Automated evaluation of hippocampal subfields volumes in mesial temporal lobe epilepsy and its relationship to the surgical outcome

Costa, Bruno Silva; Santos, Mariado Carmo V.; Rosa, Daniela V.; Schütze, Manuel; Miranda, Débora Marques de; Romano-Silva, Marco Aurélio

doi:10.1016/j.eplepsyres.2019.05.011

Cited by 17 publications

(12 citation statements)

References 27 publications

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“…Mesial temporal lobe epilepsy (Costa et al, 2019;Donos et al, 2018;Duarte et al, 2018 (Cacciaguerra et al, 2019), neuromyelitis optica spectrum disorder (Chen et al, 2019), anti-LGI1 encephalitis (Finke et al, 2017), anti-NMDA receptor encephalitis (Finke et al, 2016), subtypes of limbic encephalitis (Ernst et al, 2019) Neurotoxicity Toxic agents, radiotherapy or hypoxia (Decker et al, 2017;Lv et al, 2018 ) Socioeconomic status and chronic physiological stress (hair cortisol) (Merz et al, 2019). Perceived stress (Zimmerman et al, 2016)…”

Section: Epilepsymentioning

confidence: 99%

FreeSurfer‐based segmentation of hippocampal subfields: A review of methods and applications, with a novel quality control procedure for ENIGMA studies and other collaborative efforts

Sämann

Iglesias

Gutman

et al. 2020

Human Brain Mapping

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Structural hippocampal abnormalities are common in many neurological and psychiatric disorders, and variation in hippocampal measures is related to cognitive performance and other complex phenotypes such as stress sensitivity. Hippocampal subregions are increasingly studied, as automated algorithms have become available for mapping and volume quantification. In the context of the Enhancing Neuro Imaging Genetics

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Section: Epilepsymentioning

confidence: 99%

FreeSurfer‐based segmentation of hippocampal subfields: A review of methods and applications, with a novel quality control procedure for ENIGMA studies and other collaborative efforts

Sämann

Iglesias

Gutman

et al. 2020

Human Brain Mapping

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“…The personalized approach taken in this work is specifically intended to facilitate integration into patient‐based clinical research settings, hence the visualization approaches taken to compare profiles to a normative database. In this, it is different from many recent approaches designed for group‐based analyses . Other single‐subject approaches to evaluate HS do exist, with the most similar in setup using normalized FLAIR intensity to detect HS, which has good outcome but is limited in our original approach in only having a single "global" value per hippocampus .…”

Section: Discussionmentioning

confidence: 97%

Hippocampal profiling: Localized magnetic resonance imaging volumetry and T2 relaxometry for hippocampal sclerosis

et al. 2019

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Objective Hippocampal sclerosis (HS) is the most common cause of drug‐resistant temporal lobe epilepsy, and its accurate detection is important to guide epilepsy surgery. Radiological features of HS include hippocampal volume loss and increased T2 signal, which can both be quantified to help improve detection. In this work, we extend these quantitative methods to generate cross‐sectional area and T2 profiles along the hippocampal long axis to improve the localization of hippocampal abnormalities. Methods T1‐weighted and T2 relaxometry data from 69 HS patients (32 left, 32 right, 5 bilateral) and 111 healthy controls were acquired on a 3‐T magnetic resonance imaging (MRI) scanner. Automated hippocampal segmentation and T2 relaxometry were performed and used to calculate whole‐hippocampal volumes and to estimate quantitative T2 (qT2) values. By generating a group template from the controls, and aligning this so that the hippocampal long axes were along the anterior‐posterior axis, we were able to calculate hippocampal cross‐sectional area and qT2 by a slicewise method to localize any volume loss or T2 hyperintensity. Individual patient profiles were compared with normative data generated from the healthy controls. Results Profiling of hippocampal volumetric and qT2 data could be performed automatically and reproducibly. HS patients commonly showed widespread decreases in volume and increases in T2 along the length of the affected hippocampus, and focal changes may also be identified. Patterns of atrophy and T2 increase in the left hippocampus were similar between left, right, and bilateral HS. These profiles have potential to distinguish between sclerosis affecting volume and qT2 in the whole or parts of the hippocampus, and may aid the radiological diagnosis in uncertain cases or cases with subtle or focal abnormalities where standard whole‐hippocampal measurements yield normal values. Significance Hippocampal profiling of volumetry and qT2 values can help spatially localize hippocampal MRI abnormalities and work toward improved sensitivity of subtle focal lesions.

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“…There are in fact several pathological substrates [22], that may relate to different epilepsy history and post-surgical outcome; however, presurgical identification of these subtypes remains elusive [23]. The use of Free-Surfer subfield segmentation for volumetric assessment of the pathological hippocampus has shown different results [24,25], and the use of manual segmentation of the subfields on higher field MRI could be more appropriate [26]. Being this the case, pre-surgical neuroimaging methods aimed at evaluating the TLE-HS network structures have shown promising results in assessing the risk of seizure recurrence after surgery, mainly by measuring abnormalities in areas outside the margins of resection, either of the ipsilateral or the contralateral temporal lobe [4,8].…”

Section: Discussionmentioning

confidence: 99%

Hippocampal microstructural architecture and surgical outcome

Sala-Padró

Miró

Rodrı́guez-Fornells

et al. 2020

Seizure

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Our aim was to study the microstructural architecture of the contralateral hippocampus to the affected side in patients with temporal lobe epilepsy with hippocampal sclerosis (TLE-HS) and its relation with surgical outcome. Method: We included 33 consecutive patients evaluated in our epilepsy surgery program during a five-year period. They underwent a presurgical MRI with volumetric T1 and diffusion weighted sequences. 22 patients with TLE-HS (13 women, 12 right TLE-HS) were finally selected. Median follow-up after surgery was 6.25 years (4.5-8.83 years). We segmented the hippocampal subfields of the contralateral hippocampus using FreeSurfer and calculated the fractional anisotropy (FA) and the mean diffusivity (MD) of each subfield. We also scanned 18 healthy age-matched controls. Results: After surgery, 50 % of the patients (n = 11) remained seizure-free (SF) following surgery. Comparing non-SF to SF patients, the MD showed increased values of the CA1 (p = 0.035), the molecular layer (p = 0.010) and the dentate gyrus (p = 0.041) in the healthy hippocampus. Using a cut-off point for a survival analysis, we found that patients with lower values of MD of the molecular layer and the CA1 remained SF during long-term post-operative follow-up (p < 0.0001). Conclusions: The contralateral hippocampal internal microstructure may have be implicated in post-surgery seizure freedom in patients with TLE-HS.

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Automated evaluation of hippocampal subfields volumes in mesial temporal lobe epilepsy and its relationship to the surgical outcome

Cited by 17 publications

References 27 publications

FreeSurfer‐based segmentation of hippocampal subfields: A review of methods and applications, with a novel quality control procedure for ENIGMA studies and other collaborative efforts

FreeSurfer‐based segmentation of hippocampal subfields: A review of methods and applications, with a novel quality control procedure for ENIGMA studies and other collaborative efforts

Hippocampal profiling: Localized magnetic resonance imaging volumetry and T2 relaxometry for hippocampal sclerosis

Hippocampal microstructural architecture and surgical outcome

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