Frequent Seizures Are Associated with a Network of Gray Matter Atrophy in Temporal Lobe Epilepsy with or without Hippocampal Sclerosis

Autor(es)

Coan, Ana C. ^[1] ; Campos, Brunno M. ^[1] ; Yasuda, Clarissa L. ^[1] ; Kubota, Bruno Y. ^[1] ; Bergo, Felipe P. G. ^[1] ; Guerreiro, Carlos A. M. ^[1] ; Cendes, Fernando ^[1]

Afiliação do(s) autor(es)

^[1] Univ Estadual Campinas, Dept Neurol, Neuroimaging Lab, Campinas, SP - Brazil

• Tipo de documento: Artigo Científico
• Fonte: PLoS One; v. 9, n. 1 JAN 27 2014.
• Citações Web of Science: 30

Resumo

Objective: Patients with temporal lobe epilepsy (TLE) with hippocampal sclerosis (HS) have diffuse subtle gray matter (GM) atrophy detectable by MRI quantification analyses. However, it is not clear whether the etiology and seizure frequency are associated with this atrophy. We aimed to evaluate the occurrence of GM atrophy and the influence of seizure frequency in patients with TLE and either normal MRI (TLE-NL) or MRI signs of HS (TLE-HS). Methods: We evaluated a group of 172 consecutive patients with unilateral TLE-HS or TLE-NL as defined by hippocampal volumetry and signal quantification (122 TLE-HS and 50 TLE-NL) plus a group of 82 healthy individuals. Voxel-based morphometry was performed with VBM8/SPM8 in 3T MRIs. Patients with up to three complex partial seizures and no generalized tonic-clonic seizures in the previous year were considered to have infrequent seizures. Those who did not fulfill these criteria were considered to have frequent seizures. Results: Patients with TLE-HS had more pronounced GM atrophy, including the ipsilateral mesial temporal structures, temporal lobe, bilateral thalami and pre/post-central gyri. Patients with TLE-NL had more subtle GM atrophy, including the ipsilateral orbitofrontal cortex, bilateral thalami and pre/post-central gyri. Both TLE-HS and TLE-NL showed increased GM volume in the contralateral pons. TLE-HS patients with frequent seizures had more pronounced GM atrophy in extra-temporal regions than TLE-HS with infrequent seizures. Patients with TLE-NL and infrequent seizures had no detectable GM atrophy. In both TLE-HS and TLE-NL, the duration of epilepsy correlated with GM atrophy in extra-hippocampal regions. Conclusion: Although a diffuse network GM atrophy occurs in both TLE-HS and TLE-NL, this is strikingly more evident in TLE-HS and in patients with frequent seizures. These findings suggest that neocortical atrophy in TLE is related to the ongoing seizures and epilepsy duration, while thalamic atrophy is more probably related to the original epileptogenic process. (AU)

• Processo FAPESP: 05/56578-4 - Centro multimodal de neuroimagens para estudos em epilepsia
• Beneficiário: Fernando Cendes
• Modalidade de apoio: Auxílio à Pesquisa - Programa CINAPCE - Temático
• Processo FAPESP: 09/54552-9 - Estudo da progressão de dano na epilepsia de lobo temporal mesial com ou sem sinais de esclerose hipocampal
• Beneficiário: Ana Carolina Coan
• Modalidade de apoio: Bolsas no Brasil - Doutorado
• Processo FAPESP: 11/03477-7 - Análise da resposta hemodinâmica em pacientes com epilepsia de lobo temporal mesial através do uso simultâneo de eletrencefalografia e ressonância magnética funcional
• Beneficiário: Brunno Machado de Campos
• Modalidade de apoio: Bolsas no Brasil - Mestrado