rd., Hsinchu City 300, Taiwan. Electronic address: blue.year@msa.hinet.net.
Abstract
PURPOSE: Convulsive motor activity is a clinical manifestation of secondarily generalized seizures evolving from different focal regions. The way in which the motor seizures present themselves is not very different from most of the generalized seizures in and between epilepsy patients. This might point towards the involvement of motor-related cortices and corticospinal pathway for wide spread propagation of epileptic activity. Our aim was to identify changes in the cerebral structures and to correlate clinical variables with structural changes particularly in the motor-related cortices and pathway of patients with generalized convulsions from different seizure foci. METHODS: Sixteen patients with focal onset and secondarily generalized seizures were included, along with sixteen healthy volunteers. Structural differences were analysed by measuring grey matter (GM) volume and thickness via T1-weighted MRI, and white matter (WM) fractional anisotropy (FA) via diffusion tensor imaging. GM and WM microstructural properties were compared between patients and controls by voxel- and surface- based analyses. Next, morphometric findings were correlated with seizure severity and disease duration to identify the pathologic process. KEY FINDINGS: In addition to widely reduced GM and WM properties, increased GM volume in the bilateral precentral gyri and paracentral lobules, and elevated regional FA in the bilateral corticospinal tracts adjacent to these motor -related GM were observed in patients and with higher statistical difference in the sub-patient group with drug-resistance. SIGNIFICANCE: The increment of GM volume and WM FA in the motor pathway positively correlated with severity and duration of epilepsy. The demonstrated microstructural changes of motor pathways imply a plastic process of motor networks in the patients with frequent generalization of focal seizures.
PURPOSE:Convulsive motor activity is a clinical manifestation of secondarily generalized seizures evolving from different focal regions. The way in which the motor seizures present themselves is not very different from most of the generalized seizures in and between epilepsypatients. This might point towards the involvement of motor-related cortices and corticospinal pathway for wide spread propagation of epileptic activity. Our aim was to identify changes in the cerebral structures and to correlate clinical variables with structural changes particularly in the motor-related cortices and pathway of patients with generalized convulsions from different seizure foci. METHODS: Sixteen patients with focal onset and secondarily generalized seizures were included, along with sixteen healthy volunteers. Structural differences were analysed by measuring grey matter (GM) volume and thickness via T1-weighted MRI, and white matter (WM) fractional anisotropy (FA) via diffusion tensor imaging. GM and WM microstructural properties were compared between patients and controls by voxel- and surface- based analyses. Next, morphometric findings were correlated with seizure severity and disease duration to identify the pathologic process. KEY FINDINGS: In addition to widely reduced GM and WM properties, increased GM volume in the bilateral precentral gyri and paracentral lobules, and elevated regional FA in the bilateral corticospinal tracts adjacent to these motor -related GM were observed in patients and with higher statistical difference in the sub-patient group with drug-resistance. SIGNIFICANCE: The increment of GM volume and WM FA in the motor pathway positively correlated with severity and duration of epilepsy. The demonstrated microstructural changes of motor pathways imply a plastic process of motor networks in the patients with frequent generalization of focal seizures.
Authors: Jennifer A Ogren; Raghav Tripathi; Paul M Macey; Rajesh Kumar; John M Stern; Dawn S Eliashiv; Luke A Allen; Beate Diehl; Jerome Engel; M R Sandhya Rani; Samden D Lhatoo; Ronald M Harper Journal: Neuroimage Clin Date: 2018-07-18 Impact factor: 4.881