期刊
NEUROLOGICAL SCIENCES
卷 42, 期 8, 页码 3305-3325出版社
SPRINGER-VERLAG ITALIA SRL
DOI: 10.1007/s10072-020-05003-2
关键词
Temporal lobe epilepsy; T1-weighted MRI; Voxel-based morphometry; Hippocampus; Volumetric assessment; Lateralization; Cortical thickness; Subcortical structures
资金
- Iran's National Elites Foundation
- National Institute for Medical Research Development [971683]
- Cognitive Sciences & Technologies Council [6431]
Patients with left TLE showed more prevalent and widespread changes in subcortical volumes and cortical thickness, mainly in the left hemisphere. Hippocampus, thalamus, and pallidum were vulnerable to TLE. Volume changes in hippocampus alone could lead to accurate lateralization of TLE.
Background Advances in MRI acquisition and data processing have become important for revealing brain structural changes. Previous studies have reported widespread structural brain abnormalities and cortical thinning in patients with temporal lobe epilepsy (TLE), as the most common form of focal epilepsy. Methods In this research, healthy control cases (n = 20) and patients with left TLE (n = 19) and right TLE (n = 14) were recruited, all underwent 3.0 T MRI with magnetization-prepared rapid gradient echo sequence to acquire T1-weighted images. Morphometric alterations in gray matter were identified using voxel-based morphometry (VBM). Volumetric alterations in subcortical structures and cortical thinning were also determined. Results Patients with left TLE demonstrated more prevailing and widespread changes in subcortical volumes and cortical thickness than right TLE, mainly in the left hemisphere, compared to the healthy group. Both VBM analysis and subcortical volumetry detected significant hippocampal atrophy in ipsilateral compared to contralateral side in TLE group. In addition to hippocampus, subcortical volumetry found the thalamus and pallidum bilaterally vulnerable to the TLE. Furthermore, the TLE patients underwent cortical thinning beyond the temporal lobe, affecting gray matter cortices in frontal, parietal, and occipital lobes in the majority of patients, more prevalently for left TLE cases. Exploiting volume changes in individual patients in the hippocampus alone led to 63.6% sensitivity and 100% specificity for lateralization of TLE. Conclusion Alteration of gray matter volumes in subcortical regions and neocortical temporal structures and also cortical gray matter thickness were evidenced as common effects of epileptogenicity, as manifested by the majority of cases in this study.
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