Relationship between environmental factors and gray matter atrophy in refractory MTLE

Author(s):Show less -

Yasuda, C. L. ^{[1, 2]} ; Morita, M. E. ^{[1, 2]} ; Alessio, A. ^{[1, 2]} ; Pereira, A. R. ^[3] ; Balthazar, M. L. F. ^{[1, 2]} ; Saude, A. V. ^[4] ; Costa, A. L. F. ^[2] ; Costa, A. L. C. ^[1] ; Cardoso, T. A. ^[1] ; Betting, L. E. ^{[1, 2]} ; Guerreiro, C. A. M. ^[1] ; Damasceno, B. P. ^[1] ; Lopes-Cendes, I. ^{[5, 4]} ; Tedeschi, H. ^[1] ; de Oliveira, E. ^[1] ; Cendes, F. ^{[1, 2]}

Affiliation

^[1] Univ Estadual Campinas, Dept Neurol, BR-13083970 Campinas, SP - Brazil

^[2] Univ Estadual Campinas, Lab Neuroimaging, BR-13083970 Campinas, SP - Brazil

^[3] Univ Estadual Campinas, Fac Med Sci, BR-13083970 Campinas, SP - Brazil

^[4] Univ Fed Lavras, Dept Comp Sci, Lavras - Brazil

^[5] Univ Estadual Campinas, Dept Med Genet, BR-13083970 Campinas, SP - Brazil

• Document type: Journal article
• Source: Neurology; v. 74, n. 13, p. 1062-1068, MAR 30 2010.
• Web of Science Citations: 15

Abstract

Objective: To investigate clinical, neuropsychological, and MRI abnormalities (gray matter atrophy {[}GMA] and white matter atrophy {[}WMA]) in surgical mesial temporal lobe epilepsy (MTLE) patients with and without familial antecedent for epilepsy. Methods: A cohort study including 69 operated patients with unilateral MTLE, divided into a group of 29 patients (mean age 35.8 +/- 10.4 years) with a negative family history (FH) of epilepsy and a group of 40 patients (32.8 +/- 10 years) with a positive FH. We performed voxel-based morphometry (VBM) on preoperative MRIs and investigated possible clinical and neuropsychological differences between the 2 groups. We also performed VBM and t tests to compare the patients' groups with normal controls. Results: The negative-FH group had lower IQ scores (p = 0.004), performed poorer on the Boston Naming Test (p = 0.02) and on delayed recall (p = 0.03), and presented a more prominent asymmetry index of hippocampal volume (p = 0.04) and more frequent initial precipitating injuries (p = 0.023). VBM showed a more restricted pattern of GMA in the positive-FH group and a more bilateral and widespread pattern of GMA in the negative-FH group, involving thalami, temporal, frontal, parietal, and occipital lobes. WMA was widespread and bilateral in both groups. Conclusions: The more widespread structural voxel-based morphometry abnormalities and worse IQ performance identified in the negative-family history (FH) group may result from a stronger environmental influence, including initial precipitating injuries. This is further support for the hypothesis that hippocampal sclerosis in mesial temporal lobe epilepsy with positive FH is determined by a stronger genetic predisposition with less influence of environmental factors compared with patients in the negative-FH group. Neurology(R) 2010;74:1062-1068 (AU)