Advanced search
Start date
(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Progression of gray matter atrophy in seizure-free patients with temporal lobe epilepsy

Full text
Alvim, Marina K. M. [1] ; Coan, Ana C. [1] ; Campos, Brunno M. [1] ; Yasuda, Clarissa L. [1] ; Oliveira, Mariana C. [1] ; Morita, Marcia E. [1] ; Cendes, Fernando [1]
Total Authors: 7
[1] Univ Estadual Campinas, Neuroimaging Lab, Dept Neurol, Campinas, SP - Brazil
Total Affiliations: 1
Document type: Journal article
Source: Epilepsia; v. 57, n. 4, p. 621-629, APR 2016.
Web of Science Citations: 15

Objectives: To investigate the presence and progression of gray matter (GM) reduction in seizure-free patients with temporal lobe epilepsy (TLE). Methods: We enrolled 39 consecutive TLE patients, seizure-free for at least 2 years-20 with magnetic resonance imaging (MRI) signs of hippocampal sclerosis (TLE-HS), 19 with normal MRI (TLE-NL), and 74 healthy controls. For longitudinal analysis, we included individuals who had a second MRI with minimum interval of 18 months: 21 patients (10 TLE-HS, 11 TLE-NL) and 11 controls. Three-dimensional (3D) T-1-weighted images acquired in 3 Tesla MRI were analyzed with voxel-based morphometry (VBM). The images of patients with right-sided interictal epileptogenic zone (EZ) were right-left flipped, as well as a comparable proportion of controls. Cross-sectional analysis: The patients' images from each group were compared to controls to investigate differences in GM volumes. Longitudinal analysis: The first and second images were compared in each group to look for decreased GM volume. Results: Cross-sectional analysis: Patients with TLE-HS had diffuse GM atrophy, including hippocampus and parahippocampal gyrus, insula, frontal, and occipital lobes ipsilateral to EZ, bilateral thalamus and contralateral orbitofrontal gyrus, and caudate. In contrast, TLE-NL group did not present significant differences compared to controls. Longitudinal analysis: TLE-HS presented progressive GM reduction in ipsilateral insula and occipital lobe, contralateral motor area, and bilateral temporal and frontal lobes. TLE-NL had GM progression in ipsilateral hypothalamus and parietal lobe, contralateral cerebellum, and bilateral temporal lobe. Controls did not show changes in GM volume between MRIs. Significance: Diffuse extrahippocampal GM atrophy is present in seizure-free patients with TLE-HS. In addition, there is progressive GM atrophy in patients with and without HS. These results demonstrate that not only ongoing seizures are involved in the progression of GM atrophy. An underlying pathologic mechanism could be responsible for progressive brain volume loss in TLE patients even in seizure-free periods. (AU)

FAPESP's process: 13/07559-3 - BRAINN - The Brazilian Institute of Neuroscience and Neurotechnology
Grantee:Fernando Cendes
Support type: Research Grants - Research, Innovation and Dissemination Centers - RIDC
FAPESP's process: 15/17066-0 - Relationship between inflammatory markers and hippocampal and extra-hippocampal atrophy patterns in patients with temporal lobe epilepsy
Grantee:Marina Koutsodontis Machado Alvim
Support type: Scholarships in Brazil - Doctorate (Direct)
FAPESP's process: 13/00099-7 - EEG-fMRI in the pre-operatory evaluation of patients with focal refractory epilepsies
Grantee:Ana Carolina Coan
Support type: Scholarships in Brazil - Post-Doctorate