Effect of Patient Sex on White Matter Alterations in Unilateral Medial Temporal Lobe Epilepsy with Hippocampal Sclerosis Assessed by Diffusion Tensor Imaging

Oğuz, Kader K.; Tezer, Irsel; Sanverdi, Eser; Has, Arzu Ceylan; Bilginer, Burçak; Dolgun, Anıl; Saygı, Serap

doi:10.3174/ajnr.a3328

Cited by 10 publications

(11 citation statements)

References 23 publications

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“…We found more bilateral changes in right TLE than left TLE, the converse of previous studies (Ahmadi et al, 2009; Kemmotsu et al, 2011). However as diffusion changes in right TLE were found to be more widespread and bilateral in females than males (Oguz et al, 2013), the gender imbalance in our right TLE group, which was 79% female, could explain this difference. The presence of baseline changes highlights the importance of including controls and preoperative imaging, as a previous study comparing postoperative imaging in patients to healthy controls and demonstrating widespread reductions in FA within ipsilateral tracts was unable to conclude whether these changes were pre-existing as a result of the disease or developed following surgery (Schoene-Bake et al, 2009).…”

Section: Discussionmentioning

confidence: 51%

Progressive white matter changes following anterior temporal lobe resection for epilepsy

Winston

Stretton

Sidhu

et al. 2014

NeuroImage: Clinical

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Anterior temporal lobe resection (ATLR) is an effective treatment for refractory temporal lobe epilepsy (TLE). Widespread abnormalities in diffusion parameters involving the ipsilateral temporal lobe white matter and extending into extratemporal white matter have been shown in cross-sectional studies in TLE. However longitudinal changes following surgery have been less well addressed. We systematically assess diffusion changes in white matter in patients with TLE in comparison to controls before surgery and look at the longitudinal changes following ATLR at two timepoints (3–4 months, 12 months) using a whole brain approach.We find predominantly unilateral baseline changes in temporal and extratemporal structures compatible with altered myelination (reduced fractional anisotropy, increased mean and radial diffusivity). Following surgery, these changes progress in efferent tracts from the resected temporal lobe compatible with Wallerian degeneration. However more superiorly in the corona radiata, internal and external capsules and nearby tracts, changes compatible with plasticity are observed (increased fractional anisotropy and axial diffusivity, reduced radial diffusivity).There is little progression between 3–4 months and 12 months following surgery in patients with left TLE, but the changes become more widespread in patients with right TLE suggesting that plasticity occurs more slowly in this population. The neuropsychological correlates of such plasticity should be explored further.

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Section: Discussionmentioning

confidence: 51%

Progressive white matter changes following anterior temporal lobe resection for epilepsy

Winston

Stretton

Sidhu

et al. 2014

NeuroImage: Clinical

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“…In addition, memory performance of chronic smokers is less than non-smokers (p<0.05) and our study shows statistically significant low correlation about memory performance with FA values in nonsmoking group. Although many studies have been performed regarding hippocampal DTI measurements in Alzheimer disease, vascular dementia, epilepsy, age-related changes and cerebral small vessel disease, to the best of our knowledge, our study is the first report that showed hippocampal DTI measurements with memory performance in chronic smokers [12][13][14][15][16][17]. We hypothesized that chronic smoking would adversely affect the hippocampal structural integrity and memory performance.…”

Section: Discussionmentioning

confidence: 81%

Diffusion tensor imaging of the hippocampus in chronic cigarette smokers

Yuce

Kantarcı

Keleş

et al. 2016

European Journal of Radiology

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“…In this regard, an individual inspection of the FA results in the LATL group did not show a difference based on MTS. Fourth, gender distribution was different between our groups, raising a concern about gender related white matter changes [74]. However, the sample size available was too small to allow for a proper control of this variable.…”

Section: Discussionmentioning

confidence: 87%

Distinct Types of White Matter Changes Are Observed after Anterior Temporal Lobectomy in Epilepsy

et al. 2014

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Anterior temporal lobectomy (ATL) is commonly adopted to control medically intractable temporal lobe epilepsy (TLE). Depending on the side of resection, the degree to which Wallerian degeneration and adaptive plasticity occur after ATL has important implications for understanding cognitive and clinical outcome. We obtained diffusion tensor imaging from 24 TLE patients (12 left) before and after surgery, and 12 matched controls at comparable time intervals. Voxel-based analyses were performed on fractional anisotropy (FA) before and after surgery. Areas with postoperative FA increase were further investigated to distinguish between genuine plasticity and processes related to the degeneration of crossing fibers. Before surgery, both patient groups showed bilateral reduced FA in numerous tracts, but left TLE patients showed more extensive effects, including language tracts in the contralateral hemisphere (superior longitudinal fasciculus and uncinate). After surgery, FA decreased ipsilaterally in both ATL groups, affecting the fornix, uncinate, stria terminalis, and corpus callosum. FA increased ipsilaterally along the superior corona radiata in both left and right ATL groups, exceeding normal FA values. In these clusters, the mode of anisotropy increased as well, confirming fiber degeneration in an area with crossing fibers. In left ATL patients, pre-existing low FA values in right superior longitudinal and uncinate fasciculi normalized after surgery, while MO values did not change. Preoperative verbal fluency correlated with FA values in all areas that later increased FA in left TLE patients, but postoperative verbal fluency correlated only with FA of the right superior longitudinal fasciculus. Our results demonstrate that genuine reorganization occurs in non-dominant language tracts after dominant hemisphere resection, a process that may help implement the inter-hemispheric shift of language activation found in fMRI studies. The results indicate that left TLE patients, despite showing more initial white matter damage, have the potential for greater adaptive changes postoperatively than right TLE patients.

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Effect of Patient Sex on White Matter Alterations in Unilateral Medial Temporal Lobe Epilepsy with Hippocampal Sclerosis Assessed by Diffusion Tensor Imaging

Abstract: BACKGROUND AND PURPOSE: Studies shows ictal behavior and symptoms are affected by patient sex in temporal lobe epilepsy. The purpose of our study was to determine whether alterations in the WM as assessed by DTI display different patterns in male and female patients with unilateral HS.

Cited by 10 publications

References 23 publications

Progressive white matter changes following anterior temporal lobe resection for epilepsy

Progressive white matter changes following anterior temporal lobe resection for epilepsy

Diffusion tensor imaging of the hippocampus in chronic cigarette smokers

Distinct Types of White Matter Changes Are Observed after Anterior Temporal Lobectomy in Epilepsy

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