scholarly journals Intrinsic Thalamic Network in Temporal Lobe Epilepsy With Hippocampal Sclerosis According to Surgical Outcomes

2021 ◽  
Vol 12 ◽  
Author(s):  
Kyoo Ho Cho ◽  
Ho-Joon Lee ◽  
Kyoung Heo ◽  
Sung Eun Kim ◽  
Dong Ah Lee ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Surgical Outcomes ◽  
Hippocampal Sclerosis ◽  
Three Dimensional ◽  
Thalamic Nuclei ◽  
Characteristic Path Length ◽  
Ipsilateral Hemisphere ◽  
Hippocampal Subfields ◽  
Significant Difference

Background: The aim of this study was to identify the differences of intrinsic amygdala, hippocampal, or thalamic networks according to surgical outcomes in temporal lobe epilepsy (TLE) patients with hippocampal sclerosis (HS).Methods: We enrolled 69 pathologically confirmed TLE patients with HS. All patients had pre-operative three-dimensional T1-weighted MRI using a 3.0 T scanner. We obtained the structural volumes of the amygdala nuclei, hippocampal subfields, and thalamic nuclei. Then, we investigated the intrinsic networks based on volumes of these structures using structural covariance and graph theoretical analysis.Results: Of the 69 TLE patients with HS, 21 patients (42.1%) had poor surgical outcomes, whereas 40 patients (57.9%) had good surgical outcomes. The volumes in the amygdala nuclei, hippocampal subfields, and thalamic nuclei were not different according to surgical outcome. In addition, the intrinsic amygdala and hippocampal networks were not different between the patients with poor and good surgical outcomes. However, there was a significant difference in the intrinsic thalamic network in the ipsilateral hemisphere between them. The eccentricity and small-worldness index were significantly increased, whereas the characteristic path length was decreased in the patients with poor surgical outcomes compared to those with good surgical outcomes.Conclusion: We successfully demonstrated significant differences in the intrinsic thalamic network in the ipsilateral hemisphere between TLE patients with HS with poor and good surgical outcomes. This result suggests that the pre-operative intrinsic thalamic network can be related with surgical outcomes in TLE patients with HS.

scholarly journals Interleukin-1β secretion in hippocampal sclerosis patients with mesial temporal lobe epilepsy

2013 ◽  
Vol 5 (3) ◽  
pp. 17 ◽  
Author(s):  
Nihal Olgac Dundar ◽  
Berrin Aktekin ◽  
Nilufer Cicek Ekinci ◽  
Duygu Sahinturk ◽  
Ugur Yavuzer ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Promoter Region ◽  
Mononuclear Cells ◽  
Hippocampal Sclerosis ◽  
Intractable Epilepsy ◽  
Mesial Temporal Lobe Epilepsy ◽  
Epilepsy Syndrome ◽  
Significant Difference ◽  
Mesial Temporal Lobe

Mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) is a common medically intractable epilepsy syndrome. Although pathogenesis of HS still remains highly controversial, genetics may play a role as a predisposing factor. Previous evidence in a Japanese population revealed that the homozygotes for allele T at position −511 of the interleukin (IL)-1β gene promoter region (IL-1β-511 T/T) confers susceptibility to the development of HS. However, whether this polymorphism has an effect on IL-1β levels in MTLE-HS patients was not demonstrated. This study aimed to analyze the distribution of this particular polymorphism in a group of Turkish HS patients and correlate the polymorphism with IL-1β secretion from the lymphocytes, thus revealing a functional role for IL-1β in the etiopathogenesis of HS. A single base pair polymorphism at position −511 in the promoter region of the IL-1β gene was analyzed. The spontaneous and 1 ng/mL lipopolysaccharide-stimulated production of IL-1β by peripheral blood mononuclear cells after 4 and 24 h of incubation were measured by ELISA method. The heterozygous type (−511 C/T) was the most common genotype. There was no difference in frequency of allele −511 T between patients and controls. Analysis of IL-1β levels, genotype and allele distributions showed no significant difference among the groups (P>0.05). Nevertheless, it was seen that patients who carry a T allele at position -511 of the IL-1β gene had increased IL-1β levels. T-allele carriage may be important. Only IL-1β secretion from the lymphocytes has been assessed in this study. Considering the importance of IL-1β in the etiopathogenesis of HS, further studies are needed to evaluate locally produced IL-1β levels.

scholarly journals MRI-negative Temporal Lobe Epilepsy: Is there a Role for PET?

2005 ◽  
Vol 5 (3) ◽  
pp. 118-119 ◽  
Author(s):  
Theodore H. Schwartz
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Fdg Pet ◽  
Visual Analysis ◽  
Hippocampal Sclerosis ◽  
Significant Difference ◽  
Hippocampal Sparing ◽  
Temporal Lobe Seizures ◽  
Temporal Structures ◽  
History Of

MRI-negative PET-positive Temporal Lobe Epilepsy: A Distinct Surgically Remediable Syndrome Carne RP, O'Brien TJ, Kilpatrick CJ, MacGregor LR, Hicks RJ, Murphy MA, Bowden SC, Kaye AH, Cook MJ Brain 2004;127:2276–2285 Most patients with nonlesional temporal lobe epilepsy (NLTLE) will have the findings of hippocampal sclerosis (HS) on a high-resolution MRI. However, a significant minority of patients with NLTLE and electroclinically well-lateralized temporal lobe seizures have no evidence of HS on MRI. Many of these patients have concordant hypometabolism on fluorodeoxyglucose-PET ([18F]FDG-PET). The pathophysiologic basis of this latter group remains uncertain. We aimed to determine whether NLTLE without HS on MRI represents a variant of or a different clinicopathologic syndrome from that of NLTLE with HS on MRI. The clinical, EEG, [18F]FDG-PET, histopathologic, and surgical outcomes of 30 consecutive NLTLE patients with well-lateralized EEG but without HS on MRI (HS–ve TLE) were compared with 30 consecutive age- and sex-matched NLTLE patients with well-lateralized EEG with HS on MRI (HS+ve TLE). Both the HS+ve TLE group and the HS–ve TLE patients had a high degree of [18F]FDG-PET concordant lateralization (26 of 30 HS–ve TLE vs. 27 of 27 HS+ve TLE). HS–ve TLE patients had more widespread hypometabolism on [18F]FDG-PET by blinded visual analysis [odds ratio (OR,+∞(2.51,–); P = 0.001]. The HS–ve TLE group less frequently had a history of febrile convulsions [OR,0.077 (0.002 to 0.512), P = 0.002], more commonly had a delta rhythm at ictal onset [OR,3.67 (0.97 to 20.47); P = 0.057], and less frequently had histopathologic evidence of HS [OR,0 (0 to 0.85); P = 0.031]. No significant difference in surgical outcome despite half of those without HS having a hippocampal-sparing procedure. Based on the findings outlined, HS–ve PET-positive TLE may be a surgically remediable syndrome distinct from HS+ve TLE, with a pathophysiologic basis that primarily involves lateral temporal neocortical rather than mesial temporal structures.

scholarly journals Longer epilepsy duration and multiple lobe involvement predict worse seizure outcomes for patients with refractory temporal lobe epilepsy associated with neurocysticercosis

2015 ◽  
Vol 73 (12) ◽  
pp. 1014-1018 ◽  
Author(s):  
Lucas Crociati Meguins ◽  
Rodrigo Antônio Rocha da Cruz Adry ◽  
Sebastião Carlos da Silva Júnior ◽  
Carlos Umberto Pereira ◽  
Jean Gonçalves de Oliveira ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Surgical Outcomes ◽  
Hippocampal Sclerosis ◽  
Class I ◽  
Tertiary Center ◽  
One Year ◽  
Patients With Epilepsy ◽  
Retrospective Investigation

ABSTRACT Objective To investigate the surgical outcomes of temporal lobe epilepsy associated with hippocampal sclerosis (TLE-HS) and neurocysticercosis (NCC). Methods A retrospective investigation of patients with TLE-HS was conducted in a tertiary center. Results Seventy-nine (62.2%), 37 (29.1%), 6 (4.7%), and 5 (3.9%) patients were Engel class I, II, III, and IV, respectively. Fifty-two (71.2%) patients with epilepsy durations ≤ 10 years prior to surgery were seizure-free 1 year after the operation compared to 27 (50.0%) patients with epilepsy durations > 10 years (p = 0.0121). Forty-three (72.9%) patients with three or fewer lobes affected by NCC were seizure-free one year after the operation, and 36 (52.9%) patients with more than three involved lobes were seizure-free after surgery (p = 0.0163). Conclusions Longer epilepsy durations and multiple lobe involvement predicted worse seizure outcomes in TLE-HS plus NCC patients.

scholarly journals Determination of the Initial Abnormal Discharge Site in Temporal Lobe Epilepsy Through Combined EEG and Neuroimaging. What Is Next?

2021 ◽  
Vol 12 ◽  
Author(s):  
Ana A. Rentería-Palomo ◽  
Jose L. Montes-Ochoa ◽  
Adriana Martinez-Mayorga ◽  
Jorge Guillermo Reyes-Vaca ◽  
Ildefonso Rodríguez-Leyva
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Latin American ◽  
Epilepsy Surgery ◽  
Comprehensive Evaluation ◽  
Hippocampal Sclerosis ◽  
Hippocampal Atrophy ◽  
Significant Difference ◽  
The Relationship

Objective: The objective of this study was to determine the relationship between atrophy of the hippocampus and severity of epilepsy in patients with temporal lobe epilepsy (TLE) as the first step to evaluate the possibility of surgery for epilepsy and analyze why patients cannot undergo epilepsy surgery.Methods: Volumetric MRI of the hippocampus was performed in 51 consecutive patients (29 men; mean age 40) with TLE. TLE diagnosis, lateralization, and severity (mild, moderate, severe) of seizures were based on a comprehensive evaluation that included neurologic examination and EEG in all patients. Patients with evidence of a lesion other than hippocampal sclerosis were not included in the study. We assessed the relationship between hippocampal volumes and electrophysiological evidence of seizure severity.Results: According to the affected side based on the EEG, a statistically significant difference (p < 0.001) in volume and a positive correlation between epilepsy and hippocampal atrophy were found.Conclusion: Our results confirm that volume loss to the hippocampus in patients with TLE correlates with the severity of epilepsy based on the EEG. Therefore, surgical treatment is considered early when hippocampal atrophy is evident in patients with refractory TLE. However, in Latin American countries, it is a challenge to get a patient to undergo epilepsy surgery. Therefore, we try to analyze the sad situation in our hospital.

Abnormalities of Cortical Thickness in Pediatric Mesial Temporal Lobe Epilepsy with Hippocampal Sclerosis

2020 ◽  
Vol 16 (9) ◽  
pp. 1095-1104
Author(s):  
Kan Deng ◽  
Rushi Zou ◽  
Bingsheng Huang ◽  
Ping Zeng ◽  
Dong Liang ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Cortical Thickness ◽  
Parietal Lobe ◽  
Hippocampal Sclerosis ◽  
Mesial Temporal Lobe Epilepsy ◽  
Precentral Gyrus ◽  
Significant Difference ◽  
Mesial Temporal Lobe ◽  
And Gender

Objective: Mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) is the most common intractable seizure type of pediatric epilepsy, with alterations in the cortex across the whole brain. The aim of this study is to investigate the abnormalities of cortical thickness in pediatric MTLE-HS. Methods: Subjects were recruited from Shenzhen Children’s Hospital between September 2015 and December 2016. MTLE was confirmed by the experienced neurological physician based on International League Against Epilepsy (ILAE) diagnosis criteria, and structural magnetic resonance imaging (MRI) was performed at 3T for quantitative assessment of cortical thickness. A general linear model with age and gender as covariates was used to examine the vertex-wise differences in cortical thickness between 1) left MTLE-HS (LMTLE-HS) and healthy controls (HC), and 2) right MTLE-HS (RMTLE-HS) and HC. The family-wise error corrected significance threshold was set at P < 0.05. Through a combination of probability and cluster-size thresholding, cluster-wise P values were obtained for the resulting clusters. Results: 13 LMTLE-HS, 6 RMTLE-HS, and 20 age-matched HC were finally enrolled in the study. No significant difference in the mean age (LMTLE-HS vs. HC, p=0.57; RMTLE-HS vs. HC, p=0.39) and gender ratio (LMTLE-HS vs. HC, p=0.24; RMTLE-HS vs. HC, p=0.72) was found between MTLE-HS and HC. In LMTLE-HS, cortical thickness was found significantly decreased in the ipsilateral caudal middle frontal gyrus (p=0.012) and increased in the contralateral inferior temporal gyrus (p=0.020). In RMTLE-HS, cortical thickness significantly decreased in the ipsilateral posterior parietal lobe (superior, p<0.001 and inferior parietal gyrus, p=0.03), the anterior parietal lobe (postcentral gyrus, p=0.006), the posterior frontal lobe (precentral gyrus, p=0.04 and the lateral occipital gyrus, p<0.001), and the contralateral lateral occipital gyrus, middle frontal (p<0.0001) and superior frontal gyrus (p<0.001), and pericalcarine cortex (p=0.020). Conclusion: We detected significant cortical abnormalities in pediatric MTLE-HS patients compared with HC. These cortical abnormalities could be explained by specific pathogenesis in MTLE-HS, and may finally contribute to understanding the intrinsic mechanism of MTLE-HS.

scholarly journals Three-dimensional preoperative maps of hippocampal atrophy predict surgical outcomes in temporal lobe epilepsy

Neurology ◽  
2005 ◽  
Vol 65 (7) ◽  
pp. 1094-1097 ◽  
Author(s):  
J. J. Lin ◽  
N. Salamon ◽  
R. A. Dutton ◽  
A. D. Lee ◽  
J. A. Geaga ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Surgical Outcomes ◽  
Three Dimensional ◽  
Hippocampal Atrophy

scholarly journals P.175 Direct Visualization of Thalamic Nuclei using 7 Tesla MRI and quantification in patients with temporal lobe epilepsy.

2021 ◽  
Vol 48 (s3) ◽  
pp. S70-S70
Author(s):  
B Santyr ◽  
JC Lau ◽  
AR Khan
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
7 Tesla ◽  
Electrophysiological Recording ◽  
Small Subset ◽  
Direct Visualization ◽  
Thalamic Nuclei ◽  
Anterior Thalamic Nucleus ◽  
Significant Difference

Background: Most individual thalamic nuclei cannot be directly visualized on routine clinical MRI. Stereotactic targeting techniques are indirect, relying on histological atlases and electrophysiological recording. We investigate whether high-field MRI can directly visualize the thalamic nuclei in vivo and allow for analysis of disease-related changes. Methods: Thirty-two healthy individuals were imaged with 7T MRI at a resolution of 0.7mm3. To obtain a high-resolution composite image, these were registered across subjects and averaged together. Three thalamic structures closely integrated in seizure propagation, the anterior thalamic nucleus (ATN), mammillothalamic tract (MTT), and centromedian nucleus (CM) were manually segmented in a subset of healthy subjects and patients with temporal lobe epilepsy (TLE). Results: There is sufficient resolution within the thalamus at 7T for visualization of the ATN, CM, and MTT. In the small subset of 5 controls and 5 TLE patients examined, there was no significant difference (p>0.05) in volume or mean T1map for the three thalamic sturctures of interest. Conclusions: MRI at 7T provides a method of direct visualization of thalamic nuclei, uncovering substructures not previously identifiable in vivo. These advances will enable quantitative analysis of disease-related changes to these structures and improved clinical targeting as demonstrated in this initial ‘proof-of-concept’ subset analysis.

Memory outcome after temporal lobe epilepsy surgery: corticoamygdalohippocampectomy versus selective amygdalohippocampectomy

2010 ◽  
Vol 113 (6) ◽  
pp. 1164-1175 ◽  
Author(s):  
Taner Tanriverdi ◽  
Roy William Roland Dudley ◽  
Alya Hasan ◽  
Ahmed Al Jishi ◽  
Qasim Al Hinai ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Verbal Memory ◽  
Hippocampal Sclerosis ◽  
Surgical Approaches ◽  
Seizure Outcome ◽  
Nonverbal Memory ◽  
Selective Amygdalohippocampectomy ◽  
Significant Difference

Object The aim of this study was to compare IQ and memory outcomes at the 1-year follow-up in patients with medically refractory mesial temporal lobe epilepsy (MTLE) due to hippocampal sclerosis. All patients were treated using a corticoamygdalohippocampectomy (CAH) or a selective amygdalohippocampectomy (SelAH). Methods The data of 256 patients who underwent surgery for MTLE were retrospectively evaluated. One hundred twenty-three patients underwent a CAH (63 [right side] and 60 [left side]), and 133 underwent an SelAH (61 [right side] and 72 [left side]). A comprehensive neuropsychological test battery was assessed before and 1 year after surgery, and the results were compared between the surgical procedures. Furthermore, seizure outcome was compared using the Engel classification scheme. Results At 1-year follow-up, there was no statistically significant difference between the surgical approaches with respect to seizure outcome. Overall, IQ scores showed improvement, but verbal IQ decreased after left SelAH. Verbal memory impairment was seen after left-sided resections especially in cases of SelAH, and nonverbal memory decreased after right-sided resection, especially for CAH. Left-sided resections produced some improvement in nonverbal memory. Older age at surgery, longer duration of seizures, greater seizure frequency before surgery, and poor seizure control after surgery were associated with poorer memory. Conclusions Both CAH and SelAH can lead to several cognitive impairments depending on the side of the surgery. The authors suggest that the optimal type of surgical approach should be decided on a case-by-case basis.

scholarly journals P.027 Investigation of hippocampal sub-structures in HS and non-HS focal temporal lobe epilepsy at 7T

2016 ◽  
Vol 43 (S2) ◽  
pp. S28-S28
Author(s):  
BG Santyr ◽  
M Goubran ◽  
J Lau ◽  
B Kwan ◽  
SM Mirsattari ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Visual Inspection ◽  
Hippocampal Sclerosis ◽  
Volume Changes ◽  
Ultra High Field ◽  
Hippocampal Subfields ◽  
Mri Protocol ◽  
Magnetic Resonance Imaging Mri ◽  
Initial Classification

Background: The clinical identification of hippocampal sclerosis (HS) is important in predicting surgical outcomes in patients with temporal lobe epilepsy (TLE). In cases where gross hippocampal sclerosis is not identifiable clinically, a more detailed analysis of hippocampal subfields using ultra-high-field magnetic resonance imaging (MRI) may reveal areas of abnormality, which was the focus of our study. Methods: Patients (N=13) with drug-resistant TLE (9 no-HS, 4 HS) and 20 age-matched healthy controls were scanned and compared using a 7T MRI protocol. Using a manual segmentation scheme to delineate hippocampal subfields, subfield-specific volume changes were studied between the two groups. In addition, radiological patient assessment at 7T was correlated with measured subfield changes. Results: Volumetry of the hippocampus at 7T in HS patients revealed significant ipsilateral subfield losses in CA1 and CA4DG. Volumetry also uncovered subfield volume losses in 33% of no-HS patients, which had not been detected conventionally. Furthermore, 89% of no-HS patients showed abnormality (internal architecture or size) at 7T, identified by radiologists blinded to the patient’s initial classification. Conclusions: These preliminary findings indicate that hippocampal subfield volumetry assessed at 7T may be superior to conventional visual inspection by a neuroradiologist in the identification of hippocampal pathologies in TLE.

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