Abstract

Background Partial epilepsy represents almost 70% of the epileptic syndrome. It is characterized by partial seizures that arise from the restricted area of the cerebral cortex. Temporal lobe epilepsy (TLE) is the most frequent form of cryptogenic partial epilepsies [1]. The mesial temporal sclerosis is the pathologic abnormality most frequently detected in post mortem studies of subjects with TLE. Voxel-based morphometry (VBM) is a new MRI tool that has been developed to assess differences of brain tissue volumes between subject groups and has been applied in various studies of patients with TLE [2]. In refractory TLE (rTLE) gray (GM) and white (WM) matter abnormalities are not confined to the hippocampus but also are found in extrahippocampal structures [3]. Less is known about mild TLE (mTLE). In the present work, we used optimized voxel-based morphometry (VBM) to identify GM abnormalities beyond the hippocampus in rTLE and in mTLE with evidence of hippocampal sclerosis (HS). Materials and methods Brain MRI and VBM of GM with modulation was performed on 30 unrelated patients with mTLE (56% women; mean age 35.6 + 15.2 years), 19 patients with rTLE (52% women; mean age 38.4 + 17.4 years) and 37 healthy controls (25 women, mean age 37.3 + 10.6 years). MRI diagnosis of MTS was based on the atrophy of the hippocampal formation and/or mesial temporal hyperintensity on FLAIR or T2 images, or both. Results

Highlights

  • Materials and methods Brain MRI and Voxel-based morphometry (VBM) of GM with modulation was performed on 30 unrelated patients with mild TLE (mTLE) (56% women; mean age 35.6 + 15.2 years), 19 patients with refractory TLE (rTLE) (52% women; mean age 38.4 + 17.4 years) and 37 healthy controls (25 women, mean age 37.3 + 10.6 years)

  • No differences of GM concentrations were found between rTLE and mTLE

  • In either rTLE and mTLE, VBM shows GM reductions not confined to the hippocampus but mainly in the thalamus bilaterally

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Summary

Background

Partial epilepsy represents almost 70% of the epileptic syndrome. It is characterized by partial seizures that arise from the restricted area of the cerebral cortex. Temporal lobe epilepsy (TLE) is the most frequent form of cryptogenic partial epilepsies [1]. The mesial temporal sclerosis is the pathologic abnormality most frequently detected in post mortem studies of subjects with TLE. Voxel-based morphometry (VBM) is a new MRI tool that has been developed to assess differences of brain tissue volumes between subject groups and has been applied in various studies of patients with TLE [2]. In refractory TLE (rTLE) gray (GM) and white (WM) matter abnormalities are not confined to the hippocampus and are found in extrahippocampal structures [3]. Less is known about mild TLE (mTLE). We used optimized voxel-based morphometry (VBM) to identify GM abnormalities beyond the hippocampus in rTLE and in mTLE with evidence of hippocampal sclerosis (HS)

Materials and methods
Results
Conclusions
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