QUANTITATIVE MR WHOLE BRAIN VOLUMES IN UNILATERAL TEMPORAL LOBE EPILEPSY
Abstract number :
2.370
Submission category :
Year :
2003
Submission ID :
3720
Source :
www.aesnet.org
Presentation date :
12/6/2003 12:00:00 AM
Published date :
Dec 1, 2003, 06:00 AM
Authors :
Michael Seidenberg, Joy Parrish, Beth Kooker, Christian Dow, Kiesa Getz, Jana Jones, Brian Bell, Paul Rutecki, Russ Hansen, Bruce Hermann Department of Psychology, Finch University of Health Sciences, North Chicago, IL; Department of Neurology, University
Among people with temporal lobe epilepsy (TLE), the focus of quantitative magnetic resonance volumetric studies has been on the hippocampus and associated mesial temporal lobe regions. In contrast, there has been little investigation of extra-temporal lobe segmented gray and white matter brain volumes. The purpose of this study was to examine both whole brain and lobar segmented gray and white brain volumes in the ipsilateral and contralateral regions of patients with ictally confirmed unilateral temporal lobe epilepsy.
35 patients with unilateral TLE (16 lefts and 19 rights) and 65 controls ranging in age from 14 to 60 years underwent whole brain quantitative MR volumetrics. All TLE subjects had their seizure focus identified by continuous video/EEG monitoring of spontaneous seizures. Controls were family members or friends of the TLE subjects. There was no significant difference in age or sex distribution between either of the TLE groups and controls. ICV was used as a covariate in examining group differences in brain volume.
Both the left and right TLE groups showed significant brain volume loss compared to controls in the ipsilateral hippocampus (p[apos]s [lt] .001), ipsilateral hemisphere white matter (p[apos]s [lt] .005), and contralateral hemisphere white matter (p[apos]s [lt] .05). White matter volume loss was diffuse; noted in the frontal, temporal, and parietal lobes. There was no significant volume loss in the contralateral hippocampus, and either the ipsilateral or contralateral gray matter (all p[apos]s [gt] .05). Duration of epilepsy was signficantly correlated only with ipsilateral hippocampus volume (r=-.62, p [lt] .001); longer duration associated with less volume.
These findings indicate widespread and bilateral brain volume abnormalities in patients with unilateral TLE that is characterized by ipsilateral hippocampal atrophy and white matter volume loss that is evident both ipsilateral and contralateral to the side of seizure onset. The same pattern was evident for both the left and right TLE groups. Evidence suggestive of a progressive impact of seizure severity was observed only for ipsilateral hippocampus, despite marked volume loss in other brain regions. Additional research examining the neurodevelopmental trajectory of whole brain volume loss in TLE would be of both clinical and theoretical significance.
[Supported by: NIH 2ROI-37738 and MO1 03186]