The Role of the Amygdala in Ictal Central Apnea: New Insights from Long-term Video EEG Monitoring and Brain MRI Structural Morphometry
Abstract number :
2.169
Submission category :
5. Neuro Imaging / 5A. Structural Imaging
Year :
2022
Submission ID :
2204498
Source :
www.aesnet.org
Presentation date :
12/4/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:25 AM
Authors :
Elisa Micalizzi, MD – IRCCS Ospedale Policlinico San Martino/University of Modena and Reggio Emilia; Alice Ballerini, PhD Student – University of Modena and Reggio Emilia; Giada Giovannini, MD, PhD – Azienda Ospedaliero-Universitaria of Modena and Reggio Emilia; Giulia Turchi, MD – Azienda Ospedaliero-Universitaria of Modena and Reggio Emilia; Maria Cristina Cioclu, MD, PhD Student – University of Modena and Reggio Emilia; Leandra Giunta, Dr – Azienda Ospedaliero-Universitaria of Modena and Reggio Emilia; Marcella Malagoli, MD – Azienda Ospedaliero-Universitaria of Modena and Reggio Emilia; Anna Elisabetta Vaudano, MD, PhD – Azienda Ospedaliero-Universitaria of Modena and Reggio Emilia; Stefano Meletti, MD, PhD – Azienda Ospedaliero-Universitaria of Modena and Reggio Emilia
Rationale: Ictal central apnea (ICA) has been recently considered a potential localizing sign in temporal lobe epilepsy and a hint of amygdala involvement in the epileptogenic network (Lacuey et al., 2019). Advanced neuroimaging techniques may be used to find valuable biomarkers for ictal apnea occurrence.
Methods: To describe the electroclinical characteristics of temporal lobe seizures with ICA, data from video EEG Long-Term Monitoring with extensive polygraphic recordings were collected among a population of 51 patients with seizures recorded from January 2021 to March 2022. To evaluate possible structural morphometric differences in relation to the occurrence of ICA, brain MRI scans were post-processed with FreeSurfer to extract cortical thickness and subcortical volumes in three groups of subjects (7 patients with temporal lobe seizures with ICA and 10 patients without ICA, and 30 healthy controls).
Results: Seven patients (4 males; aged 20-55 years) had apnea-related seizures (Figure 1). Among these patients, 21 seizures were recorded and ictal apnea was observed in 80.9% of seizures. Oxygen desaturation occurred in 5/7 with a nadir ranging from 92% to 74%. The morphometric analyses revealed a significant increase in volume of the amygdala ipsilateral to the epileptic focus, and more specifically of the basolateral complex, in the patients with ICA compared to healthy controls (p=.000) and patients without ICA (p=.023) (Figure 2).
Conclusions: Our findings, while confirming the key role of the amygdala in temporal lobe epilepsy, offer new insights on subtle structural modifications of the amygdala and its subnuclei as possible morphological biomarkers of ICA.
Funding: This study was funded by the Ministry of Health under the "Ricerca Finalizzata" (project code NET-2013-02355313) and by MIUR under the "Dipartimenti di eccellenza 2018-2022" grant.
Neuro Imaging