Longitudinal distribution of hippocampal atrophy in mesial temporal lobe epilepsy
Abstract
Patients with mesial temporal lobe epilepsy (MTLE) have asymmetric hippocampal volumes with atrophy that sometimes by visual inspection appears to favor different regions along the longitudinal axis of the affected hippocampus. Histological studies suggest that cell loss may affect the anterior hippocampus preferentially, and that hippocampal sclerosis (HS) limited to the anterior of the hippocampus may indicate better surgical outcome. We used volumetric magnetic resonance imaging (MRI): (1) to objectively describe the distribution of volume loss in HS; and (2) to relate this distribution to outcome of temporal lobectomy. Hippocampal volumes and anterior and posterior subvolumes (AHV, PHV) were measured from MP-RAGE MRI in 43 temporal lobectomy patients with MTLE determined by pathological findings of HS and compared to 23 age-matched controls. Atrophy was defined as 'anterior', 'diffuse', 'posterior', or 'normal' depending on position of AHV and PHV relative to the mean +/- 2 S.D. of regional volumes of control hippocampi. Anterior to posterior ratios (APR = AHV/PHV) were also calculated. Mean APR of hippocampi ipsilateral to lobectomy cannot be distinguished from hippocampi contralateral to lobectomy or from controls. AHV an...Continue Reading
References
Magnetic resonance imaging-based volume studies in temporal lobe epilepsy: pathological correlations
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