scholarly journals Comparative Lateralizing Ability of Multimodality MRI in Temporal Lobe Epilepsy

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Karabekir Ercan ◽  
Hediye Pinar Gunbey ◽  
Erhan Bilir ◽  
Elcin Zan ◽  
Halil Arslan
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Diffusion Tensor ◽  
Febrile Convulsion ◽  
Significant Negative Correlation ◽  
Quantitative Mr ◽  
Single Voxel ◽  
Adc Values ◽  
History Of ◽  
Preoperative Examination

Purpose. The objective is to compare lateralizing ability of three quantitative MR (qMRI) modalities to depict changes of hippocampal architecture with clinical entities in temporal lobe epilepsy.Methods. We evaluated 14 patients with clinical and EEG proven diagnosis of unilateral TLE and 15 healthy volunteers. T1-weighted 3D dataset for volumetry, single-voxel1H MR spectroscopy (MRS), and diffusion tensor imaging (DTI) were performed for bilateral hippocampi of all subjects.Results. Individual volumetric measurements provided accurate lateralization in 85% of the patients, spectroscopy in 57%, and DTI in 57%. Higher lateralization ratios were acquired combining volumetry-spectroscopy (85%), spectroscopy-DTI (85%), and volumetry-DTI (100%). Significantly decreased NAA/(Cho+Cr) ratios (p=0.002) and increased FA (p=0.001) values were obtained in ipsilateral to epileptogenic hippocampus. Duration of epilepsy and FA values showed a significant negative correlation (p=0.016,r=-0.847). The history of febrile convulsion associated with ipsilateral increased ADC values (p=0.015,r=0.851) and reduced NAA/(Cho+Cr) ratios (p=0.047,r=-761).Conclusion. Volumetry, MRS, and DTI studies provide complementary information of hippocampal pathology. For lateralization of epileptogenic focus and preoperative examination, volumetry-DTI combination may be indicative of diagnostic accuracy.

scholarly journals The Relationships Between Quantitative MR Parameters in Hippocampus in Healthy Subjects and Patients With Temporal Lobe Epilepsy

2015 ◽  
pp. 407-417 ◽  
Author(s):  
D. WAGNEROVÁ ◽  
V. HERYNEK ◽  
M. DEZORTOVÁ ◽  
P. MARUSIČ ◽  
P. KRŠEK ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Diffusion Tensor ◽  
Relaxation Times ◽  
Mean Diffusivity ◽  
Epileptogenic Zone ◽  
Quantitative Mr ◽  
Measurement Protocol ◽  
Mr Artifacts ◽  
Automated Processing

We introduce a new magnetic resonance (MR) method based on a pixel-by-pixel image processing to examine relationships between metabolic and structural processes in the pathologic hippocampus. The method was tested for lateralization of the epileptogenic zone in patients with temporal lobe epilepsy (TLE). Twenty patients with drug-resistant TLE and fifteen healthy controls were examined at 3T. The measurement protocol contained T2-weighted MR images, spectroscopic imaging, diffusion tensor imaging and T2 relaxometry. Correlations between quantitative MR parameters were calculated on a pixel-by-pixel basis using the CORIMA program which enables automated pixel identification in the normal tissue according to control data. All MR parameters changed in the anteroposterior direction in the hippocampus and correlation patterns and their slopes differed between patients and controls. Combinations of T2 relaxation times with metabolite values represent the best biomarkers of the epileptogenic zone. Correlations with mean diffusivity did not provide sufficiently accurate results due to diffusion image distortions. Quantitative MR analysis non-invasively provides a detailed description of hippocampal pathology and may represent complementary tool to the standard clinical protocol. However, the automated processing should be carefully monitored in order to avoid possible errors caused by MR artifacts.

scholarly journals Multi-scale image analysis and prediction of visual field defects after selective amygdalohippocampectomy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Bastian David ◽  
Jasmine Eberle ◽  
Daniel Delev ◽  
Jennifer Gaubatz ◽  
Conrad C. Prillwitz ◽  
...  
Keyword(s):  
Visual Field ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Diffusion Tensor ◽  
Global Network ◽  
Visual Field Defects ◽  
Whole Brain ◽  
Network Analyses ◽  
Postoperative Mri ◽  
Selective Amygdalohippocampectomy

AbstractSelective amygdalohippocampectomy is an effective treatment for patients with therapy-refractory temporal lobe epilepsy but may cause visual field defect (VFD). Here, we aimed to describe tissue-specific pre- and postoperative imaging correlates of the VFD severity using whole-brain analyses from voxel- to network-level. Twenty-eight patients with temporal lobe epilepsy underwent pre- and postoperative MRI (T1-MPRAGE and Diffusion Tensor Imaging) as well as kinetic perimetry according to Goldmann standard. We probed for whole-brain gray matter (GM) and white matter (WM) correlates of VFD using voxel-based morphometry and tract-based spatial statistics, respectively. We furthermore reconstructed individual structural connectomes and conducted local and global network analyses. Two clusters in the bihemispheric middle temporal gyri indicated a postsurgical GM volume decrease with increasing VFD severity (FWE-corrected p < 0.05). A single WM cluster showed a fractional anisotropy decrease with increasing severity of VFD in the ipsilesional optic radiation (FWE-corrected p < 0.05). Furthermore, patients with (vs. without) VFD showed a higher number of postoperative local connectivity changes. Neither in the GM, WM, nor in network metrics we found preoperative correlates of VFD severity. Still, in an explorative analysis, an artificial neural network meta-classifier could predict the occurrence of VFD based on presurgical connectomes above chance level.

scholarly journals The “Natural” History of Medically Treated Temporal Lobe Epilepsy: What Can an Evidence-Based Approach Tell Us?

2012 ◽  
Vol 2012 ◽  
pp. 1-8
Author(s):  
Colin Bruce Josephson ◽  
Bernhard Pohlmann-Eden
Keyword(s):  
Natural History ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Population Based ◽  
Seizure Freedom ◽  
History Of ◽  
Prospective Cohorts ◽  
Eeg Recordings ◽  
Incident Cases ◽  
Treatment Prognosis

We systematically reviewed the literature to describe the “natural” history of medically treated temporal lobe epilepsy (TLE). No population-based studies recruiting incident cases of TLE irrespective of age exist. Prospective, population-based studies were limited to those recruiting only childhood-onset TLE or those reporting TLE as a subgroup of cohorts of focal epilepsies. Few studies have been performed in the “MRI era” limiting information on natural history secondary to specific pathologies. Available data suggests that TLE is highly variable, with unpredictable transient remissions and low rates of seizure freedom (30 to 50%). Etiology and failure of first and second drug seem to be the most important predictors for treatment prognosis. The role of initial precipitating injuries remains speculative, as imaging information of related events is either missing or conflicting. Prospective cohorts of new-onset TLE with long-term followup using advanced MRI techniques, timely EEG recordings, and assessments of psychiatric comorbidities are needed.

scholarly journals Role of Diffusion Tensor Imaging in Detection and Lateralization of Temporal Lobe Epilepsy

2018 ◽  
Vol 86 (9) ◽  
pp. 2501-2505
Author(s):  
NERMEEN M.S. GARHY, M.D.; AMR O.M.A. AZAB, M.D. ◽  
RANIA Z. HASSAN, M.D.; ASMAA M. EBRAHEIM, M.D.
Keyword(s):  
Diffusion Tensor Imaging ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Diffusion Tensor

scholarly journals Imaging Depression in Epilepsy: Hints at the Biology of Despair

2007 ◽  
Vol 7 (5) ◽  
pp. 129-131
Author(s):  
Paul A. Garcia
Keyword(s):  
Major Depression ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Hippocampal Sclerosis ◽  
Morphological Characteristics ◽  
Similar Degree ◽  
P Value ◽  
Depression Symptoms ◽  
History Of ◽  
Severity Of Depression

Major Depression in Temporal Lobe Epilepsy with Hippocampal Sclerosis: Clinical and Imaging Correlates. Briellmann RS, Hopwood MJ, Jackson GD. J Neurol Neurosurg Psychiatry 2007 Jan 26; [Epub ahead of print] PURPOSE: Refractory temporal lobe epilepsy (TLE) is often associated with hippocampal sclerosis (HS). Patients with Major Depression (MD) may also show structural abnormalities in the limbic system. Co-occurrence of TLE with HS and MD is not uncommon. We investigate clinical and morphological characteristics of TLE patients in relation to MD. METHODS: Thirty-four TLE patients with HS were assessed at a Comprehensive Epilepsy Program. All relevant clinical data were obtained, including the history of antecedent events to epilepsy. MD was diagnosed based on detailed psychiatric investigation. MRI was used to measure the volume and tissue signal (T2-relaxometry) of the hippocampus and amygdala. The imaging data were expressed as percentage of the values obtained in a series of 55 controls. RESULTS: A history of MD was present in 15 (44%) of the 34 patients. Patients with MD had a longer duration of their epilepsy ( p < 0.05), and a lower frequency of antecedent events (13% with MD, 58% without MD, p < 0.05). Both groups had a similar degree of ipsilateral HS (small hippocampal volume, increased hippocampal T2-relaxation time), and demonstrated bilateral amygdaloid atrophy. However, the contralateral amygdala showed lower signal in presence of MD (97 ± 9 msec; no MD: 103 ± 8 msec, ANCOVA, p < 0.05). CONCLUSION: The integrity of the amygdala may influence mood disturbances in TLE patients with HS, as depression was associated with a relative preservation of the contralateral amygdala. In contrast, hippocampal abnormalities were not related to the presence of depression. Hippocampal 1H-MRSI Correlates with Severity of Depression Symptoms in Temporal Lobe Epilepsy. Gilliam FG, Maton BM, Martin RC, Sawrie SM, Faught RE, Hugg JW, Viikinsalo M, Kuzniecky RI. Neurology 2007;68(5):364–368. OBJECTIVE: To investigate the association of an indicator of hippocampal function with severity of depression symptoms in temporal lobe epilepsy. METHODS: We evaluated 31 patients with video/EEG-confirmed temporal lobe epilepsy using creatine/ N-acetylaspartate ratio maps derived from a previously validated 1H magnetic resonance spectroscopic imaging (1H-MRSI) technique at 4.1 T. We also assessed depression symptoms, epilepsy-related factors, and self-perceived social and vocational disability. We used conservative nonparametric bivariate procedures to determine the correlation of severity of depression symptoms with imaging and clinical variables. RESULTS: The extent of hippocampal 1H-MRSI abnormalities correlated with severity of depression (Spearman rho = 0.65, p value < 0.001), but other clinical factors did not. CONCLUSION: The extent of hippocampal dysfunction is associated with depression symptoms in temporal lobe epilepsy and may be a more important factor than seizure frequency or degree of disability.

scholarly journals A Case of Cognitive Decline Resulting from Aging, Temporal Lobe Epilepsy, and Environmental Factors

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Nikhila Veluri
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Cognitive Decline ◽  
Cognitive Functioning ◽  
Temporal Lobe ◽  
Panic Attacks ◽  
Caucasian Woman ◽  
Age Related ◽  
Imaging Results ◽  
Patient Reported ◽  
History Of

Cognitive functioning is imperative in our daily lives. It allows us to understand, process, and react appropriately to different situations. Aging has been linked to cognitive decline. The degree and rate of cognitive decline are crucial as they differentiate normal aging from dementia or memory loss secondary to medical conditions. A 63-year-old Caucasian woman with a 50-year history of temporal lobe epilepsy experienced memory difficulties in recent years. She was admitted voluntarily to the neuropsychiatry ward for a 3-day ambulatory electroencephalogram (EEG), which reported mild bitemporal structural or functional abnormality. The patient reported subjective seizure experiences that were not reflective of seizure activity on the EEG. Possible causes included panic attacks or other anxiety experiences. Routine laboratory test and magnetic resonance imaging results were unremarkable. During her hospital stay she showed improvement in cognitive functioning. However, anxiety continued to negatively impact her memory. We hypothesized that the memory impairments could have resulted from age, psychological factors, the patient’s own expectations, pressure from the environment and history of TLE. We diagnosed the patient with mild cognitive impairment and adjustment disorder with anxiety. She was discharged with seizure and anxiety medication. This report highlights the importance of both age-related and disease-related variables when diagnosing patients with cognitive decline.

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