Auras and clinical features in temporal lobe epilepsy: A new approach on the basis of voxel-based morphometry

Santana, Marcos Gonçalves de; Jackowski, Andrea Parolin; Silva, Henrique Hattori da; Caboclo, Luís Otávio Sales Ferreira; Centeno, Ricardo Silva; Bressan, Rodrigo A.; Carrete, Henrique; Yacubian, Elza Márcia Targas

doi:10.1016/j.eplepsyres.2010.02.006

Cited by 37 publications

(34 citation statements)

References 54 publications

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“…Certainly, one possible mechanism to explain the widespread GM decrease in patients with TLE is seizure activity propagation. For example, ongoing seizure activity via the interhemispheric pathway could explain the contralateral thalamic atrophy . Some authors hypothesized that extra‐temporal brain volume decrease could be secondary to seizure propagation based on the association between seizure frequency and duration of epilepsy with GM atrophy .…”

Section: Discussionmentioning

confidence: 99%

Progression of gray matter atrophy in seizure‐free patients with temporal lobe epilepsy

et al. 2016

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SUMMARYObjectives: To investigate the presence and progression of gray matter (GM) reduction in seizure-free patients with temporal lobe epilepsy (TLE). Methods: We enrolled 39 consecutive TLE patients, seizure-free for at least 2 years-20 with magnetic resonance imaging (MRI) signs of hippocampal sclerosis (TLE-HS), 19 with normal MRI (TLE-NL), and 74 healthy controls. For longitudinal analysis, we included individuals who had a second MRI with minimum interval of 18 months: 21 patients (10 TLE-HS, 11 TLE-NL) and 11 controls. Three-dimensional (3D) T 1 -weighted images acquired in 3 Tesla MRI were analyzed with voxel-based morphometry (VBM). The images of patients with right-sided interictal epileptogenic zone (EZ) were right-left flipped, as well as a comparable proportion of controls. Cross-sectional analysis: The patients' images from each group were compared to controls to investigate differences in GM volumes. Longitudinal analysis: The first and second images were compared in each group to look for decreased GM volume. Results: Cross-sectional analysis: Patients with TLE-HS had diffuse GM atrophy, including hippocampus and parahippocampal gyrus, insula, frontal, and occipital lobes ipsilateral to EZ, bilateral thalamus and contralateral orbitofrontal gyrus, and caudate. In contrast, TLE-NL group did not present significant differences compared to controls. Longitudinal analysis: TLE-HS presented progressive GM reduction in ipsilateral insula and occipital lobe, contralateral motor area, and bilateral temporal and frontal lobes. TLE-NL had GM progression in ipsilateral hypothalamus and parietal lobe, contralateral cerebellum, and bilateral temporal lobe. Controls did not show changes in GM volume between MRIs. Significance: Diffuse extrahippocampal GM atrophy is present in seizure-free patients with TLE-HS. In addition, there is progressive GM atrophy in patients with and without HS. These results demonstrate that not only ongoing seizures are involved in the progression of GM atrophy. An underlying pathologic mechanism could be responsible for progressive brain volume loss in TLE patients even in seizure-free periods.

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Section: Discussionmentioning

confidence: 99%

Progression of gray matter atrophy in seizure‐free patients with temporal lobe epilepsy

et al. 2016

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“…For this kind of understanding, it is worthwhile examining the visuo-perceptual changes occurring at onset of seizure auras. Adults with seizure auras can experience visual disturbances as the somatosensory cortex is implicated in seizure auras (Santana et al, 2010). During the seizure aura, the visual environment changes from being a predictable and systematic environment to an unsystematic environment which may not conform to the relational systematic laws of physical properties.…”

Section: Systemizing and Empathising Abilities In Epilepsymentioning

confidence: 99%

“…When changes occur, this activation is relayed via an 'as if body loop' mechanism to the somatosensory cortices eliciting an appropriate activity pattern in the cortices from the somatosensory structures. This has implications for individuals with epilepsy and specifically seizure auras which disrupt somatosensory functioning in these cortices (Santana et al, 2010). Somatosensory auras are found in focal epilepsy, multifocal epilepsy, FLE and mesial frontal epilepsy (Janszky, Fogarasi, Jokeit, & Ebner, 2001;Tuxhorn, 2005).…”

Section: Somatosensory Corticesmentioning

confidence: 99%

Autistic characteristics in adults with epilepsy

Wakeford

Hinvest

Ring

et al. 2014

Epilepsy & Behavior

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“…Only few studies have so far sought to evaluate the impact of the side of the seizure focus on overall structural connectivity by comparing LTLE patients to those with RTLE; moreover, mesiotemporal lobe structures and the neocortex have not been analyzed conjointly in the same cohorts. Findings have been mixed with some studies reporting more marked atrophy in LTLE than RTLE [Coan et al, ; Keller et al, ; Kemmotsu et al, ; Santana et al, ], while others observed the reverse [Pail et al, ] or no differences [Dabbs et al, ]. In four reports, direct morphological comparisons compared hemispheric differences, neglecting the side of the seizure focus [Coan et al, ; Dabbs et al, ; Kemmotsu et al, ; Santana et al, ].…”

Section: Introductionmentioning

confidence: 99%

“…Findings have been mixed with some studies reporting more marked atrophy in LTLE than RTLE [Coan et al, ; Keller et al, ; Kemmotsu et al, ; Santana et al, ], while others observed the reverse [Pail et al, ] or no differences [Dabbs et al, ]. In four reports, direct morphological comparisons compared hemispheric differences, neglecting the side of the seizure focus [Coan et al, ; Dabbs et al, ; Kemmotsu et al, ; Santana et al, ]. On the other hand, the assessment in which hemispheres were flipped (i.e., comparing the left hemisphere of LTLE to the right hemisphere of RTLE) did not account for interhemispheric asymmetries [Keller et al, ].…”

Section: Introductionmentioning

confidence: 99%

Gray matter structural compromise is equally distributed in left and right temporal lobe epilepsy

Liu

Bernhardt

Bernasconi

et al. 2015

Human Brain Mapping

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In drug-resistant temporal lobe epilepsy (TLE), MRI studies have shown consistent mesiotemporal and neocortical structural alterations when comparing patients to healthy controls. It remains, however, relatively unclear whether the side of seizure focus differentially impacts the degree of structural damage. This work performed a comprehensive surface-based analysis of mesiotemporal and neocortical morphology on preoperative 1.5 T MRI in 25/35 LTLE/RTLE patients that achieved seizure freedom after surgery (i.e., Engel-I outcome; 7 ± 2 years follow-up), an imaging-independent confirmation of focus lateralization. Compared to 46 age- and sex-matched controls, both TLE groups displayed marked ipsilateral atrophy in mesiotemporal regions, while cortical thinning was bilateral. Direct contrasts between LTLE and RTLE did not reveal significant differences. Bootstrap simulations indicated low reproducibility of observing a between-cohort difference; power analysis revealed that more than 110 patients would be necessary to detect subtle differences. No difference between LTLE and RTLE was confirmed when using voxel-based morphometry, an independent proxy of gray matter volume. Similar results were obtained analyzing a separate 3 T dataset (15/15 LTLE/RTLE patients; Engel-I after 4 ± 2 years follow-up; 42 controls). Our results strongly support equivalent gray matter compromise in left and right TLE. The morphological profile of seizure-free patients, presenting with ipsilateral mesiotemporal and bilateral cortical atrophy, motivates the development of neuromarkers of outcome that consider both mesiotemporal and neocortical structures. Hum Brain Mapp 37:515-524, 2016. © 2015 Wiley Periodicals, Inc.

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Auras and clinical features in temporal lobe epilepsy: A new approach on the basis of voxel-based morphometry

Cited by 37 publications

References 54 publications

Progression of gray matter atrophy in seizure‐free patients with temporal lobe epilepsy

Progression of gray matter atrophy in seizure‐free patients with temporal lobe epilepsy

Autistic characteristics in adults with epilepsy

Gray matter structural compromise is equally distributed in left and right temporal lobe epilepsy

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