Career Center AES Connect

Abstracts

Cerebral and Cerebellar Atrophy Patterns in Rasmussen’s Encephalitis

Abstract number : 1.24
Submission category : 5. Neuro Imaging / 5A. Structural Imaging
Year : 2021
Submission ID : 1826547
Source : www.aesnet.org
Presentation date : 12/4/2021 12:00:00 PM
Published date : Nov 22, 2021, 06:54 AM

Authors :
Johannes Reiter, - Department of Epileptology, University Hospital Bonn, Bonn, Germany; Bastian David - Department of Epileptology, University Hospital Bonn, Bonn, Germany; Selma Enders - Department of Epileptology, University Hospital Bonn, Bonn, Germany; Conrad Prillwitz - Department of Epileptology, University Hospital Bonn, Bonn, Germany; Tobias Bauer - Department of Epileptology, University Hospital Bonn, Bonn, Germany; Deniz Atalay - Charité - Universitätsmedizin Berlin, Department of Pediatric Neurology, Berlin, Germany; Anna Tietze - Charité - Universitätsmedizin Berlin, Institute of Neuroradiology, Berlin, Germany; Angela Kaindl - Charité - Universitätsmedizin Berlin, Department of Pediatric Neurology, Berlin, Germany; Vera Keil - Department of Neuroradiology, University Hospital Bonn, Bonn, Germany; Alexander Radbruch - Department of Neuroradiology, University Hospital Bonn, Bonn, Germany; Bernd Weber - Institute of Experimental Epileptology and Cognition Research, University Hospital Bonn, Bonn, Germany; Albert Becker - Section for Translational Epilepsy Research, Department of Neuropathology, University Hospital Bonn, Bonn, Germany; Christian Elger - Department of Epileptology, University Hospital Bonn, Bonn, Germany; Rainer Surges - Department of Epileptology, University Hospital Bonn, Bonn, Germany; Theodor Rüber - Department of Epileptology, University Hospital Bonn, Bonn, Germany

Rationale: Rasmussen encephalitis (RE) is conceptualized by strictly unilateral brain inflammation and atrophy. Volumetric group level analyses in the past have shown wide-spread atrophy within the ipsilesional hemisphere, most pronounced in perisylvian and frontal regions. However, these studies do not sufficiently describe variability in the topographical distribution of cerebral atrophy between patients. Using MRI, this study focused on the description of subgroup-specifying atrophy patterns both on a cerebral and cerebellar level, and hypothesized an influence of the distribution of supratentorial atrophy on infratentorial abnormalities.

Methods: Based on the most affected cerebral lobe, a cohort of 57 patients with RE (37 female, mean age: 21.6 years) was visually subdivided into six subgroups by an experienced rater. The cortical thickness of the ipsilesional hemisphere was compared between patients with RE of each group and matched controls. A voxel-based-morphometry of the cerebellum between the 57 patients and 57 age- and gender-matched controls as well as between subgroups and controls was conducted. For the differentiation of atrophy patterns, an independent component analysis (ICA) was applied. Fractional anisotropy (FA) of cortico-ponto-cerebellar (CPC) tracts of 13 patients was assessed and asymmetry indices (AI) of cerebellar volumes and intensity on Fluid Attenuated Inversion Recovery (FLAIR) datasets were correlated.

Results: Patients with RE of each subgroup showed significantly lower cortical thickness within the ipsilesional cerebral hemisphere than controls (p < 0.05), most pronounced within the respective lobe. The whole group comparison demonstrated bilaterally lower cerebellar volume in patients with RE than in controls (p < 0.01). The ICA revealed bilateral as well as strictly contralesional and strictly ipsilesional patterns of cerebellar atrophy (p < 0.05). CPC tracts connecting the ipsilesional cerebrum with the contralesional cerebellum showed significantly lower FA than opposite tracts (p < 0.05). In patients with predominantly ipsilesional cerebellar atrophy morphometric AIs strongly correlated with FLAIR intensity AIs (r=0.86, p < 0.0001). The topographical distribution of cerebellar atrophy differed between subgroups of predominantly involved cerebral lobes (p < 0.05).
Neuro Imaging