Document Detail


Extratemporal white matter abnormalities in mesial temporal lobe epilepsy demonstrated with diffusion tensor imaging.
MedLine Citation:
PMID:  16922882     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Recent studies have demonstrated bilateral white matter abnormalities in temporal lobe epilepsy (TLE) patients with unilateral mesial temporal sclerosis (MTS). The purpose of this project was to determine whether abnormalities of water diffusion are seen in extratemporal white matter of patients with TLE and pathologically confirmed MTS and to determine whether these findings are associated with worse surgical outcome. METHODS: Eleven patients with TLE and unilateral MTS confirmed in surgical specimens and 14 controls were studied by using cerebrospinal fluid-suppressed diffusion tensor imaging (DTI) and T2 relaxometry. RESULTS: Hippocampal T2 signal for patients was significantly elevated both ipsilateral (p<0.001) and contralateral (p=0.006) to MTS. DTI demonstrated reduced fractional anisotropy of the genu of the corpus callosum (p=0.003) and external capsule (p=0.02) and elevated mean diffusivity of the genu (p=0.005), splenium (p=0.03), and external capsule (p<0.001). For both the genu and external capsule, parallel diffusion of patients was not different from that of controls (genu, p=0.81; external capsule, p=0.45), whereas perpendicular diffusion was elevated (genu, p=0.001; external capsule, p<0.001). With mean postsurgical follow-up of 18.5 months, eight of 11 patients were entirely seizure free and the remaining three had all experienced a worthwhile reduction in seizure frequency. CONCLUSIONS: Our findings suggest that although patients with TLE and MTS have extensive bilateral and extratemporal pathology, these findings may not be associated with a worse postsurgical outcome.
Authors:
Donald W Gross; Luis Concha; Christian Beaulieu
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Epilepsia     Volume:  47     ISSN:  0013-9580     ISO Abbreviation:  Epilepsia     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-08-22     Completed Date:  2006-09-15     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  2983306R     Medline TA:  Epilepsia     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1360-3     Citation Subset:  IM    
Affiliation:
Division of Neurology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada. donald.gross@ualberta.ca
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MeSH Terms
Descriptor/Qualifier:
Adult
Anisotropy
Brain / pathology*,  surgery
Brain Mapping
Cerebral Cortex / pathology,  surgery
Corpus Callosum / pathology
Diffusion Magnetic Resonance Imaging / methods,  statistics & numerical data*
Disease-Free Survival
Epilepsy, Temporal Lobe / pathology*,  surgery
Female
Follow-Up Studies
Functional Laterality*
Hippocampus / pathology
Humans
Internal Capsule / pathology
Male
Middle Aged
Preoperative Care
Sclerosis / pathology
Temporal Lobe / pathology,  surgery
Treatment Outcome

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


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