The role of voxel‐based morphometry in the detection of cortical dysplasia within the temporal pole in patients with intractable mesial temporal lobe epilepsy

Pail, Martin; Mareček, Radek; Hermanová, Markéta; Slaná, Bronislava; Tyrlíková, Ivana; Kuba, Robert; Brázdil, Milan

doi:10.1111/j.1528-1167.2012.03456.x

Cited by 22 publications

(17 citation statements)

References 48 publications

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“…It was postulated that cortical dysplasia of the amygdala may extend to the ipsilateral temporal pole. In general, cerebral FCD was detected as increased gray matter volume by VBM analysis …”

Section: Discussionmentioning

confidence: 99%

Temporal Lobe Epilepsy with Unilateral Amygdala Enlargement: Morphometric MR Analysis with Clinical and Pathological Study

Kimura

Sato

Saito

et al. 2014

Journal of Neuroimaging

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Section: Discussionmentioning

confidence: 99%

Temporal Lobe Epilepsy with Unilateral Amygdala Enlargement: Morphometric MR Analysis with Clinical and Pathological Study

Kimura

Sato

Saito

et al. 2014

Journal of Neuroimaging

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“…The feasibility of utilizing quantitative MRI methods for detecting visually apparent (i.e., MRI-positive) FCD lesions has been established using voxel-based morphometry [13–16]. Cortical surface-based methods have been combined in a multivariate approach with high accuracy in classifying small, visually subtle FCD lesions [17, 48].…”

Section: Introductionmentioning

confidence: 99%

Cortical feature analysis and machine learning improves detection of “MRI-negative” focal cortical dysplasia

Ahmed

Brodley

Blackmon

et al. 2015

Epilepsy & Behavior

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Focal cortical dysplasia (FCD) is the most common cause of pediatric epilepsy and the third most common lesion in adults with treatment-resistant epilepsy. Advances in MRI have revolutionized the diagnosis of FCD, resulting in higher success rates for resective epilepsy surgery. However, many histologically confirmed FCD patients have normal pre-surgical MRI studies (‘MRI-negative’), making pre-surgical diagnosis difficult. The purpose of this study is to test whether a novel MRI post-processing method successfully detects histopathologically-verified FCD in a sample of patients without visually appreciable lesions. We applied an automated quantitative morphometry approach which computed five surface-based MRI features and combined them in a machine learning model to classify lesional and non-lesional vertices. Accuracy was defined by classifying contiguous vertices as “lesional” when they fell within the surgical resection region. Our multivariate method correctly detected the lesion in 6 of 7 MRI-positive patients, which is comparable with the detection rates that have been reported in univariate vertex-based morphometry studies. More significantly, in patients that were MRI-negative, machine learning correctly identified 14 out of 24 FCD lesions (58%). This was achieved after separating abnormal thickness and thinness into distinct classifiers, as well as separating sulcal and gyral regions. Results demonstrate that MRI-negative images contain sufficient information to aid in the in-vivo detection of visually elusive FCD lesions.

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“…One of the most important brain regions to consider within the context of epilepsy resection surgery is the temporal pole (TP), corresponding roughly to Brodmann area 38 (Brodmann, 1909). Temporopolar cortex is frequently implicated in the pathogenesis of temporal lobe epilepsy, and standard surgical techniques used to resect mesial temporal lobe seizure foci often involve resecting TP tissue (Chabardes et al, 2005, Ding et al, 2009, Kahane et al, 2002, Pail et al, 2012). Accurately defining the ictal and interictal involvement of the TP cortex is therefore important for epileptic focus localization.…”

Section: Introductionmentioning

confidence: 99%

Mapping the temporal pole with a specialized electrode array: technique and preliminary results

et al. 2014

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Temporopolar cortex plays a crucial role in the pathogenesis of temporal lobe epilepsy and subserves important cognitive functions. Because of its shape and position in the middle cranial fossa, complete electrode coverage of the temporal pole (TP) is difficult to achieve using existing devices. We designed a novel TP electrode array that conforms to the surface of temporopolar cortex and achieves dense electrode coverage of this important brain region. A multi-pronged electrode array was designed that can be placed over the surface of the TP using a straightforward insertion technique. Twelve patients with medically intractable epilepsy were implanted with the TP electrode array for purposes of seizure localization. Select patients underwent cognitive mapping by electrocorticographic (ECoG) recording from the TP during a naming task. Use of the array resulted in excellent TP electrode coverage in all patients. High quality ECoG data were consistently obtained for purposes of delineating seizure activity and functional mapping. During a naming task, significant increases in ECoG power were observed within localized subregions of the TP. One patient developed a transient neurological deficit thought to be related to the mass effect of multiple intracranial recording arrays, including the TP array. This deficit resolved following removal of all electrodes. The TP electrode array overcomes limitations of existing devices and enables clinicians and researchers to obtain optimal multi-site recordings from this important brain region.

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The role of voxel‐based morphometry in the detection of cortical dysplasia within the temporal pole in patients with intractable mesial temporal lobe epilepsy

Cited by 22 publications

References 48 publications

Temporal Lobe Epilepsy with Unilateral Amygdala Enlargement: Morphometric MR Analysis with Clinical and Pathological Study

Temporal Lobe Epilepsy with Unilateral Amygdala Enlargement: Morphometric MR Analysis with Clinical and Pathological Study

Cortical feature analysis and machine learning improves detection of “MRI-negative” focal cortical dysplasia

Mapping the temporal pole with a specialized electrode array: technique and preliminary results

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