Hippocampal Sclerosis in Temporal Lobe Epilepsy: Findings at 7 T

Henry, Thomas R.; Chupin, Marie; Lehericy, Stéphane; Strupp, John; Sikora, Michael; Sha, Zhiyi; Uğurbil, Kâmil; Moortele, Pierre-François Van de

doi:10.1148/radiol.11101651

Cited by 107 publications

(101 citation statements)

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“…Separate epidemiological studies indicate the presence of hippocampal atrophy in TLE patients (a) more frequent and severe in left hemispheres either in ipsilateral or contralateral ictal onset, [33] (b) at ipsilateral side of ictal onset in most cases, and (c) more at contralateral sides [right hemispheres] of ictal onset in bilateral hippocampal atrophy cases of epileptic patients [25,[33][34][35]. The memory dysfunction is more evident in (i) TLE patients with bilateral hippocampal atrophy having right-left hemispheric asymmetry in certain cases [25,36,37] and (ii) TLE patients with unilateral hippocampal atrophy having hippocampal atrophy at left hemispheres in other cases [38].…”

Section: Introductionmentioning

confidence: 99%

MRI characterization of temporal lobe epilepsy using rapidly measurable spatial indices with hemisphere asymmetries and gender features

et al. 2015

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Section: Introductionmentioning

confidence: 99%

MRI characterization of temporal lobe epilepsy using rapidly measurable spatial indices with hemisphere asymmetries and gender features

et al. 2015

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“…The added diagnostic value of 7T, compared to lower field strengths, has been demonstrated for polymicrogyria, 28 vascular malformations, 29 hippocampal sclerosis, 30 brain tumors, 31 stroke, 32 multiple sclerosis, 33 and degenerative brain diseases. 34 However, no studies using a field strength of 7T have addressed its Of note, D, and its magnified image E show normal distinction between white and gray matter in the right superior temporal gyrus and the insula.…”

Section: Discussionmentioning

confidence: 99%

7TMRIin focal epilepsy with unrevealing conventional field strength imaging

Ciantis

Barba

Tassi³

et al. 2016

Epilepsia

137

127

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SUMMARYObjective: To assess the diagnostic yield of 7T magnetic resonance imaging (MRI) in detecting and characterizing structural lesions in patients with intractable focal epilepsy and unrevealing conventional (1.5 or 3T) MRI. Methods: We conducted an observational clinical imaging study on 21 patients (17 adults and 4 children) with intractable focal epilepsy, exhibiting clinical and electroencephalographic features consistent with a single seizure-onset zone (SOZ) and unrevealing conventional MRI. Patients were enrolled at two tertiary epilepsy surgery centers and imaged at 7T, including whole brain (three-dimensional [3D] T 1 -weighted [T1W] fast-spoiled gradient echo (FSPGR), 3D susceptibility-weighted angiography [SWAN], 3D fluid-attenuated inversion recovery [FLAIR]) and targeted imaging (2D T 2 *-weighted dual-echo gradient-recalled echo [GRE] and 2D gray-white matter tissue border enhancement [TBE] fast spin echo inversion recovery [FSE-IR]). MRI studies at 1.5 or 3T deemed unrevealing at the referral center were reviewed by three experts in epilepsy imaging. Reviewers were provided information regarding the suspected localization of the SOZ. The same team subsequently reviewed 7T images. Agreement in imaging interpretation was reached through consensus-based discussions based on visual identification of structural abnormalities and their likely correlation with clinical and electrographic data. Results: 7T MRI revealed structural lesions in 6 (29%) of 21 patients. The diagnostic gain in detection was obtained using GRE and FLAIR images. Four of the six patients with abnormal 7T underwent epilepsy surgery. Histopathology revealed focal cortical dysplasia (FCD) in all. In the remaining 15 patients (71%), 7T MRI remained unrevealing; 4 of the patients underwent epilepsy surgery and histopathologic evaluation revealed gliosis. Significance: 7T MRI improves detection of epileptogenic FCD that is not visible at conventional field strengths. A dedicated protocol including whole brain FLAIR and GRE images at 7T targeted at the suspected SOZ increases the diagnostic yield.

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“…Using hippocampus subfields can significantly decrease the rate of false positive findings in the prediction of future conversion from MCI to AD using manual [168] or automated [169] measurement. Sequences at 7 Tesla provide higher spatial resolution, new contrasts and access to even finer substructures of the hippocampus [170,171], but the clinical relevance of these measures needs to be explored in future studies [172].…”

Section: Future Directions: Novel Methodsmentioning

confidence: 99%

Perspective on future role of biological markers in clinical therapy trials of Alzheimer's disease: A long-range point of view beyond 2020

Hampel

Lista

Teipel

et al. 2014

Biochemical Pharmacology

Self Cite

105

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Recent advances in understanding the molecular mechanisms underlying various paths toward the pathogenesis of Alzheimer's disease (AD) has begun to provide new insight for interventions to modify disease progression. The evolving knowledge gained from multidisciplinary basic research has begun to identify new concepts for treatments and distinct classes of therapeutic targets; as well as putative disease-modifying compounds that are now being tested in clinical trials. There is a mounting consensus that such disease modifying compounds and/or interventions are more likely to be effectively administered as early as possible in the cascade of pathogenic processes preceding and underlying the clinical expression of AD. The budding sentiment is that "treatments" need to be applied before various molecular mechanisms converge into an irreversible pathway leading to morphological, metabolic and functional alterations that characterize the pathophysiology of AD. In light of this, biological indicators of pathophysiological mechanisms are desired to chart and detect AD throughout the asymptomatic early molecular stages into the prodromal and early dementia phase. A major conceptual development in the clinical AD research field was the recent proposal of new diagnostic criteria, which specifically incorporate the use of biomarkers as defining criteria for preclinical stages of AD. This paradigm shift in AD definition, conceptualization, operationalization, detection and diagnosis represents novel fundamental opportunities for the modification of interventional trial designs. This perspective summarizes not only present knowledge regarding biological markers but also unresolved questions on the status of surrogate indicators for detection of the disease in asymptomatic people and diagnosis of AD

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Hippocampal Sclerosis in Temporal Lobe Epilepsy: Findings at 7 T

Abstract: Ultrahigh-field-strength MR imaging permitted detection of selectively greater Ammon horn atrophy in patients with TLE and hippocampal sclerosis. Paucity of digitations is a deformity of the hippocampal head that was detected independent of hippocampal atrophy in patients with mesial TLE.

Cited by 107 publications

References 29 publications

MRI characterization of temporal lobe epilepsy using rapidly measurable spatial indices with hemisphere asymmetries and gender features

MRI characterization of temporal lobe epilepsy using rapidly measurable spatial indices with hemisphere asymmetries and gender features

7TMRIin focal epilepsy with unrevealing conventional field strength imaging

Perspective on future role of biological markers in clinical therapy trials of Alzheimer's disease: A long-range point of view beyond 2020

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