Temporopolar blurring in temporal lobe epilepsy with hippocampal sclerosis and long-term prognosis after epilepsy surgery

Naves, Pedro V.F.; Caboclo, Luís Otávio Sales Ferreira; Carrete, Henrique; Kelmann, Bruno V.; Gaça, Larissa Botelho; Sandim, Gabriel Barbosa; Centeno, Ricardo Silva; Yacubian, Elza Márcia Targas

doi:10.1016/j.eplepsyres.2015.02.013

Cited by 22 publications

(49 citation statements)

References 28 publications

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“…In line with the range of frequencies reported in literature [15,17,24,42], temporopolar abnormalities were observed in more than half of patients, and were always ipsilateral to HS [17,19,22,42,43]. Therefore, they may play a role in lateralizing the temporal epileptogenesis [20,44].…”

Section: Discussionsupporting

confidence: 82%

“…HS was qualitatively diagnosed by means of the comparative visual detection of atrophy and loss of definition of the internal structures of the hyppocampal formation and increased signal intensity in the T2-weighted images. According to Garbelli et al [22] and Naves et al [24], the criteria for TB definition were increased signal intensity in the white matter together with loss of grey/white matter demarcation of the temporal pole on coronal T2-weighted and FLAIR images (Fig. 1).…”

Section: Preoperative 15 T Magnetic Resonance Imagingmentioning

confidence: 99%

“…Also, the presence of TB atrophy was also assessed. The boundaries of the temporal pole on MRI were defined according to Coste et al [18] and Naves et al [24], with the posterior limit defined by the first coronal section intersecting the uncinate bundle.…”

Section: Preoperative 15 T Magnetic Resonance Imagingmentioning

confidence: 99%

“…On one hand, some studies reported a significantly higher success rate of surgery in patients with TLE-HS with TB than in patients without this abnormality [15,23], or no TB-related differences in preoperative and postoperative scores on neuropsychological tests [24]. On the other hand, several studies showed that the proportion of seizure-free patients was the same in those with and without TB [22,24], or that patients with TB showed lower scores on neuropsychological tests than those without TB [22]. Moreover, no study, to our knowledge, investigated the clinical significance and prognostic value of TA in terms of seizure outcome after surgery.…”

Section: Introductionmentioning

confidence: 97%

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Temporal pole abnormalities in temporal lobe epilepsy with hippocampal sclerosis: Clinical significance and seizure outcome after surgery

Gennaro

D’Aniello

Risi

et al. 2015

Seizure

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Section: Discussionsupporting

confidence: 82%

Section: Preoperative 15 T Magnetic Resonance Imagingmentioning

confidence: 99%

Section: Preoperative 15 T Magnetic Resonance Imagingmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

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Temporal pole abnormalities in temporal lobe epilepsy with hippocampal sclerosis: Clinical significance and seizure outcome after surgery

Gennaro

D’Aniello

Risi

et al. 2015

Seizure

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“…The extensive temporopolar FLAIR changes and blurring of the gray–white matter boundary quantified here may be revealing subtle, widespread ipsi‐lesional pathological changes corresponding to the nonspecific histological changes seen in the resected specimens, such as subpial (Chaslin's) gliosis in the gray matter and perivascular glial clustering and perivascular lymphocytes in the white matter. In adults, HS is often observed in conjunction with temporopolar T2/FLAIR signal abnormalities 33, 34. Our recent study of neocortical changes in adults with TLE showed a paralimbic distribution of FLAIR hyperintensities and indicated a vulnerability of cortex with similar intracortical tissue composition to FLAIR signal hyperintensities.…”

Section: Discussionmentioning

confidence: 84%

Multimodal computational neocortical anatomy in pediatric hippocampal sclerosis

Adler

Blackwood

Northam

et al. 2018

Ann Clin Transl Neurol

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ObjectiveIn contrast to adult cohorts, neocortical changes in epileptic children with hippocampal damage are not well characterized. Here, we mapped multimodal neocortical markers of epilepsy‐related structural compromise in a pediatric cohort of temporal lobe epilepsy and explored how they relate to clinical factors.MethodsWe measured cortical thickness, gray–white matter intensity contrast and intracortical FLAIR intensity in 22 patients with hippocampal sclerosis (HS) and 30 controls. Surface‐based linear models assessed between‐group differences in morphological and MR signal intensity markers. Structural integrity of the hippocampus was measured by quantifying atrophy and FLAIR patterns. Linear models were used to evaluate the relationships between hippocampal and neocortical MRI markers and clinical factors.ResultsIn the hippocampus, patients demonstrated ipsilateral atrophy and bilateral FLAIR hyperintensity. In the neocortex, patients showed FLAIR signal hyperintensities and gray–white matter boundary blurring in the ipsilesional mesial and lateral temporal neocortex. In contrast, cortical thinning was minimal and restricted to a small area of the ipsilesional temporal pole. Furthermore, patients with a history of febrile convulsions demonstrated more pronounced FLAIR hyperintensity in the ipsilesional temporal neocortex.InterpretationPediatric HS patients do not yet demonstrate the widespread cortical thinning present in adult cohorts, which may reflect consequences of a protracted disease process. However, pronounced temporal neocortical FLAIR hyperintensity and blurring of the gray–white matter boundary are already detectable, suggesting that alterations in MR signal intensities may reflect a different underlying pathophysiology that is detectable earlier in the disease and more pervasive in patients with a history of febrile convulsions.

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Magnetic resonance fingerprinting of temporal lobe white matter in mesial temporal lobe epilepsy

Wang

Cao

et al. 2019

Ann Clin Transl Neurol

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Objective Mesial temporal lobe epilepsy (MTLE) is a network disorder. We aimed to quantify the white matter alterations in the temporal lobe of MTLE patients with hippocampal sclerosis (MTLE‐HS) by using magnetic resonance fingerprinting (MRF), a novel imaging technique, which allows simultaneous measurements of multiple parameters with a single acquisition. Methods We consecutively recruited 27 unilateral MTLE‐HS patients and 22 healthy controls. Measurements including T1, T2, and PD values in the temporopolar white matter and temporal stem were recorded and analyzed. Results We found increased T2 value in both sides, and increased T1 value in the ipsilateral temporopolar white matter of MTLE‐HS patients, as compared with healthy controls. The T1 and T2 values were higher in the ipsilateral than the contralateral side. In the temporal stem, increased T1 and T2 values in the ipsilateral side of the MTLE‐HS patients were also observed. Only increased T2 values were observed in the contralateral temporal stem. No significant differences in PD values were observed in either the temporopolar white matter or temporal stem of the MTLE‐HS patients. Correlation analysis revealed that T1 and T2 values in the ipsilateral temporopolar white matter were negatively correlated with the age at epilepsy onset. Interpretation By using MRF, we were able to assess the alterations of T1 and T2 in the temporal lobe white matter of MTLE‐HS patients. MRF could be a promising imaging technique in identifying mild changes in MTLE patients, which might optimize the pre‐surgical evaluation and therapeutic interventions in these patients.

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Temporopolar blurring in temporal lobe epilepsy with hippocampal sclerosis and long-term prognosis after epilepsy surgery

Cited by 22 publications

References 28 publications

Temporal pole abnormalities in temporal lobe epilepsy with hippocampal sclerosis: Clinical significance and seizure outcome after surgery

Temporal pole abnormalities in temporal lobe epilepsy with hippocampal sclerosis: Clinical significance and seizure outcome after surgery

Multimodal computational neocortical anatomy in pediatric hippocampal sclerosis

Magnetic resonance fingerprinting of temporal lobe white matter in mesial temporal lobe epilepsy

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