ABSTRACT
Objective:
In temporal lobe epilepsies (TLE), mesial temporal sclerosis (MTS) is characterized by gliosis and atrophy in the ipsilateral hippocampusof epilepsy centerand associated limbic structures. This study aimed to examine whether there was a volumetric change in the contralateral hippocampus showing normal signal characteristics in patients with unilateral MTS.
Methods:
The patients diagnosed of TLE and applied to radiology clinic between 2008 and 2010 for visualization, were evaluated retrospectively. 69 patients (35 males, 34 females) with unilateral MTS and no EEG in other focus were selected as the treatment group. 49 patients (20 males, 29 females), who applied to the clinic due to headache complaint, underwent cranial MRI and diagnosed of normal in neurological examination, were selected as the control group. The hippocampus volume of both sides in the control group and the side thought to be normal during visualization in the treatment groupwas evaluated using the area calculation method. The visualization of all patients were performed in 1.5T magnet system.
Results:
Patients’ age range was 8-58 years in the treatment group and 15-49 years in the control group. MTS was diagnosed in the right side of 29 patients and in the left side of 40 patients. The mean hippocampal area in the normal side of the patients in treatment group was statistically significantly lower than the mean hippocampal area of the patients in control group (p <0.05).
Conclusion:
It is argued in recent years that there may be volumetric changes in white and gray matter on the normal accepted side and non-hippocampal regions of patients with unilateral MTS. This study results support the views advocated in recent years. It is thought that this study and similar studies will contribute to understand functional and anatomic changes in epilepsy cases, neurodegenerative diseases, natural aging process and limbic system.
Keywords:
Epilepsy, mesial temporal sclerosis, magnetic resonance imaging (MRI)
References
1İzci Y, Erbaş C. Hipokampus:Yapısı ve Fonksiyonları. Türk Nöroşir Derg 2015;25:287-95.
2Hogan RE, Wang L, Bertrand ME, Willmore JL, Bucholz RD, et al. MRI- based high dimensional hippocampal mapping in mesial temporal lobe epilepsy. Brain 2004;127:1731-40.
3Hogan RE, Bucholz RD, Choudhuri I, Mark KE, Butler CS, et al. Shape analysis of hippocampal surface structure in patients with unilateral mesial temporal sclerosis. Journal of digital imaging. 2000; 113: 39-42.
4Bernasconi N, Bernasconi AZ, Caramanos Z, Antel SB, Andermann F, et al. Mesial temporal damage in temporal lobe epilepsy: a volumetric MRI study of the hippocampus, amgydala and parahippocampal region. Brain 2003;126:462-9.
5Alhusaini S, Doherty CP, Scanlon C, Ronan L, Maguire S, et al. A cross-sectional MRI study of brain reigonal atrophy and clinical characteristics of temporal lobe epilepsy with hippocampal sclerosis. Epilepsy Research 2012;99:156-66.
6Keller SS, Mackay CE, Barrick TR, Wieshmann UC, Howard MA, et al. Voxel-based morphometric comparison of hippocampal and extrahippocampal abnormalities in patients with left and right hippocampal atrophy. Neuroimage 2002;16:23-31.
7Szabo CA, Lancaster JL, Lee S, Xiong JH, Cook C, et al. MR Imaging volumetry of subcortical structures and cerebellar hemispheres in temporal lobe epilepsy. Am J Neuroradiol 2006;32:1857-61.
8Labate A, Cerasa A, Aguglia U, Mumoli L, Quattrone A, et al. Voxel-based morphometry of sporadic epileptic patients with mesiotemporal sclerosis. Epilepsia 2010;51:506-10.
9Diniz PRB, Velasco TR, Salmon CEG, Sakamato AC, Leite JP, et al. Extratemporal damage in temporal lobe epilepsy: Magnetic transfer adds information to volumetric MR imaging. Am J Neuroradiol 2011;32:1857-61.
10Seidenberg M, Kelly KG, Parrish J, Geary E, Dow C, et al. Ipsilateral and contralateral MRI volumetric abnormalities in chronic unilateral temporal lobe epilepsy and their clinical correlates. Epilepsia 2005;46:420-30.
11Araujo D, Santos AC, Velasco TR, Wichert-Ana L, Terra-Bustamante VC, et al. Volumetric evidence of bilateral damage in unilateral mesial temporal lobe epilepsy. Epilepsia 2006;47:1354-9.
12Hakyemez B, Yücel K, Bora İ, Parlak M. Temporal lob epilepsili olgularda kalitatif ve kantitatif MRG bulgularının klinik tanı değeri. Tanısal ve Girişimsel Radyoloji 2003;9:157-65.
13Glasper ER, Gould E. Sexuel experience restores age related decline in adult neurogenesis and hippocampal function. Hippocampus 2013;23:303-12.
14Silva I, Lin K, Jackowski AP, Centeno RS, Pinto ML, et al. Absence of gender effect on amygdala volume in temporal lobe epilepsy. Epilepsy Behavior 2010;19:501-3.
15Bonilha L, Halford JJ, Morgan PS, Edwards JC. Hippocampal atrophy in temporal lobe epilepsy: the generator and receiver. Acta Neurol Scand 2012;125:105-10.
16Morgan VL, Rogers BP, Sonmezturk HH, Gore JC, Khalil BA. Cross hippocampal influence in mesial temporal lobe epilepsy measured with high temporal resolution functional magnetic resonance imaging. Epilepsia 2011;52:1741-9.
17Marsh L, Morrell MJ, Shear PK, Sullivan EV, Freeman H, et al. Cortical and hippocampal volume deficits in temporal lobe epilepsy. Epilepsia 1997;38:576-87.
18Noulhiane M, Samson S, Cl’emenceau S, Dormont D, Baulac M, Hasboun D. A volumetric MRI study of the hippocampus and the parahippocampal reigon after unilateral medial temporal lobe resection. Journal of Neuroscience Methods 2006;156:293-304.
19Gamss RP, Slasky SE, Bello JA, Miller TS, Shinnar S. Prevalance of hippocampal malrotation in a population without seizures. Am J Neurol 2009;30:1571-3.
20Jones LD, Payne ME, Messer DF, Beyer JL, MacFall JR, et al. Temporal lobe volume in bipolar disorder: Relationship with diagnosis and antipsychotic medication use. J Affect Disord 2009;114:50-7.
21Murakami M, Takao H, Abe O, Yamasue H, Sasaki H, et al. Cortical thickness, gray matter volume, and white matter anisotropy and diffusivity in schizophrenia. Neuroradiology 2011;53:859-66.
22Strandberg M, Larsson EM, Backman S, Kallen K. Pre-surgical epilepsy evaluation using 3T MRI. Do surface coils provide additional information? Epileptic Disord 2008;10:83-92.
23Berg AT, Pardoe HR, Fulbright RK, Schuele SU, Jackson GD. Hippocampal size anomalies in a community-based cohort with childhood onset. Neurology 2011;76:1415-21.
24Shamim S, Hasler G, Liew C, Sato S, Theodore WH. Temporal lobe epilepsy, depression, and hippocampal volume. Epilepsia 2009;50:1067-71.
25Li X, Coyle D, Maguire L, Watson DR, McGinnity TM. Gray matter concentration and effective connectivity changes in Alzhemier’s disease: a longitudinal structural MRI study. Neuroradiology 2011;53:733-48.
26O’Brien CE, Bowden SC, Bardenhagen FJ, Cook MJ. Neuropsychological correlates of hippocampal and rhinal cortex volumes in patients with mesial temporal sclerosis. Hippocampus 2003;13:892-904.