scholarly journals Bilateral volume reduction in posterior hippocampus in psychosis of epilepsy

2019 ◽  
Vol 90 (6) ◽  
pp. 688-694 ◽  
Author(s):  
James Allebone ◽  
Richard Kanaan ◽  
Jerome Maller ◽  
Terry O'Brien ◽  
Saul Alator Mullen ◽  
...  

ObjectivePsychosis of epilepsy (POE) occurs more frequently in temporal lobe epilepsy, raising the question as to whether abnormalities of the hippocampus are aetiologically important. Despite decades of investigation, it is unclear whether hippocampal volume is reduced in POE, perhaps due to small sample sizes and methodological limitations of past research.MethodsIn this study, we examined the volume of the total hippocampus, and the hippocampal head, body and tail, in a large cohort of patients with POE and patients with epilepsy without psychosis (EC). One hundred adults participated: 50 with POE and 50 EC. Total and subregional hippocampal volumes were manually traced and compared between (1) POE and EC; (2) POE with temporal lobe epilepsy, extratemporal lobe epilepsy and generalised epilepsy; and (3) patients with POE with postictal psychosis (PIP) and interictal psychosis (IP).ResultsCompared with EC the POE group had smaller total left hippocampus volume (13.5% decrease, p<0.001), and smaller left hippocampal body (13.3% decrease, p=0.002), and left (41.5% decrease, p<0.001) and right (36.4% decrease, p<0.001) hippocampal tail volumes. Hippocampal head volumes did not differ between groups.ConclusionPosterior hippocampal volumes are bilaterally reduced in POE. Volume loss was observed on a posteroanterior gradient, with severe decreases in the tail and moderate volume decreases in the body, with no difference in the hippocampal head. Posterior hippocampal atrophy is evident to a similar degree in PIP and IP. Our findings converge with those reported for the paradigmatic psychotic disorder, schizophrenia, and suggest that posterior hippocampal atrophy may serve as a biomarker of the risk for psychosis, including in patients with epilepsy.

Author(s):  
CA Elliott ◽  
C Yasuda ◽  
L Concha ◽  
M Liu ◽  
M Wheatley ◽  
...  

Background: Temporal Lobe Epilepsy is associated with bilateral gray (GM) and white matter (WM) loss. After surgical treatment progressive bilateral temporal and extra-temporal WM change occur, however, less is known regarding post-operative GM change. We set out to measure contralateral hippocampal volume (CHV) following TLS. Methods: 1.5T-3D-1mm-isotropic-MPRAGE scans in 26 TLE patients and 3 controls in two groups: longitudinal (n=10)(imaged POD1,2,3,6,60,120 and >360d) and single post-operative scan (n=16). Manual volumetry protocols. Results: We find significant CHV atrophy at delayed scan relative to baseline (mean atrophy 26.8%). In the longitudinal group there is significant and progressive atrophy from baseline to POD4-8 (72.6+/-6.5%), POD60-360 (69.7+/-12.3%) and >360 (58.5+/-10.6%). No significant atrophy in either the control group HV or contralateral CV over time. No significant difference in mean HV at the most delayed exam for surgery type (p=0.13) or side (p=0.24). Conclusions: We find a statistically significant CHV atrophy following surgery which is progressive over time. Our longitudinal within-subject design describes the time course and extent more fully than previous work. Caudate analysis indicates that early CHV atrophy is not due to global atrophy following brain surgery but rather may be due to deafferentation and deefferentation. Finally, we find no significant difference in atrophy when analyzed by surgical approach or surgical side.


2019 ◽  
Vol 26 (07) ◽  
pp. 1009-1013
Author(s):  
Abdul Raouf ◽  
Saba Jehangir ◽  
Asma Shoukat ◽  
Muhammad Ahsan

Mesial temporal sclerosis (MTS) is the most common pathology in patients undergoing anterior temporal lobectomy. Magnetic resonance imaging (MRI) is valuable in detecting MTS. Reduced hippocampal volume and elevated T2 signal are associated with MTS, and both quantitative T2 and volumetric measurementshave been associated with hippocampal cellular loss that characterizes this condition. Objectives: To determine the accuracy of hippocampal quantitative (T2 relaxometric) assessment in diagnosing hippocampal atrophy in patients with temporal lobe epilepsy by comparing it with qualitative (visual) assessment on MRI. Study Design: Cross sectional study. Setting: Radiology department of Allied Hospital Faisalabad. Period: 12 months from theapproval from Sep, 2016 to Dec, 2017. Subjects & Methods: After taking permission from hospital ethical committee, and written informed consent, patients with history of temporal lobe epilepsy and EEG findings consistent with temporal lobe epilepsy were examined on 1.5 Tesla Achieva philips scanner, visual assessment and T2 relaxometry. Section of the hippocampus head was defined as the first in which it was possible to see the temporal horn of the lateral ventricle and therefore to appropriately separate the hippocampal formation from the amygdala. The body of the hippocampus defined in the fourth coronal section after the region of interest of the hippocampus head, and the tail was defined in the third coronal section after the hippocampus body, in which it is also possible to visualize the quadrigeminal plate (section of 5mm).Visually the images were assessed and MRI examination was done. All the data was collected on a performa. Results: We concluded that the frequency of accuracy of hippocampal quantitative (t2 relaxometric) assessment in diagnosing hippocampal atrophy in patients with temporal lobe epilepsy by comparing it with qualitative (visual) assessment on MRIis high but needs validation through some-other studies. Conclusion: We concluded that the frequency of accuracy of hippocampal quantitative (t2 relaxometric) assessment in diagnosing hippocampal atrophy in patients with temporal lobe epilepsy by comparing it with qualitative (visual) assessment on MRI is high but needs validation through some-other studies. 


2021 ◽  
pp. 216770262110302
Author(s):  
M. Justin Kim ◽  
Maxwell L. Elliott ◽  
Annchen R. Knodt ◽  
Ahmad R. Hariri

Past research on the brain correlates of trait anger has been limited by small sample sizes, a focus on relatively few regions of interest, and poor test–retest reliability of functional brain measures. To address these limitations, we conducted a data-driven analysis of variability in connectome-wide functional connectivity in a sample of 1,048 young adult volunteers. Multidimensional matrix regression analysis showed that self-reported trait anger maps onto variability in the whole-brain functional connectivity patterns of three brain regions that serve action-related functions: bilateral supplementary motor areas and the right lateral frontal pole. We then demonstrate that trait anger modulates the functional connectivity of these regions with canonical brain networks supporting somatomotor, affective, self-referential, and visual information processes. Our findings offer novel neuroimaging evidence for interpreting trait anger as a greater propensity to provoked action, which supports ongoing efforts to understand its utility as a potential transdiagnostic marker for disordered states characterized by aggressive behavior.


2011 ◽  
Vol 21 (1) ◽  
pp. 94-99 ◽  
Author(s):  
Shigeki Sunaga ◽  
Michiharu Morino ◽  
Taro Kusakabe ◽  
Hidenori Sugano ◽  
Hiroyuki Shimizu

2018 ◽  
Vol 10 (1S) ◽  
pp. 51-55
Author(s):  
E. S. Solomatova ◽  
N. A. Shnaider ◽  
A. A. Molgachev ◽  
D. V. Dmitrenko ◽  
I. G. Strotskaya

The temporal lobe is the most epileptogenic region of the brain. 90% of patients with temporal ictal epileptomorphic EEG activity have a variable long history of seizures. Magnetic resonance spectroscopy  (MRS) may be useful in identifying an epileptogenic focus in patients  with epilepsy without apparent structural pathology at neuroimaging.Objective: to systematize the results of early studies on this issue.Materials and methods. An electronic search was carried out in two English-language (Medline, PubMed) and one Russian-language (eLIBRARY.RU) databases. The search queries found  18,019 citations, by which 12 full-text articles were selected.Results and discussion. The main criteria for the diagnosis of temporal lobe epilepsy by MRS is to lower the level of N-acetylaspartate (NAA), the ratio of NAA to creatinine + choline  (NAA/(Cr + Cho) in the brain region where there is neuronal death  or damage, as well as a change in the level of myo-inositol, the  elevated level of which indicates the presence of an epileptogenic  focus, while the decreased one shows the spread of pathological activity to the adjacent tissues.Conclusion. This review will contribute to a better diagnosis of temporal lobe epilepsy, as well as to the intravital noninvasive detection of metabolic changes in the brain long before the development of structural pathology.


2013 ◽  
Vol 119 (5) ◽  
pp. 1098-1104 ◽  
Author(s):  
Takehiro Uda ◽  
Michiharu Morino ◽  
Hirotaka Ito ◽  
Noriaki Minami ◽  
Atsushi Hosono ◽  
...  

Object Amygdalohippocampectomy is a well-established, standard surgery for medically intractable mesial temporal lobe epilepsy (MTLE). However, in the case of MTLE without hippocampal atrophy or sclerosis, amygdalohippocampectomy is associated with decreased postoperative memory function. Hippocampal transection (HT) has been developed to overcome this problem. In HT the hippocampus is not removed; rather, the longitudinal hippocampal circuits of epileptic activities are disrupted by transection of the pyramidal layer of the hippocampus. The present study describes a less invasive modification of HT (transsylvian HT) and presents the seizure and memory outcomes for this procedure. Methods Thirty-seven patients with MTLE (18 men and 19 women; age range 9–63 years; 19 with surgery on the right side and 18 with surgery on the left side; seizure onset from 3 to 34 years) who were treated with transsylvian HT were retrospectively analyzed. All patients had left-side language dominance, and follow-up periods ranged from 12 to 94 months (median 49 months). Seizure outcomes were evaluated for all patients by using the Engel classification. Memory function was evaluated for 22 patients based on 3 indices (verbal memory, nonverbal memory, and delayed recall), with those scores obtained using the Wechsler Memory Scale–Revised. Patients underwent evaluation of the memory function before and after surgery (6 months–1 year). Results Engel Class I (completely seizure free) was achieved in 25 patients (67.6%). Class II and Class III designation was achieved in 10 (27%) and 2 patients (5.4%), respectively. There were differences in memory outcome between the sides of operation. On the right side, verbal memory significantly increased postoperatively (p = 0.003) but nonverbal memory and delayed recall showed no significant change after the operation (p = 0.718 and p = 0.210, respectively). On the left side, all 3 indices (verbal memory, nonverbal memory, and delayed recall) showed no significant change (p = 0.331, p = 0.458, and p = 0.366, respectively). Conclusions Favorable seizure outcome and preservation of verbal memory were achieved with transsylvian HT for the treatment of MTLE without hippocampal atrophy or sclerosis.


2005 ◽  
Vol 253 (3) ◽  
pp. 294-300 ◽  
Author(s):  
E. Düzel ◽  
K. Schiltz ◽  
T. Solbach ◽  
Th. Peschel ◽  
T. Baldeweg ◽  
...  

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