Document Detail


Entorhinal cortex involvement in human mesial temporal lobe epilepsy: an electrophysiologic and volumetric study.
MedLine Citation:
PMID:  15857433     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Several studies have demonstrated diminution in the volume of entorhinal cortex (EC) ipsilateral to the pathologic side in patients with temporal lobe epilepsy (TLE). The relation between the degree of EC atrophy and the epileptogenicity of this structure has never been directly studied. The purpose of the study was to determine whether atrophy of the EC evaluated by the quantitative magnetic resonance imaging (MRI) method is correlated with the epileptogenicity of this structure in TLE. METHODS: Intracerebral recordings (SEEG method) of seizures from 11 patients with mesial TLE were analyzed. Seizures were classified according to patterns of onset: pattern 1 was the emergence of a low-frequency, high-amplitude rhythmic spiking followed by a tonic discharge, and pattern 2 was the emergence of a tonic discharge in the mesial structures. A nonlinear measure of SEEG signal interdependencies was used to evaluate the functional couplings occurring between hippocampus (Hip) and EC at seizure onset. MRI volumetric analysis was performed by using a T(1)-weighted three-dimensional gradient-echo sequence in TLE patients and 12 healthy subjects. RESULTS: Significant interactions between Hip and Ec were quantified at seizure onset. The EC was found to be the leader structure in most of the pattern 2 seizures. Volumetric measurements of EC demonstrated an atrophy in 63% of patients ipsilateral to the epileptic side. A significant correlation between the strength of EC-Hip coupling and the degree of atrophy was found. In addition, in those patients that had a normal EC volume, the EC was never the leader structure in Ec-Hip coupling. CONCLUSIONS: These results validate the potential role of volumetry to predict the epileptogenesis of the EC in patients with hippocampal sclerosis and MTLE.
Authors:
Fabrice Bartolomei; Mouhamad Khalil; Fabrice Wendling; Anna Sontheimer; Jean Régis; Jean-Phillipe Ranjeva; Maxime Guye; Patrick Chauvel
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Epilepsia     Volume:  46     ISSN:  0013-9580     ISO Abbreviation:  Epilepsia     Publication Date:  2005 May 
Date Detail:
Created Date:  2005-04-28     Completed Date:  2005-06-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  2983306R     Medline TA:  Epilepsia     Country:  United States    
Other Details:
Languages:  eng     Pagination:  677-87     Citation Subset:  IM    
Affiliation:
Service de Neurophysiologie Clinique et Epileptologie and INSERM EMI 9926 CHU TIMONE et Université de la Méditerranée, Marseille, France. fbartolo@medecine.univ-mrs.fr
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Atrophy / pathology
Brain Mapping
Electrodes, Implanted
Electroencephalography / methods,  statistics & numerical data*
Electrophysiology
Entorhinal Cortex / pathology*,  physiopathology*
Epilepsy, Temporal Lobe / physiopathology*
Female
Functional Laterality
Humans
Magnetic Resonance Imaging
Male
Monitoring, Physiologic
Parahippocampal Gyrus / pathology,  physiopathology
Regression Analysis
Videotape Recording

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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