Progressive Hippocampal Changes Before and After Surgery in Refractory Temporal Lobe Epilepsy
Abstract number :
2.148
Submission category :
5. Neuro Imaging / 5A. Structural Imaging
Year :
2021
Submission ID :
1825711
Source :
www.aesnet.org
Presentation date :
12/5/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:50 AM
Authors :
Matus Velicky, MD - Cantonal Hospital in St. Gallen; Richard Zubal, MD - Department of Neurology - Cantonal Hospital in St. Gallen; Robert Terziev, MD - Department of Neurology - University Hospital Zurich; Jane de Tisi, MD - UCL Queen Square Institute of Neurology; Andrew McEvoy, MD - UCL Queen Square Institute of Neurology; Anna Miserocchi, MD - UCL Queen Square Institute of Neurology; Sjored Vos, PhD - UCL Queen Square Institute of Neurology; Barbara Tettenborn, MD - Department of Neurology - Cantonal Hospital in St. Gallen; Christian Baumann, MD - Department of Neurology - University Hospital Zurich; John Duncan, MD - UCL Queen Square Institute of Neurology; Matthias Koepp, MD - UCL Queen Square Institute of Neurology; Marian Galovic, MD - Department of Neurology - University Hospital Zurich
Rationale: Temporal lobe epilepsy (TLE) is associated with progressive thinning of the cortex that may be prevented by successful resective surgery. There is little knowledge on accelerated morphological changes of the hippocampus before and after epilepsy surgery.
Methods: In this longitudinal case-control neuroimaging study, we included patients with unilateral refractory TLE before (n=24) or after (n=54) anterior temporal lobe resection and healthy volunteers (n=120) matched for age and sex. We evaluated hippocampal volumes and surface shape morphology on paired structural magnetic resonance imaging scans in all participants and compared progressive changes between groups using linear mixed effects models.
Results: In left TLE, there was progressive preoperative hypertrophy of the contralateral hippocampus, particularly affecting areas in the superior hippocampal head (p< 0.001) and the inferior hippocampal body (p=0.01). This accelerated hypertrophy of the contralateral hippocampus persisted after left anterior temporal lobe resection (head, p=0.009; tail, p< 0.001). In right TLE, there was a trend towards focal progressive hypertrophy of the contralateral hippocampal tail before surgery (p=0.07). After right temporal lobe resection, there was focal accelerated hypertrophy of the contralateral hippocampal head (p=0.003). We did not detect accelerated volume changes before surgery in the ipsilateral hippocampi of patients with left or right TLE.
Neuro Imaging