Hippocampal atrophy on MRI is predictive of histopathological patterns and surgical prognosis in mesial temporal lobe epilepsy with hippocampal sclerosis

Hippocampal atrophy on MRI is predictive of histopathological patterns and surgical prognosis in mesial temporal lobe epilepsy with hippocampal sclerosis

Author Jardim, Anaclara Prada Autor UNIFESP Google Scholar
Corso, Jeana Torres Autor UNIFESP Google Scholar
Garcia, Maria Teresa Fernandes Castilho Autor UNIFESP Google Scholar
Gaca, Larissa Botelho Autor UNIFESP Google Scholar
Comper, Sandra Mara Autor UNIFESP Google Scholar
Penteado Lancellotti, Carmen Lucia Google Scholar
Centeno, Ricardo Silva Autor UNIFESP Google Scholar
Carrete Junior, Henrique Autor UNIFESP Google Scholar
Cavalheiro, Esper Abrão Autor UNIFESP Google Scholar
Scorza, Carla Alessandra Autor UNIFESP Google Scholar
Yacubian, Elza Márcia Targas Autor UNIFESP Google Scholar
Abstract Purpose: To correlate hippocampal volumes obtained from brain structural imaging with histopathological patterns of hippocampal sclerosis (HS), in order to predict surgical outcome. Methods: Patients with mesial temporal lobe epilepsy (MTLE) with HS were selected. Clinical data were assessed pre-operatively and surgical outcome in the first year post surgery. One block of mid hippocampal body was selected for HS classification according to ILAE criteria. NeuN-immunoreactive cell bodies were counted within hippocampal subfields, in four randomly visual fields, and cell densities were transformed into z-score values. FreeSurfer processing of 1.5 T brain structural images was used for subcortical and cortical volumetric estimation of the ipsilateral hippocampus. Univariate analysis of variance and Pearson's correlation test were applied for statistical analyses. Results: Sixty-two cases (31 female, 32 right HS) were included. ILAE type 1 HS was identified in 48 patients, type 2 in eight, type 3 in two, and four had no-HS. Better results regarding seizure control, i.e. ILAE 1, were achieved by patients with type 1 HS (58.3%). Patients with types 1 and 2 had smaller hippocampal volumes compared to those with no-HS (p<0.001 and p=0.004, respectively). Positive correlation was encountered between hippocampal volumes and CA1, CA3, CA4, and total estimated neuronal densities. CA2 was the only sector which did not correlate its neuronal density with hippocampal volume (p = 0.390). Conclusion: This is the first study correlating hippocampal volume on MRI submitted to FreeSurfer processing with ILAE patterns of HS and neuronal loss within each hippocampal subfield, a fundamental finding to anticipate surgical prognosis for patients with drug-resistant MTLE and HS. (C) 2016 Elsevier B.V. All rights reserved.
Keywords Mesial temporal lobe epilepsy
Hippocampal sclerosis
Hippocampal atrophy
Surgical outcome
FreeSurfer analysis
xmlui.dri2xhtml.METS-1.0.item-coverage Amsterdam
Language English
Sponsor Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
Date 2016
Published in Epilepsy Research. Amsterdam, v. 128, p. 169-175, 2016.
ISSN 0920-1211 (Sherpa/Romeo, impact factor)
Publisher Elsevier Science Bv
Extent 169-175
Origin http://dx.doi.org/10.1016/j.eplepsyres.2016.10.014
Access rights Closed access
Type Article
Web of Science ID WOS:000390742500023
URI https://repositorio.unifesp.br/handle/11600/56614

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