Journal
EPILEPSIA
Volume 51, Issue 4, Pages 511-518Publisher
WILEY
DOI: 10.1111/j.1528-1167.2009.02324.x
Keywords
Hippocampal sclerosis; Insula; Mesial temporal lobe epilepsy; Thalamus
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Funding
- MSMT CR [MSM0021622404]
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P>Purpose: To determine whether changes in gray matter volume (GMV) differ according to the affected side in mesial temporal lobe epilepsy/hippocampal sclerosis (MTLE/HS) syndrome, and moreover to test the hypothesis of more pronounced structural changes in right-sided MTLE/HS. This hypothesis (especially that the contralateral thalamus is more affected in right-sided MTLE/HS) arose from the results of our recent study, wherein more expressed structural and functional changes were observed in a small sample of patients with right-sided MTLE/HS (Brazdil et al., 2009). Methods: Twenty patients with left-sided and 20 with right-sided MTLE/HS and 40 sex- and age-matched healthy controls were included in the study. Voxel-based morphometry (VBM) with a modulation step was applied to magnetic resonance imaging (MRI) brain images. Statistical parametric maps were used to compare structural changes between patients and controls separately for the left- and right-sided MTLE/HS subgroups. We also compared the local GMV of the brain structures (insula and thalamus) between the subgroups of patients. Results: In the subgroup with right-sided MTLE/HS, a reduction of GMV was detected in the mesiotemporal structures and the ipsilateral thalamus (as in left-sided MTLE/HS), but also notably in the ipsilateral insula and contralateral thalamus. A statistical analysis revealed a significantly more extensive reduction of GMV in the ipsilateral/contralateral insula and the contralateral thalamus in the subgroup with right-sided compared to left-sided MTLE/HS. Conclusion: We found asymmetrical morphologic changes in patients with left- and right-sided MTLE/HS syndrome (more pronounced in right-sided MTLE/HS). These differences could be theoretically explained by different neuronal networks and pathophysiologic changes in temporolimbic structures.
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